title: Nurse consultants: organizational influences on role achievement.
abstract: OBJECTIVE
  This paper reports on organizational influences on nurse consultant post holders. The influence of individual characteristics has been the subject of another paper.
  
  
  BACKGROUND
  Nurse consultant posts were set up in the United Kingdom from the late 1990s onwards and, therefore, there has been little opportunity to report on evaluations of these innovative initiatives.
  
  
  METHODS
  A cross-sectional design, using a convenience sample, was adopted.
  
  
  METHODS
  Ten nurse consultants working in a variety of settings and specialties participated in in-depth, tape-recorded interviews. The data were analysed using the Framework approach.
  
  
  RESULTS
  Support systems were important influences on nurse consultants' role achievement levels. These took the form of internal trust networks, nurse consultant forums and links with higher education institutions. Post holders both gave and received support and acted to empower other nurses. Thus, relationships were vital to successful role integration. The culture and structures of the National Health System were also a powerful influence in terms of local and national modernization policies, and participants had to be careful in their choice of strategies to deal with the traditional medically dominated culture.
  
  
  CONCLUSIONS
  The new nurse consultant role is challenging and innovative, but a major area of contention is how much post holders are expected to take on work previously done by doctors rather than developing their nursing role. Organizational support and commitment are needed if nurse consultants are to maximize the benefits of this innovation.
  
  
  CONCLUSIONS
  The findings show that new nursing roles are not always easily accepted in multidisciplinary settings and that holders of such post need to have the appropriate previous knowledge, skills and personal characteristics, as well as the ability to negotiate their way through organizational influences.
authors.affiliation: School of Social Work & Primary Care, University of Plymouth, Plymouth, UK. v.a..woodward@plymouth.ac.uk
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Woodward
authors.forename: Christine
authors.initials: C
authors.lastname: Webb
authors.forename: Morag
authors.initials: M
authors.lastname: Prowse
mesh_terms: D000378:Agonistic Behavior; D001291:Attitude of Health Personnel; D003253:Consultants / Q000523:psychology*; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D018166:Health Care Reform / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D007400:Interprofessional Relations; D007587:Job Description; D009720:Nurse Clinicians / Q000458:organization & administration / Q000523:psychology; D024802:Nurse's Role / Q000523:psychology*; D015404:Nursing Methodology Research; D015279:Organizational Culture; D009937:Organizational Objectives; D016134:Organizational Policy; D010348:Patient Care Team / Q000458:organization & administration; D011209:Power, Psychological; D036301:Qualitative Research; D012649:Self Concept; D012944:Social Support; D013222:State Medicine / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D017132:Workplace / Q000458:organization & administration / Q000523:psychology