IDEAS home Printed from https://ideas.repec.org/a/wly/jocnur/v23y2014i19-20p2874-2885.html
   My bibliography  Save this article

How clinical nurse and midwifery consultants optimise patient care in a tertiary referral hospital

Author

Listed:
  • Christine Atsalos
  • Karen Biggs
  • Sabine Boensch
  • Fiona Lee Gavegan
  • Susan Heath
  • Marlene Payk
  • Grace Trapolini

Abstract

Aims and objectives To develop new insights into the phenomenon of clinical nurse/midwifery consultant clinical effectiveness in a tertiary referral hospital. Background International studies identify the pivotal role clinical nurse/midwifery consultants play in patient outcomes. There remains, however, a significant deficit in our knowledge of how these, or other advanced practice nurses and midwives, apply their extensive experience, ontological understandings and tacit knowledge to the enhancement of patient outcomes in complex healthcare environments. Design This study was underpinned by the principles of Heideggerian hermeneutic phenomenology. Methods Recruitment involved expressions of interest distributed hospital‐wide to clinical nurse/midwifery consultants. Inclusion criteria specified a minimum of three years’ experience. Fifteen clinical nurse/midwifery consultants, representing a broad range of specialties, were interviewed. Preliminary descriptive analysis of transcribed data was followed by in‐depth hermeneutic analysis. Results The findings comprise four themes: walking beside the patient, anticipating the unexpected, pushing through barriers and leading within a complex system. These themes highlight how clinical nurse/midwifery consultants significantly influence pre‐existing trajectories of patient care delivery through context‐appropriate strategies. Conclusion This study introduces new insights into the meanings advanced practice nurses and midwives develop from their engagements with patients and how these meanings inform clinical decisions. The paper accomplishes this by drawing on Heideggerian philosophical concepts such as ontological understandings, authenticity and care. It also casts light on the participants’ shared understandings of how to synergise expectations within the team. Relevance to clinical practice The significance of this paper lies in the uncovering of ontological understandings and tacit knowledge of how consultant nurses and midwives optimise patient care delivery in challenging situations. The findings indicate, however, that the value of these internationally established roles is yet to be fully realised. The paper concludes by recommending strategies to assist newly appointed clinical nurse/midwifery consultants transition into these demanding autonomous roles.

Suggested Citation

  • Christine Atsalos & Karen Biggs & Sabine Boensch & Fiona Lee Gavegan & Susan Heath & Marlene Payk & Grace Trapolini, 2014. "How clinical nurse and midwifery consultants optimise patient care in a tertiary referral hospital," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(19-20), pages 2874-2885, October.
  • Handle: RePEc:wly:jocnur:v:23:y:2014:i:19-20:p:2874-2885
    DOI: 10.1111/jocn.12567
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/jocn.12567
    Download Restriction: no

    File URL: https://libkey.io/10.1111/jocn.12567?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Valerie A Woodward & Christine Webb & Morag Prowse, 2006. "Nurse consultants: organizational influences on role achievement," Journal of Clinical Nursing, John Wiley & Sons, vol. 15(3), pages 272-280, March.
    2. Debra Fairley & S. Jose Closs, 2006. "Evaluation of a nurse consultant's clinical activities and the search for patient outcomes in critical care," Journal of Clinical Nursing, John Wiley & Sons, vol. 15(9), pages 1106-1114, September.
    3. Krista Jokiniemi & Anna‐Maija Pietilä & Jari Kylmä & Kaisa Haatainen, 2012. "Advanced nursing roles: A systematic review," Nursing & Health Sciences, John Wiley & Sons, vol. 14(3), pages 421-431, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Krista Jokiniemi & Anna‐Maija Pietilä & Jari Kylmä & Kaisa Haatainen, 2012. "Advanced nursing roles: A systematic review," Nursing & Health Sciences, John Wiley & Sons, vol. 14(3), pages 421-431, September.
    2. Michelle Giles & Vicki Parker & Jane Conway & Rebecca Mitchell, 2018. "Knowing how to get things done: Nurse consultants as clinical leaders," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(9-10), pages 1981-1993, May.
    3. Helen Franks, 2014. "The contribution of nurse consultants in England to the public health leadership agenda," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(23-24), pages 3434-3448, December.
    4. Weijie Xing & Linjun Ao & Huiting Xiao & Li Cheng & Yan Liang & Junqiao Wang, 2018. "Nurses’ Attitudes toward, and Needs for Online Learning: Differences between Rural and Urban Hospitals in Shanghai, East China," IJERPH, MDPI, vol. 15(7), pages 1-11, July.
    5. Michelle Giles & Vicki Parker & Rebecca Mitchell, 2016. "Examining Nurse Consultant connectivity: An Australian mixed method study," Nursing & Health Sciences, John Wiley & Sons, vol. 18(2), pages 154-162, June.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:jocnur:v:23:y:2014:i:19-20:p:2874-2885. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://doi.org/10.1111/(ISSN)1365-2702 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.