title: Discovering the nature of advanced nursing practice in high dependency care: a critical care nurse consultant's experience.
abstract: This paper describes how a critical care nurse consultant's clinical role has evolved within a surgical high dependency unit (SHDU) in a large teaching hospitals trust. In order to provide some background to role development, an overview of the research exploring the nature of advanced nursing practice in the context of critical care will be presented. From the outset, advanced nursing practice was not perceived as the acquisition and application of technical procedures usually undertaken by doctors, but possibly an integration of medicine and nursing where holistic nursing assessment is combined with symptom-focused physical examination. A reflective account of practical problems encountered relating to role integration, professional autonomy, legal and consent issues, non-medical prescribing, and role evaluation will be presented. A model of working that can be applied to high dependency units, integrating the role of the advanced nurse practitioner within the clinical team, will be described.
authors.affiliation: Surgical High Dependency Unit, C/O Intensive Care Office, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK. Debra.Fairley@leedsth.nhs.uk
authors.forename: Debra
authors.initials: D
authors.lastname: Fairley
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D003422:Critical Care / Q000458:organization & administration*; D011307:Drug Prescriptions; D006301:Health Services Needs and Demand; D006694:Holistic Health; D006784:Hospitals, Teaching; D006801:Humans; D007258:Informed Consent; D007400:Interprofessional Relations; D016294:Models, Nursing; D009720:Nurse Clinicians / Q000458:organization & administration / Q000523:psychology; D024802:Nurse's Role; D009730:Nursing Assessment; D009742:Nursing Theory; D010808:Physical Examination / Q000451:nursing; D011182:Postoperative Care / Q000451:nursing*; D017009:Professional Autonomy; D013222:State Medicine; D006113:United Kingdom