Changing patients' worlds through nursing practice expertise
A five-year RCN research project shows that expert nurses make a dramatic difference to patient care.
The work has now been used to develop a framework to help other nurses demonstrate their contribution to health care.
Twenty-two expert nurses across the UK, working with an RCN team, have put together evidence about how their work has an impact on patient care and their colleagues’ working lives.
The nurses worked with a colleague (known in the project as a critical companion) to look in detail at their work and unpick how they affected patient care. What they found was that they not only improved patient care but also helped their colleagues to improve their own practice. They also influenced service changes and played a part in teaching students and colleagues.
Patients were able to talk about what it was that made a good nurse. One said, “anybody could talk to Tom, I cannot imagine anyone not being able to talk to him. He has such a great approach to people, so down to earth and natural. He is not there as someone who thinks they know it all, even though he does. He’s just so natural”.
Another said, “My nurse made me feel not special, but normal, they knew all about me and remembered things about my treatment and family and went way beyond the call of duty.”
The project also asked work colleagues about what they saw as important in an expert nurse.
One manager said, “I am in no doubt that the success of this unit is largely due to Sue’s skills and expertise. She leads the team of specialised staff who deliver care for patients requiring complex regimes. Sue communicates well at all levels and with all disciplines.”
For the nurses taking part in the project, they told the research team that taking part was not easy, and how the project helped them to express the invisibility of nurses’ roles. “Analysing and reflecting on what I do and how and why I do it, in a systematic way has helped me to recognise my own skills and knowledge. Prior to this project, I did not recognise a lot of what I do. Articulating them has made them more visible for me and to help me share them with others.”
Dr Kim Manley, project leader, said, “this project reveals how nurses change patients' worlds, and impact on all aspects of service delivery. These nurses are visionaries and provide a gold standard of care that is patient centred and evidence based.”
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