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The times they are a changin

Thomas, M; Hynes, C


M Thomas

C Hynes


Aim A discussion paper outlining the potential for a multi-qualified health practitioner
who has undertaken a programme of study incorporating the strengths of the
specialist nurse with other professional routes.
Background and rationale The concept and the context of nursing is wide and
generalized across the healthcare spectrum with a huge number of practitioners in
separate branches, specialities and sub-specialities. As a profession, nursing consists
of different groups in alliance with each other. How different is the work of
the mental health forensic expert from an acute interventionalist, or a nurse
therapist, from a clinical expert in neurological deterioration? The alliance holds
because of the way nurses are educated and culturalized into the profession, and
the influence of the statutory bodies and the context of a historical nationalized
health system. This paper discusses the potential for a new type of healthcare
professional, one which pushes the intra- and inter-professional agenda towards
multi-qualified staff who would be able to work across current care boundaries
and be more flexible regarding future care delivery. In September 2003, the
Nursing and Midwifery Council stated that there were more than 656 000
practitioners on its register and proposed that from April 2004, there were new
entry descriptors. Identifying such large numbers of practitioners across a wide
range of specialities brings several areas of the profession into question. Above all
else, it highlights how nursing has fought and gained recognition for specialisms
and that through this, it may be argued client groups receive the best possible
fit for their needs, wants and demands. However, it also highlights deficits in
certain disciplines of care, for example, in mental health and learning disabilities.
We argue that a practitioner holding different professional qualifications would be
in a position to provide a more holistic service to the client. Is there then a gap
for a 'new breed' of practitioner; 'a hybrid' that can achieve a balanced care
provision to reduce the stress of multiple visits and multiple explanations?
Methods Review of the literature but essentially informed by the authors personal
vision relating to the future of health practitioner education.
Implications for nursing management This article is of significance for nurse managers
as the future workforce and skill mix of both acute and community settings
will be strongly influenced by the initial preregistration nurse education.


Thomas, M., & Hynes, C. (2009). The times they are a changin. Journal of Nursing Management, 17(5), 523-531.

Journal Article Type Article
Publication Date Jan 1, 2009
Deposit Date May 13, 2011
Journal Journal of Nursing Management
Print ISSN 0966-0429
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 17
Issue 5
Pages 523-531
Publisher URL