Academics have defended the current trend in training where nurses specialise in different areas of practice, denying that this depletes general duties staff. Louis White reports

Some see this as a negative, resulting in nurses losing general skills and unable or unwilling to transfer their skills to another section of the hospital or to a completely different area in nursing.

This is because of the difficult processes involved in applying for another job, such as getting the required police and reference checks, interviews and preparation. However, others see it as a positive.

“ I have never heard anyone complain that we have too many specialist doctors,” says Julie Considine, professor in nursing at the school of nursing and midwifery at Deakin University.“ So, I am not sure why people would complain about there being too many specialist nurses?

“ Nurses have always specialised but I know a lot of nurses that transfer their specialist skills. For example, I have emergency nursing colleagues who now work in ICU and hospital in the home and they have benefited from the experience.

“ Personally, I have always worked in emergency care and relished the challenges that it presents.”

Considine believes it was inevitable that the medical profession would become more specialised as medical research revealed more

details about particular illnesses and diseases.

The more complex a sickness, the more it requires each area within the medical profession to have greater knowledge and that invariably leads to specialisation.

“ If I had a cardiac arrest, I would want an expert emergency nurse, if I was having a baby, I would want an expert midwife, if I’ ve had a stroke, I would want an expert stroke nurse,” Considine says.“ No one ever suggests that orthopaedic surgeons take over the plastic surgery list.”

Training

General medical training has advanced greatly in all areas since Considine started out 30 years ago.“ When I trained in the late 1980s, there were still general medical and surgical units, but it was common for surgical specialties to be clustered on the same wards like plastics, orthopaedics, gastrointestinal,” she says.

“ Now medicine has also sub-specialised and you find medical units with specific expertise in stroke, respiratory problems, diabetes and new areas are developing too. There are many benefits to nurses specialising … such as patients receiving expert care in that area and the nurses can help out with answering questions, thereby comforting the patient.

“ It improves the outcome for the patient and specialised nurses might notice something that a general nurse doesn’ t. A patient may have broken his or her leg and that is what they are treated for. A nurse who may have worked with stroke victims would naturally look to see if there was any head trauma rather than just treating the immediate injury.

“ Of course, there can also be some disadvantages to nurses specialising as it can lead to a less flexible workforce and nurses might become deskilled in areas other than their speciality, which means hospitals have decreased

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26 | Issue 2 2013