Nurse practitioners: a contract for change and excellence in nursing

Educating advanced midwife practitioners: a collaborative venture

AIM

To describe the collaborative development of an MSc course preparing Ireland's first advanced midwife practitioners.

BACKGROUND

Ireland has 55 advanced nurse practitioner posts, but, as yet, no advanced midwife practitioners.

METHODS

A consultative, collaborative process involving 38 midwives across Ireland generated the philosophy, aims and content of the course.

RESULTS

Participants stated that candidates should be committed to the conceptual uniqueness of midwifery; the advanced midwife practitioner role should be clearly defined and supported by the candidate's sponsors; programme content should emphasize normal midwifery, be practice led, and encourage reflective, evidence-based, women-centred care.

CONCLUSION

The collaborative process used to develop this programme ensures that it will meet individual students' needs, thus enhancing the education of Ireland's first advanced midwife practitioners. IMPLICATIONS FOR MIDWIFERY MANAGEMENT: The emphasis on normality rather than specialization is a message that could be assimilated by managers in other countries to the benefit of childbearing women across the world.

Clinical leadership in contemporary clinical practice: implications for nursing in Australia

BACKGROUND

Leadership in the clinical practice environment is important to ensure both optimal patient outcomes and successive generations of motivated and enthusiastic clinicians.

AIM

The present paper seeks to define and describe clinical leadership and identify the facilitators and barriers to clinical leadership. We also describe strategies to develop clinical leaders in Australia. Key drivers to the development of nursing leaders are strategies that recognize and value clinical expertise. These include models of care that highlight the importance of the nursing role; evidence-based practice and measurement of clinical outcomes; strategies to empower clinicians and mechanisms to ensure participation in clinical decision-making.

KEY ISSUES

Significant barriers to clinical leadership are organizational structures that preclude nurses from clinical decision making; the national shortage of nurses; fiscal constraints; absence of well evaluated models of care and trends towards less skilled clinicians.

CONCLUSIONS

Systematic, strategic initiatives are required to nurture and develop clinical leaders. These strategies need to be collegial collaborations between the academic and health care sectors in order to provide a united voice for advancing the nursing profession.