Advanced practice/expert nurses: hospitals can't live without them

This paper draws on material from a recent phenomenological study that explored the experience of being a clinical nurse specialist (CNS) in a large metropolitan teaching hospital in New South Wales, Australia. As part of the process a group of nurses were observed as they went about their daily work. During the study the nurses demonstrated they were operating at an advanced level and were clearly experts in their fields. The benefits to the workings of the hospital that stemmed from this expertise is the focus of this paper. The study showed that an expert nurse's position on the ward is integral to the well-being of the patient and the well-being of the ward: in maintaining and setting standards and, at the same time, is cost-effective. The study preserves the expertise of nurses in text so that their work can be seen. The results demonstrate that the existence of expert nurses on the ward has direct implications for quality patient care. Recommendations arising from the study include that hospital policy makers and decision takers, including nurses themselves, need to more fully recognise these implications.