Enrolled nurse skill extension: metropolitan myth or rural reality?

OBJECTIVE The objective of this study was to examine whether the position of 'after hours clinical support enrolled nurse' is embracing clinical skill extension in the acute surgical area. DESIGN Experienced enrolled nurses employed in a supernumerary capacity documented all activities with which they were engaged over a six-month period. SETTING Six surgical wards within a tertiary referral hospital, Sydney, Australia. SUBJECTS Enrolled nurses working after hours in an extended support role in a supernumerary capacity. RESULTS Data demonstrated that, in this study, the 'after hours clinical support enrolled nurse' was primarily performing routine nursing activities. Although the number of extended skills (n=13) performed could be considered diverse for an enrolled nurse, many were seldom performed. The most frequently performed extended skills were patient escorts and undertaking bladder ultrasounds with a mobile scanner. Medication administration was rarely performed. CONCLUSION The role primarily incorporates basic nursing care with minimal scope for extended skills. The paper recommends that basic nursing practices be delegated to assistants in nursing to enable the 'after hours clinical support enrolled nurse' to effectively support registered nurses and extend their own practice.