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
Intensive/Coronary Care units and Accident and Emergency
departments, have a tendency to focus on the extension of their
nursing roles and the adoption of technical activities and tasks
(Goldman 1999, Carver 1998).
A major limitation of this study is the generalizability of the
findings. The low response rate and the consequential small sample
size resulted in a high risk of sampling bias. In addition,
generalizability of the study is limited by the selection of sample
from three hospitals in one health board region, in rural areas. In
addition, the research design used in this study provided a limited
perspective into the attitudes of nurses towards role extension, role
expansion and the Scope of Practice. To gain a broader perspective,
further research using a qualitative paradigm may be valuable.
Conclusion
The nursing profession has been presented with an opportunity to
develop its practice beyond the boundaries set by previous
developments. With the advent of role expansion, nurses are in the
position to assume authority and autonomy over their expanding
clinical practice while improving the quality of patient care. To
ensure that nurses are developing their roles safely and
appropriately, An Bord Altranais (2000) has developed a framework
to guide nurses in the determination of their scope of professional
practice. The framework was developed in a manner that avoids
restricting the developments of nursing practice and expansion of
nursing roles.
However, in their attempt to promote independence in the
determination of the scope of practice and avoiding strict
regulations and protocols, there are risks of infringement of the
guidelines established in the framework. Without an outright
denunciation and restriction on the practice of role extension,
nurses will continue to develop their nursing roles in this manner, as
implied in this and numerous other studies. This can have critical
implications on the standards of patient care as well as the nursing
profession. In extending their nursing roles, nurses are returning to
a task-focused and task-oriented approach to providing care.
Developing nursing roles without adequate knowledge of the
guidelines for safe and appropriate role development can also be
detrimental to the quality of patient care as well as to the nursing
profession. In an era of evidence-based best practice to ensure that
the best possible care is provided to patients, ad hoc and
unstructured development of nursing roles is undesirable. As
recommended by An Bord Altranais (2000), nursing practice need to
develop to meet the current needs of the population and the health
- 527 -