Attitudes of paediatric intensive care nurses to development of a nurse practitioner role for critical care transport.
OBJECTIVE
This paper is a report of a descriptive study of the attitudes and opinions of nurses before and after the introduction of independent Retrieval Nurse Practitioners into a critical care transport service for children.


BACKGROUND
Little is known about nurses' attitudes to advanced practice roles, particularly when these function as part of a team in a high-risk, remote setting (distant to the base hospital). Increasing knowledge in this area may give insight into ways of improving team working and enhancing quality of patient care.


METHODS
A qualitative questionnaire was sent to nurses pre- (June 2006) and post- (July 2007) retrieval nurse practitioner introduction. Questionnaires were analysed using an adapted phenomenological method.


RESULTS
The response rates were 62% (2006) and 48% (2007). The main themes that emerged included fear, communication, trust, team working, role conflict, role division and role boundaries. In the first survey, most nurses anticipated difficulties during retrieval with retrieval nurse practitioners and felt anxious about the prospect of being part of a team with an independent retrieval nurse practitioner. However, by the second survey (after retrieval nurse practitioner introduction), the majority reported confidence in the retrieval nurse practitioners' knowledge and skills.


CONCLUSIONS
This advanced practice development has been a challenge for the nurses and the retrieval nurse practitioners, but initial anxieties and fears of a host of anticipated problems have been largely dispelled as enhanced communication and team working were reported.
Davies
Joanna
J
Paediatric Intensive Care, Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. joanna.davies@gstt.nhs.uk
Bickell
Fiona
F
Tibby
Shane M
SM
D057179:Advanced Practice Nursing; D001291:Attitude of Health Personnel; D002648:Child; D002983:Clinical Competence; D003422:Critical Care; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric; D007400:Interprofessional Relations; D008297:Male; D009722:Nurse Practitioners / Q000523:psychology*; D024802:Nurse's Role / Q000523:psychology*; D015279:Organizational Culture; D010348:Patient Care Team / Q000458:organization & administration; D010360:Patient Transfer / Q000458:organization & administration; D010371:Pediatric Nursing; D036301:Qualitative Research; D014187:Transportation of Patients / Q000458:organization & administration*; D006113:United Kingdom