Third year student nurses perceptions of the role and impact of Clinical Nurse Specialists: a multi-centred descriptive study

The United Kingdom (UK) National Health Service (NHS) has experienced a rapid expansion in the number of clinical nurse specialist (CNS) posts in the last two decades. Despite this, there is limited robust evidence that evaluates the role and impact that the CNS makes. Furthermore there is reportedly considerable confusion and inconsistency surrounding the titles, descriptions, qualifications and grading of CNS posts. It is against this background the findings from this multi-centre descriptive survey are presented which explored final year ‘soon to be qualified' student nurses' perceptions of the CNS role and the impact they had on care delivery and other members of the nursing team. A specially designed self report instrument was distributed to 269 student nurses undertaking pre-registration adult branch nurse education at three higher education institutions in England and Scotland. A response rate of 82% (n=220) was obtained. The instrument contained a combination of open and closed questions. Quantitative data were analysed using SPSS (v 11.0) and a thematic approach as described by Miles and Huberman (1994) was used to categorise responses to the open ended items. The results indicate that the students had encountered clinical nurse specialists during their education. The students ranked CNS' in the fields of diabetes, palliative care and acute pain as the most frequent recipient of patient referrals. The students recognised the added value brought to patient care by involvement of a CNS in care delivery and valued the CNS as a source of knowledge and support to both themselves and other staff. Students also identified a number of disadvantages associated with the CNS role. These included role conflict and potential for deskilling nurses fulfilling a generalist role. This paper will discuss the findings and offer possible explanations for the result