A New Model for Enacting the Scope of Nursing Practice

The current ANS featured article addresses the disconnects that prevail between the full scope of nursing practice, and the practices that actually are enacted.  The article is titled “Influences on and Outcomes of Enacted Scope of Nursing Practice: A New Model” by Johanne D´ery, PhD, RN; Danielle D’Amour, PhD, RN; R´egis Blais, PhD and Sean P. Clarke, PhD, RN, FAAN.  Dr. D’ery has shared this message about their work:

This article “Influences on and outcomes of enacted scope of nursing practice. A new Model” explains the conceptual thinking that guided my PhD thesis and is at the heart of my ongoing program of research. Scope of nursing practice, especially enacted (real) scope of practice, is the extent to which nurses use the full breadth of their knowledge and competencies in their daily work. I’m interested not only in work characteristics and nurse personal attributes that affect scope of practice, but also the outcomes from organizational and patient perspectives that may change as a result of differences in the implementation of the nursing role.

I am currently Assistant Director of Nursing (Research Development) at Hôpital Ste-Justine (Montreal, Canada), one of the largest maternal-child academic health sciences centers in the French-speaking world. I have had the good fortune to do PhD work where I tested the model described in the article under the supervision of Dr Danielle D’Amour. In the next months, I’ll begin postdoctoral training with Drs. Sean Clarke (Boston College) and Mélanie Lavoie-Tremblay (McGill University, Montreal, Canada).   I plan on continuing my work around scope of practice in some new contexts.

To me, scope of practice is not only a vital issue for the nursing profession, and relates to nurses’ experiences and public perceptions of nursing work, but it also holds promise in improving access to care, as well as quality and continuity of care and patient safety. Only when nurses are working to full scope can we expect patients to benefit fully from nurses’ presence in health care settings.

In this article, I was looking for a way to bring together some important theoretical ideas to a better understanding of characteristics on which nursing administrators should consider when developing new strategies around nurses’ use of their knowledge and skills.

I and my coauthors hope the discussion will be helpful to educators, administrators and researchers concerned with this concept, as I said before, a vital issue for our profession. It deserves continued and focused attention from various quarters in nursing.

We do welcome your comments and ideas related to the important issues discussed in this article!  You can download this article while it is featured on the ANS web site – then return here to share your comments!