The Use of Unregulated Staff: Time for Regulation?
Internationally, shortages in the nursing workforce, escalating patient demands, and financial constraints within the health system have led to the growth of unlicensed nursing support workers. Recently, in relation to the largest publicly funded health system (National Health Service), it was reported that extensive substitution of registered nurses with unskilled nursing support workers resulted in inadequate patient care, increased morbidity and mortality rates, and negative nurse outcomes. We argue that it is timely to consider regulation of nursing support workers with their role and scope of practice clearly defined. Further, the addition of these workers in a complementary model of care (rather than substitutive model) should also be explored in future research, in terms of impact on patient and nurse outcomes.
Centre for Health Services Management, Faculty of Health, University of Technology, Sydney, NSW, Australia Christine.Duffield@uts.edu.au.|Clinical Nursing and Midwifery Research Centre, School of Nursing and Midwifery, Edith Cowan University, Joondalup, Perth, WA, Australia.|Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia.
Christine M
CM
Duffield
Clinical Nursing and Midwifery Research Centre, School of Nursing and Midwifery, Edith Cowan University, Joondalup, Perth, WA, Australia.|Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia.
Di E
DE
Twigg
School of Nursing and Midwifery, Edith Cowan University, Joondalup, Perth, WA, Australia.
Judith D
JD
Pugh
Clinical Nursing and Midwifery Research Centre, School of Nursing and Midwifery, Edith Cowan University, Joondalup, Perth, WA, Australia.
Gemma
G
Evans
Centre for Health Services Management, Faculty of Health, University of Technology, Sydney, NSW, Australia.
Sofia
S
Dimitrelis
Centre for Health Services Management, Faculty of Health, University of Technology, Sydney, NSW, Australia.
Michael A
MA
Roche
D002983:Clinical Competence / Q000592:standards*; D006801:Humans; D008007:Licensure, Medical / Q000592:standards*; D016294:Models, Nursing; D024802:Nurse's Role; D009728:Nursing Assistants / Q000592:standards*; D009740:Nursing Staff / Q000592:standards*; D014481:United States
nursing support worker; patient outcomes; registered nurse; regulation; scope of practice; skill mix