IDEAS home Printed from https://ideas.repec.org/a/wly/jocnur/v23y2014i19-20p2874-2885.html
   My bibliography  Save this article

How clinical nurse and midwifery consultants optimise patient care in a tertiary referral hospital

Author

Listed:
  • Christine Atsalos
  • Karen Biggs
  • Sabine Boensch
  • Fiona Lee Gavegan
  • Susan Heath
  • Marlene Payk
  • Grace Trapolini

Abstract

Aims and objectives To develop new insights into the phenomenon of clinical nurse/midwifery consultant clinical effectiveness in a tertiary referral hospital. Background International studies identify the pivotal role clinical nurse/midwifery consultants play in patient outcomes. There remains, however, a significant deficit in our knowledge of how these, or other advanced practice nurses and midwives, apply their extensive experience, ontological understandings and tacit knowledge to the enhancement of patient outcomes in complex healthcare environments. Design This study was underpinned by the principles of Heideggerian hermeneutic phenomenology. Methods Recruitment involved expressions of interest distributed hospital‐wide to clinical nurse/midwifery consultants. Inclusion criteria specified a minimum of three years’ experience. Fifteen clinical nurse/midwifery consultants, representing a broad range of specialties, were interviewed. Preliminary descriptive analysis of transcribed data was followed by in‐depth hermeneutic analysis. Results The findings comprise four themes: walking beside the patient, anticipating the unexpected, pushing through barriers and leading within a complex system. These themes highlight how clinical nurse/midwifery consultants significantly influence pre‐existing trajectories of patient care delivery through context‐appropriate strategies. Conclusion This study introduces new insights into the meanings advanced practice nurses and midwives develop from their engagements with patients and how these meanings inform clinical decisions. The paper accomplishes this by drawing on Heideggerian philosophical concepts such as ontological understandings, authenticity and care. It also casts light on the participants’ shared understandings of how to synergise expectations within the team. Relevance to clinical practice The significance of this paper lies in the uncovering of ontological understandings and tacit knowledge of how consultant nurses and midwives optimise patient care delivery in challenging situations. The findings indicate, however, that the value of these internationally established roles is yet to be fully realised. The paper concludes by recommending strategies to assist newly appointed clinical nurse/midwifery consultants transition into these demanding autonomous roles.

Suggested Citation

  • Christine Atsalos & Karen Biggs & Sabine Boensch & Fiona Lee Gavegan & Susan Heath & Marlene Payk & Grace Trapolini, 2014. "How clinical nurse and midwifery consultants optimise patient care in a tertiary referral hospital," Journal of Clinical Nursing, John Wiley & Sons, vol. 23(19-20), pages 2874-2885, October.
  • Handle: RePEc:wly:jocnur:v:23:y:2014:i:19-20:p:2874-2885
    DOI: 10.1111/jocn.12567
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/jocn.12567
    Download Restriction: no

