A challenge for clinical nurses: a new nursing role

As a result of difficulties in attracting resident medical officers (RMOs) to the outer western suburbs of Sydney, the intensive care unit at Nepean Hospital created a new nursing position in 1992 called the clinical assistant (CA). This position was trialed and, after a successful period in the intensive care unit, it was expanded to the surgical, pediatric, and mental health divisions. The generic job description of the CA is comprehensive and includes advanced clinical, educational, research, and managerial components. There are a number of variations within the areas of practice. For example, within the clinical component, the intensive care CA is expected to be able to insert central venous and arterial catheters, whereas the mental health CA adopts a full caseload and is responsible for patient assessment and management. A working party was established in 1995 and comprised previous and current CAs, an education manager, a senior nursing administrator, and representatives from personnel and the New South Wales Nursing Association (nursing union). The working party conducted an extensive evaluation of this new nursing role, and the recommendations that followed received a positive response from the hospital management.