Nurse specialist: an evolving need

For too long, to advance their careers and earn higher salaries, nurses have had to veer away from clinical experience, which they knew best, into managerial and other fields. To curb this trend and respond to the need for high-quality care, St. Edward Mercy Medical Center, Fort Smith, AR, instituted the nurse specialist program, in which nurses can develop competency in multiple clinical areas with accompanying financial incentives. In developing the program, which provides a cadre of nurses to augment the regular staff wherever needed, job descriptions and the requirements for selection, recruitment, and training were developed, as was some method to evaluate the program. Requirements for participation included at least one year of hands-on experience at the medical center, good clinical skills, and adherence to the Mercy philosophy of care. Those selected were trained in five specialized clinical areas: intensive care, labor and delivery, emergency services, post-anesthesia recovery, and nursery. The program at first met resistance from other nurses and abuse from nursing supervisors. But this has been replaced by acceptance and appreciation. The nurse specialists are seen as an elite group, meeting patient and staff needs as extra pairs of caring and competent hands, with the potential to calm a stressful clinical environment.