    File URL: https://libkey.io/10.1111/jocn.12567?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Unknown, 2005. "Forward," 2005 Conference: Slovenia in the EU - Challenges for Agriculture, Food Science and Rural Affairs, November 10-11, 2005, Moravske Toplice, Slovenia 183804, Slovenian Association of Agricultural Economists (DAES).
    2. Valerie A Woodward & Christine Webb & Morag Prowse, 2006. "Nurse consultants: organizational influences on role achievement," Journal of Clinical Nursing, John Wiley & Sons, vol. 15(3), pages 272-280, March.
    3. Debra Fairley & S. Jose Closs, 2006. "Evaluation of a nurse consultant's clinical activities and the search for patient outcomes in critical care," Journal of Clinical Nursing, John Wiley & Sons, vol. 15(9), pages 1106-1114, September.
    4. Krista Jokiniemi & Anna‐Maija Pietilä & Jari Kylmä & Kaisa Haatainen, 2012. "Advanced nursing roles: A systematic review," Nursing & Health Sciences, John Wiley & Sons, vol. 14(3), pages 421-431, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Krista Jokiniemi & Anna‐Maija Pietilä & Jari Kylmä & Kaisa Haatainen, 2012. "Advanced nursing roles: A systematic review," Nursing & Health Sciences, John Wiley & Sons, vol. 14(3), pages 421-431, September.
    2. Pilar Lopez-Llompart & G. Mathias Kondolf, 2016. "Encroachments in floodways of the Mississippi River and Tributaries Project," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 81(1), pages 513-542, March.
    3. Michelle Sheran Sylvester, 2007. "The Career and Family Choices of Women: A Dynamic Analysis of Labor Force Participation, Schooling, Marriage and Fertility Decisions," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 10(3), pages 367-399, July.
    4. DAVID M. BLAU & WILBERT van der KLAAUW, 2013. "What Determines Family Structure?," Economic Inquiry, Western Economic Association International, vol. 51(1), pages 579-604, January.
    5. Afanasyev, Dmitriy O. & Fedorova, Elena A. & Popov, Viktor U., 2015. "Fine structure of the price–demand relationship in the electricity market: Multi-scale correlation analysis," Energy Economics, Elsevier, vol. 51(C), pages 215-226.
    6. Peter Viggo Jakobsen, 2009. "Small States, Big Influence: The Overlooked Nordic Influence on the Civilian ESDP," Journal of Common Market Studies, Wiley Blackwell, vol. 47(1), pages 81-102, January.
    7. Billio, Monica & Casarin, Roberto & Osuntuyi, Anthony, 2016. "Efficient Gibbs sampling for Markov switching GARCH models," Computational Statistics & Data Analysis, Elsevier, vol. 100(C), pages 37-57.
    8. Jan Babecký & Fabrizio Coricelli & Roman Horváth, 2009. "Assessing Inflation Persistence: Micro Evidence on an Inflation Targeting Economy," Czech Journal of Economics and Finance (Finance a uver), Charles University Prague, Faculty of Social Sciences, vol. 59(2), pages 102-127, June.
    9. Lloyd, S. P., 2017. "Unconventional Monetary Policy and the Interest Rate Channel: Signalling and Portfolio Rebalancing," Cambridge Working Papers in Economics 1735, Faculty of Economics, University of Cambridge.
    10. Ichiro Fukunaga, 2007. "Imperfect Common Knowledge, Staggered Price Setting, and the Effects of Monetary Policy," Journal of Money, Credit and Banking, Blackwell Publishing, vol. 39(7), pages 1711-1739, October.
    11. Albertazzi, Ugo & Gambacorta, Leonardo, 2009. "Bank profitability and the business cycle," Journal of Financial Stability, Elsevier, vol. 5(4), pages 393-409, December.
    12. Beck, Thorsten & Demirgüç-Kunt, Asli & Merrouche, Ouarda, 2013. "Islamic vs. conventional banking: Business model, efficiency and stability," Journal of Banking & Finance, Elsevier, vol. 37(2), pages 433-447.
    13. Jinho Bae & Chang-Jin Kim & Dong Kim, 2012. "The evolution of the monetary policy regimes in the U.S," Empirical Economics, Springer, vol. 43(2), pages 617-649, October.
    14. McMahon, Rob, 2020. "Co-developing digital inclusion policy and programming with indigenous partners: Interventions from Canada," Internet Policy Review: Journal on Internet Regulation, Alexander von Humboldt Institute for Internet and Society (HIIG), Berlin, vol. 9(2), pages 1-26.
    15. George W. Evans & Seppo Honkapohja, 2009. "Robust Learning Stability with Operational Monetary Policy Rules," Central Banking, Analysis, and Economic Policies Book Series, in: Klaus Schmidt-Hebbel & Carl E. Walsh & Norman Loayza (Series Editor) & Klaus Schmidt-Hebbel (Series (ed.),Monetary Policy under Uncertainty and Learning, edition 1, volume 13, chapter 5, pages 145-170, Central Bank of Chile.
    16. Lehtonen, Heikki & Kujala, Sanna, 2007. "Climate change impacts on crop risks and agricultural production in Finland," 101st Seminar, July 5-6, 2007, Berlin Germany 9259, European Association of Agricultural Economists.
    17. Michael Pomerleano, 2011. "Developing Regional Financial Markets – the Case of East Asia," Chapters, in: Ulrich Volz (ed.), Regional Integration, Economic Development and Global Governance, chapter 9, Edward Elgar Publishing.
    18. Gary Charness & Francesco Feri & Miguel A. Meléndez-Jiménez & Matthias Sutter, 2023. "An Experimental Study on the Effects of Communication, Credibility, and Clustering in Network Games," The Review of Economics and Statistics, MIT Press, vol. 105(6), pages 1530-1543, November.
    19. Kitsul, Yuriy & Wright, Jonathan H., 2013. "The economics of options-implied inflation probability density functions," Journal of Financial Economics, Elsevier, vol. 110(3), pages 696-711.
    20. Dieter Balkenborg & Rosemarie Nagel, 2016. "An Experiment on Forward vs. Backward Induction: How Fairness and Level k Reasoning Matter," German Economic Review, Verein für Socialpolitik, vol. 17(3), pages 378-408, August.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:jocnur:v:23:y:2014:i:19-20:p:2874-2885. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://doi.org/10.1111/(ISSN)1365-2702 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.