title: Rheumatology nurse practitioners' perceptions of their role.
abstract: OBJECTIVE
  To identify the current practices of rheumatology nurse practitioners and ascertain their perceptions of how their role could be enhanced.
  
  
  METHODS
  A cross-sectional questionnaire study of currently employed nurse practitioners in rheumatology in the United Kingdom (UK) was undertaken.
  
  
  RESULTS
  200 questionnaires were distributed and 118 nurses responded. Ninety-five respondents met the inclusion criteria for undertaking an advanced nursing role. Typical conditions dealt with included: rheumatoid arthritis (96.8%); psoriatic arthritis (95.8%); osteoarthritis (63.2%); ankylosing spondylitis (62.8%); systemic lupus erythematosus (51.6%); and scleroderma (34.7%). Drug monitoring, education, counselling of patients and arranging basic investigations were routinely performed by more than 80% of respondents. A smaller proportion performed an extended role that included dealing with referrals, research and audit, the administration of intra-articular injections, and admission of patients. Specific attributes identified as being necessary for competence were: knowledge and understanding of rheumatic diseases (48.4%); drug therapy (33.7%); good communication skills (35.8%); understanding of the roles of the team (27.4%); working effectively (23.2%) as part of a multidisciplinary team; assessment of patients by physical examination (28.4%); teaching (26.3%), research (17.9%); organizational skills (14.7%); and the interpretation of investigations (9.5%). Factors that could enhance their role included: attendance at postgraduate courses (30.5%); obtaining further qualifications (13.7%); active participation in the delivery of medical education (41.1%); training in practical procedures (31.6%); protected time and resources for audit and research (11.6%); formal training in counselling (11.6%); and implementation of nurse prescribing (10.5%).
  
  
  CONCLUSIONS
  Nurse practitioners already have a wide remit and play an invaluable part in the delivery of modern rheumatology services. An extended role could improve patient care and enhance nursing career pathways in rheumatology.
authors.affiliation: Department of Rheumatology, Royal Cornwall Hospital, Truro, UK.
authors.forename: Leslie
authors.initials: L
authors.lastname: Goh
authors.forename: Jo
authors.initials: J
authors.lastname: Samanta
authors.forename: Ash
authors.initials: A
authors.lastname: Samanta
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D006801:Humans; D009722:Nurse Practitioners / Q000193:education / Q000523:psychology*; D024802:Nurse's Role; D010818:Practice Patterns, Physicians'; D012219:Rheumatology / Q000193:education; D011795:Surveys and Questionnaires; D006113:United Kingdom