NURSES TAKING ON JUNIOR DOCTORS WORK - A CONFUSION OF ACCOUNTABILITY

The number of hospital based posts in which nurses take over clinical work previously done by junior doctors is growing. Accountability for the scope of such new roles and the standards of practice which apply to them are still unclear. When analysed together and compared, the re gulations arising from the professional bodies (GMC and UKCC), civil l aw concerning certain wrongs to patients, and employment law are somet imes contradictory and hard to interpret. The resulting uncertainties about appropriate management for clinical roles evolving between the p rofessions, coupled with an increasingly litigious public, put the nur ses and consultants involved at risk of complaints and of disciplinary and legal action. Drawing on our current research into changing clini cal roles at the medical-nursing interface, we suggest strategies to r educe risk. Doctors and nurses should be equal partners in planning an d managing these new posts, patients should be informed adequately abo ut the nature of the postholder's role and training, significant chang es in the work of such postholders should be formally acknowledged by the employer and relevant insurers, individuals taking up new roles sh ould have access to legal advice and support to cover legal risk, and national regulatory bodies need to work together to harmonise their co des of practice in relation to changing clinical roles between the pro fessions.