Do you need an external consultant? A model for decision making

Consultation is an integral part of the clinical nurse specialist (CNS) role. Some problems, however, are best resolved by a consultant from outside of the organization. This paper presents a decision-making model for use by CNSs in determining the need for an external consultant. The decision-making model involves two general steps. Each step introduces a series of incumbent questions. In the first step, the nature of the problem is assessed, and questions about the philosophical foundation, theoretical framework, and problem substruction are introduced. In the second step, the requirements for solution of the problem are described, precipitating questions about the consultant role requirements, role functions, and introspection and evaluation. Through systematic questioning about the nature of the problem and the solution requirements, the CNS may make an informed decision regarding the recommendation to employ an external consultant. An overall blueprint for the systematic questioning in this decision-making process is presented.