Nurse consultants as higher level practitioners: factors perceived to influence role implementation and development...

This paper discusses the main factors perceived to influence higher level practice in critical care drawing upon personal experience as a critical care nurse consultant. Implementation and development of the role towards a higher level of practice has been influenced--both positively and negatively--by policy, legislative, organisational, cultural, professional and individual factors. Discussion focuses on professional, policy and organisational issues because--on reflection--these are the main factors that have facilitated and inhibited role implementation and development towards a higher level practice in the United Kingdom. Relevant research exploring advances in nursing practice in critical care, and how this has influenced the development of higher level practice in relation to the nurse consultant role, will also be discussed.