Implications of nursing role expansion for professional practice

The topic of nursing role expansion has caused much heated debate in the nursing press in recent years. The contemporary relevance of the debate is heightened by the current recruitment and retention crisis in nursing, and continued pressures to reduce junior doctors' hours and workload. This article re-examines the 'expanded role debate' by putting current concerns in an historical framework. The perceived benefits of role expansion are discussed, and balanced against continued concerns expressed by practitioners regarding possible detrimental effects on care delivery. The potential erosion of 'caring' as the heart of nursing practice is acknowledged, and challenges are made to the belief that nursing has the 'monopoly on caring'. The issue of 'nursing time', perhaps the major barrier to continued role expansion, is also explored. The future division of labour within healthcare delivery is seen as pivotal to this aspect of the debate, and a pragmatic vision for the future is offered. Finally, the issue of the paucity of the evidence base underpinning role expansion is considered and a plea is made for future developments to be soundly underpinned by research.