The Role of the Clinical Nurse Specialist in the Provision of Paediatric Ambulatory Care

Abstract

The terms ‘clinical nurse specialist’, ‘consultant nurse’ and ‘nurse practitioner’ are an increasing part of modern nursing nomenclature. Although such terms are used extensively throughout the profession, they are often used interchangeably and, as a result, much confusion surrounds their defined roles. Changes in junior doctors’ working hours in the UK, coupled with reprofiled health reforms, have placed nursing in the professional spotlight. Rapid changes in service delivery to patients, linked to a demise of inpatient care and a corresponding rise in ambulatory care, have accelerated the trend towards specialisation within nursing. Castledine (1995) has indicated that the nurse practitioner/specialist movement in the UK may be seen as nothing more than a stopgap for the shortage of doctors. Despite this, the robustness of the movement in North America is such that the American Academy of Nurse Practitioners (1993) believes that nurse practitioners have performed as well as physicians with respect to patient outcomes, proper diagnosis, management of specified medical conditions and frequency of patient satisfaction. American definitions of terms tend to have greater clarity than those used in the UK; for example, the American Academy of Nurse Practitioners defines nurse practitioners as primary health care providers.