Clarification of nursing roles will provide an opportunity for development
This article by Daly and Carnwell provides some food for thought about roles within diabetes nursing. The article helpfully demonstrates that the difficulties found by diabetes nurses in relation to these roles (in addition to titles and responsibilities) and the debates that have occurred over many years about these issues are not restricted to the diabetes healthcare arena alone.
There are several recent initiatives, associated partly with the NSF for Diabetes (Department of Health, 2002), which make the article particularly pertinent at this point in time. These initiatives include the development of the roles of nurse consultant and diabetes support worker, the refocusing of diabetes services in primary care, and the proposals regarding stopping the clinical grading system (Agenda for Change), amongst many others.
There is currently an increasing emphasis on achievement of competencies at different levels of practice, which is demonstrated by the recently published knowledge and skills framework (Department of Health, 2003). When taken together with the continuing work on competencies in diabetes care as part of the workforce planning process, it is clear that there is an impetus for diabetes nurses of all varieties (not just those with an existing nurse specialist title) to clarify for themselves where they stand in relation to the suggested framework for levels of nursing practice published in this article.
Many may find these initiatives threatening. However, I think that greater clarification and, hopefully, a resolution of these issues which seem to have been with us for decades, provide real opportunities for growth, diversity and development.
Department of Health (2002) National Service Framework for Diabetes: Delivery Strategy. Department of Health, London
Department of Health (2003) The Knowledge and Skills Framework (NHS KSF) and Development Review Guidance (Working Draft).
Department of Health, London
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