Clinical Nurse Specialists making up numbers on wards – abuse or an appropriate use?
The NHS is going through hard times. The Prime Ministers says we are in for a challenging year. The use of agency nursing staff is being minimised or fully banned. Tony is right. The impact of this, especially on ward based staff, is going to be substantial. What level of patient care can be provided under these circumstances? Some Trusts have responded to this by taking Clinical Nurse Specialists (CNSs) away from their normal role for one or two days per week to make up the numbers on the ward. Cancer services, for many years now, have seen the CNS role as integral to the quality of cancer services. So how do nurses caring for cancer patients, at any level or in any area, feel about this approach?
I want you to consider three ways of viewing this:
1. A necessary evil during difficult times. It won’t last forever and CNSs are glad to help out.
2. An appallingly bad use of the knowledge and skills of a CNS which questions whether the Trust is compliant with the Manual of Cancer Standards site specific measures.
3. A great opportunity for Clinical Nurse Specialists to work alongside the ward based nurses, role modelling expert nursing practice and educating nurses in their area of expertise and maybe that is where they should spend more of their time, even under more ‘normal’ circumstances.
Have I hit a raw nerve? Which of the three ways of viewing this issue resonates with you? Is this a crisis for CNSs or a constructive development of their role? Please let me have your comments and views. UKONS will consider your opinions and comments and display the really juicy ones at the UKONS meeting in Cardiff on September 11th – 13th and here on the UKONS website.
To submit your comments, and to read the comments of others, click on the ‘Comment’ link below.
Maggie Crowe, UKONS Board
Maggie Crowe
6 Comments
Reader Comments (6)
However I am well awre how full workloads can be and it would be a difficult task to give up on their own patient commitments, although perhaps support from management about giving up a few meetings a week may be a help.
Should of course read "inexperienced"
I would recommend a shared role to any CNS but they do have to be careful not to get caught up in ward politics and to be able to say to all involved, 'I will deal with this tomorrow/next week when I am in my other role. (I must add that I work alongside another CNS who has no ward involvement and who will, if asked, take on things where I feel they need to be dealt with quickly).
D. Steel
Upper GI CNS
Belfast City Hospital
Lisburn Road
Belfast
08 September 2006
Maggie Crowe
Consultant Nurse Cancer Services
Royal United Hospitals
Bath
Dear Maggie,
I am writing on behalf of a group of Clinical Nurse Specialists from the oncology/haematology directorate of the Belfast City Hospital Trust in response to the article about CNS’s working on the wards highlighted by UKONS.
The general consensus of opinion from our group would seem to be that whilst we do not disagree with the notion of Clinical Nurse Specialists working alongside ward staff, it should be with the aim of sharing our knowledge and skills through role modelling and facilitation of learning in others, not routinely as a “pair of hands”. However as the motivating factors behind the government’s proposals appear to be predominantly driven by resource issues etc there is a danger that we would indeed just be used to maintain adequate staffing levels which would be a wholly inappropriate use of our time, knowledge and skills. There is a danger that once such a precedent is set it is very difficult to withdraw from. Using us in such a way reflects a lack of understanding of our role in its totality, undervalues our contribution and reinforces the notion that clinical nurse specialists are a luxury as opposed to an integral and effective part of the clinical team.
I hope this is of help
Best regards,
Lesley Rutherford
Their natural exposure should be such that ward/clinic based nurses should already be benefiting from their expert nursing skills and teaching roles without them having to be pulled back to support ward based teams in times of crisis.
One question l would ask is, "who is doing their job when they are working on the wards?"
It appears that the CNS role has gone from been seen as "A nurse with time!" to "A luxury that the NHS can not afford".