Changes in practice at the nurse-doctor interface. Using focus groups to explore the perceptions of first level nurses working in an acute care setting.

A unique combination of factors has recently triggered a rapid change in the clinical practice of nurses in the UK. This study was carried out to explore the consequences of changing practice at the nurse-doctor interface, as perceived by first level nurses working in an acute care setting in the UK. Qualitative data were collected using focus group interviews and analysed thematically. Findings suggest that role change to these nurses is represented by a 'shift' in the practice of technical activities from junior doctors and a corresponding delegation of nursing activity to care assistants. It is suggested that the wholesale incorporation of technical interventions into the role of the nurse without an increase in the number of qualified nurses is turning nursing back to a task system of care delivery. This has the potential to depersonalize patients and reduce work satisfaction for nurses.