Learning from the past to inform the future--a survey of consultant nurses in emergency care.

This paper reports the findings of a survey of UK consultant nurses in emergency care. The purpose of the survey was to elicit information regarding level of preparation for the consultant nurse role, the use of formal competency frameworks, current clinical scope of practice and perspectives on future preparation for the role. A semi-structured questionnaire was e-mailed to consultant nurses in emergency care. Respondents had an average of only 2 years in post and for 24% of respondents this was their second post as a consultant nurse. The survey identified that three quarters of the respondents had no specific preparation for the consultant nurse role. The remainder had varying levels of preparation ranging from brief induction to 6-month clinical training. It could be argued that this diversity of preparation is a reflection of the lack of clarity regarding the consultant nurse role and the ill-defined organisational frameworks within which some consultant nurse posts were established. With the exception of the expert practice domain and clinical leadership, the majority of respondents felt under prepared for one or more elements of the consultant nurse role. Clinically their scope of practice ranged from managing patients with minor illness or injury, to leading resuscitation teams. There was great inequity in the level of preparation for the role, particularly in the transformational leadership, education and training, and practice and service development domains. Strategies for addressing these deficiencies are identified.