The extended role of the nurse: practical realities

This article provides an overview of the development of the extended role of fertility nurses. The key factors discussed are the historical development of the nurses' role in the Oxford Fertility Unit at John Radcliffe Hospital and the relevant issues that influence this process and how this is reflected in other units nationally. Each practitioner is accountable for his or her actions and must be aware of the legal implications of practice within the process of role extension. Appropriate training and standards of competence are required for both professional indemnification, provided by the Royal College of Nursing (RCN), and vicarious liability, provided by the individual's employer. There is great variation in nurses' scope of practice, job titles, salaries and standards of training, particularly in the fertility specialism. The United Kingdom Central Council for Nurses, Midwives and Health Visitors (UKCC) is currently piloting a new standard for nurses to attain a 'higher level of practice'. The aim is to provide a generic standard of practice for nurses undertaking an extended role and to overcome many of the inconsistencies experienced by nurses across the UK. Central to any role extension is the delivery of safe care to all patients. Many fertility nurses face new challenges within their practice but require the support of the multidisciplinary team to ensure good standards of patient care.