Background Rheumatology nurses, as integral members of rheumatology teams, are instrumental in increasing treatment in response to clinical need to improve patient outcomes. Yet their specialist knowledge and skills are not always recognised or acknowledged with specialist or advanced practice titles (IRNF, 2014).
Objectives The objectives of this online survey were to characterise rheumatology nursing role activities, assess confidence with these roles, and assess educational requirements to gain understanding about current rheumatology nursing practice in Ireland.
Methods Approval was granted by Our Lady's Hospice & Care Services and the UK authors to use the tool. Following conversion from paper to online, it was emailed to all Irish Rheumatology Nursing Forum (IRNF) members (approx. 75 members at time of survey), with 2 further reminders. The UK survey was originally 38 questions with a mix of multiple choice and likert type questions analysing demographic information, patient-based and non-patient based clinical and professional activities, and self-assessment of competence in practice related clinical activities. Minor language changes were required within the tool to make it suitable to an Irish population. An additional component was added asking about postgraduate education to date, intention to study further and courses of interest. It took approx. 15–20 mins to complete.
Results Response rate was approximately 45%, from rheumatology nurses. Respondents were working as specialist (51%), advanced (6%) or registered nurses (25%) or others (including management and research roles) (18%). Patient based clinical activities include high levels of confidence counselling patients on Methotrexate (73%), calculating a DAS score (68%) and to a lesser extent performing a joint count (54%) and least of all 19% supporting patients with chronic pain. Clinical activities included monitoring patients on DMARDs (62.5%) and Biologics (68%) as a major role although the majority were not qualified to prescribe medications (72%) or give joint/ soft tissue injections (68%). Providing psychological support was a major or significant role for all respondents. Non-patient based activities included majority of those surveyed taking part in activities such as clinical research (63%), teaching nursing students (58%), conducting audits (55%) with less writing business cases (26%) or giving talks outside their department (42%). 72% had undertaken rheumatology specific education while a third were considering further post graduate study.
Conclusions The rheumatology nurses who completed the survey demonstrated advanced clinical knowledge and skills that are not reflected by their occupation title with many nurses not employed as specialist or advanced practitioners. Characterising the clinical practice of rheumatology nurses will inform the debate on nurses being acknowledged for the clinical skills they are delivering
Irish Rheumatology Nursing Forum (IRNF) (2014) Business Proposal for Advanced Nurse Practitioners and Clinical Nurse Specialists Posts (Rheumatology) Dublin
Ryan, S; Hassell, A & Carpenter, E (2010) Characterising the clinical practice and professional behaviour of rheumatology nurse specialists: a pilot study Musculoskeletal Care 8 136–142
Acknowledgement Thanks to Sarah Ryan and Jackie Hill for permission to use their survey tool
Disclosure of Interest None declared