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Doctor–nurse substitution: the workforce equation
Author(s) -
Calpindavies,
Akehurst
Publication year - 1999
Publication title -
journal of nursing management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.925
H-Index - 76
eISSN - 1365-2834
pISSN - 0966-0429
DOI - 10.1046/j.1365-2834.1999.00113.x
Subject(s) - workforce , skill mix , nursing , context (archaeology) , function (biology) , balance (ability) , work (physics) , substitution (logic) , psychology , medicine , economics , health care , mechanical engineering , evolutionary biology , neuroscience , computer science , engineering , biology , programming language , economic growth , paleontology
Aim This paper examines the historical background and context to the doctor–nurse substitution debate, and then addresses the sufficiency assumptions inherent in the new nursing roles. Background The NHS Executive considers ‘new nursing roles’ as a means of substituting part of the doctors’ skills. Whilst the literature abounds with professional debate related to the desirability of nurses extending their roles, the underlying assumption of a sufficiency of skilled nurses is not considered. Methods The NHS hospital workforce data for the year 1994/95 were analysed and the changes in the overall numbers of doctors and nurses available for work were calculated as the doctors’ hours were progressively reduced. Findings The changes in skill mix were compared; firstly, as a result of the estimated potential reductions in nurses available to undertake the nursing function as movements up the nursing skills spectrum occurs, and secondly, as a result of the alteration in the balance of available skilled staff. Conclusion The policy assumption that suggests that a sufficiency of nurses is available for doctor substitution, whilst still allowing the nursing element to function may be false.