Role of a paediatric nurse in primary care 1: research issues

This study, which looked at the potential for the role of a paediatric nurse in primary care, was a tripartite partnership arrangement with Community Health Sheffield NHS Trust, the University of Sheffield and the Children's Hospital Sheffield. The study focused on the role and function of two qualified children's nurses each working within a different primary healthcare team (PHCT). It was important to allow the role to evolve without undue pressure, so that members of the PHCT could work with the nurses to establish what would be the most useful and relevant tasks to be carried out by the team. The methodological problems posed in this type of study where little was known about how a children's nurse would work in a PHCT resulted in exploring the concept of a formative evaluation process. The major data source and contribution to the evaluation were the nurses' reflective accounts of their role and function as members of the PHCT. Case studies written in the form of reflective diaries provided a self-critical approach to the record of tasks undertaken and explained why the service was taken up. Five constructions emerged: duplication and perceived threats to established nursing roles within the PHCT; improved care of children in PHCT settings; the nature of support for children and families; working as a nurse practitioner; and meeting unmet need. A clear need was demonstrated for a qualified children's nurse working in a community setting to raise the overall support and quality of care for a whole range of conditions which are currently low profile. There was evidence that these nurses met unmet need and were, at times, functioning as nurse practitioners and at times as advanced practitioners. This article, the first of two parts, focuses on the methods used and the associated problems. The second part will present the findings and discussions of the research.