J. Mcintosh et al., Evolutionary change in the use of skills within the district nursing team:a study in two Health Board areas in Scotland, J ADV NURS, 32(4), 2000, pp. 783-790
Grade mix within the district nursing team in the United Kingdom has change
d markedly over the last 10 years but the relationship between grade mix an
d skill mix has received only intermittent research attention. This study a
dopted an ethnographic approach and aimed to explore the way in which grade
and skill are taken into account in the delegation of nursing care. After
gaining ethical approval, a total of 76 members of 21 district nursing team
s in two areas were observed and interviewed. Delegation practices were fou
nd to vary both within and between areas and considerable differences were
uncovered in the responsibilities allocated to more junior and unqualified
team members. The developing role of nursing auxiliaries is discussed in re
lation to the role of the G grade sister, resource constraints and the stan
dards of patient care. The paper concludes by arguing that the supervision
and leadership role provided by the G grade sister should be fully recogniz
ed and safeguarded.