Nurse led care

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7493.682 (Published 24 March 2005) Cite this as: BMJ 2005;330:682
  1. Nicky Cullum, professor (nac2@york.ac.uk),
  2. Karen Spilsbury, research fellow,
  3. Gerry Richardson, research fellow
  1. Department of Health Sciences, University of York, York YO10 5DD
  2. Centre for Health Economics, University of York, York YO10 5DD

Determining long term effects is harder than measuring short term costs

What's the difference between medical and nursing care? The answer is not straightforward, but shortages in the medical workforce mean that nurses are increasingly called on to undertake work that was previously done by doctors (such as undertaking surgery,1 prescribing drugs, performing triage in emergency departments), whereas shortages in the nursing workforce mean that healthcare assistants now do many tasks that nurses are trained to do. This fluidity in professional roles and competencies enables the health workforce to respond to need, but are outcomes for patients being improved? Do these benefits come at an additional cost, and if so, are they worth paying for?

Over the past decade, research has increasingly compared nurse led care with usual care for aspects of health care previously delivered by doctors. However, nurse led care does not have one meaning. Nurse led care can be usefully viewed as a continuum with, at one end, nurses undertaking highly protocol driven, focused tasks (cardioversion,2 colposcopy, smoking cessation) and, at …

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