Role determination in nursing–implications for service provision

Abstract

The current changes in nursing practice which have placed a greater need than ever before for nurses to have clearly defined roles, has resulted from the demand for cost-effective care and for nurses to justify their contribution to that care. This two stage, descriptive study was undertaken as part of a larger study to determine the implications of definition of the role of nursing for service provision in Hong Kong. The initial data collected using group interviews to generate ideas about the activities of the registered nurse (RN) and enrolled nurse (EN), was followed by a questionnaire to a sample of 410 RNs, representing three different grades of nursing staff. The 5-point Likert type questionnaire asked respondents to indicate levels of agreement with 67 activities. Sixty-five of the 67 activities of the RN were agreed to and were statistically significant (P < 0.001) in the difference from the undecided position. The findings also demonstrated a lack of agreement amongst grades of staff in their perception of nursing role. Fifty-six of the same 67 activities were agreed to for the EN and were statistically significant (P < 0.001) in the difference from the undecided position. This similarity between perceptions of EN and RN activities highlights the need to reconsider the contribution of ENs to patient care within the nursing structure in Hong Kong. These findings have implications not only for the management of nursing but also for further research in determining the interpretation of role in nursing to high quality patient care.