Education and debate

With nurse practitioners, who needs house officers?

^a Department of Social Medicine, University of Bristol, Bristol BS8 2PR, ^b Centre for Social Management School for Advanced Urban Studies, University of Bristol, ^c Department of Postgraduate Medical Education, University of Bristol, Frenchay Hospital, Bristol BS16 1LE

Correspondence to: Dr Dowling.

The boundaries between the work of doctors and that of nurses are changing, with nurses taking over important parts of junior hospital doctors' clinical work. In 1993 an exploratory study was carried out to identify the professional, educational, and management issues that such developments raise. Interviews were carried out with a range of stakeholders in three innovatory posts in which nurses were doing much of the clinical work of house officers. A complex picture of perceived benefits and problems for patients, junior doctors, and nurses emerged. These seemed to be associated with (a) the extent to which the contribution of professional nursing was valued in the new role and (b) the amount of clinical discretion which the postholder was allowed, this depending on the type of preparatory education provided and the . . . [Full text of this article]

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