Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
Role extension was described as a growth in nursing practice
through the mechanical addition of parts (Hunt and Wainwright
1994). It involved nurses adopting tasks and activities not included
in the basic training for the register through training, supervision
and certification by other healthcare professionals (Mitchinson and
Goodlad 1996). These tasks and activities included intravenous
venepuncture and cannulation, application of Plaster of Paris,
suturing and changing of gastrostomy tubes.
This concept was criticized for its emphasis on the tasks and
technical skills. In an era of high quality patient care using a holistic
approach, this task-centered approach was found to be
incompatible with the patient-centered approach that was
advocated. In addition, role extension was found to limit the scope
of nursing practice through the strict guidelines and protocols that
were put in place to ensure that nurses were performing only the
extended roles that they were trained and certified to perform. In
addition, there was no obligation on nurses to bear responsibility
and accountability for their clinical practice, as doctors were
maintaining overall responsibility for these duties and tasks.
In response, nurses were encouraged to expand, rather than
extend, their roles by adopting and performing duties from other
healthcare professional within the philosophy of nursing. Mitchinson
and Goodlad (1996:734) defined it as “a higher level of nursing
practice within the existing boundaries of nursing.” The concept
involves nurses performing a wider range of roles and activities
facilitated by theory and knowledge of nursing, developed through
research, experience and continuing education. In expanding their
roles, nurses were encouraged to take into consideration the
philosophy of nursing by incorporating the caring and holistic aspect
of nursing.
Literature Review
There is a plethora of research highlighting the positive attitudes of
nurses towards role expansion. In Goldman’s (1999) cross-sectional
survey into intensive care nurses’ view of role expansion, findings
revealed that respondents perceived that patients were the main
beneficiaries to nurses expanding their role. The findings from
Goldman’s (1999) study were supported by Carver’s (1998)
phenomenological study, which found that respondents agreed that
role expansion will lead to improved patient care through the
promotion of holistic approach and increased time spent with the
patients. The ability to expedite the care and treatment was also
perceived as a benefit of the expanded role in a study carried out by
Jones (2003).
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