The Expanded Role of the Nurse: A Position Paper, by P. Hayes, P. A. Field, R. E. McClure, H. Hiskala and S. Stinson

Abstract

This position paper on the expanded role of the nurse reflects the opinions of the director of the University of Alberta School of Nursing and the program co-ordinators. For many years nurses in the rural areas of Western Canada and in the isolated area of the Canadian North have functioned in expanded roles, without these being designated as such. However, emerging societal and governmental pressures related to reducing health care costs, better utilization of health care workers and the need for selected types of physician substitutes to provide medical care in remote areas, have together created a trend toward greater formalization of "expanded" roles for nurses. At the University of Alberta, we have tended to identify the expanded role of the nurse in terms of developing "independent" aspects of nursing in the care domain. Our focus is on developing greater depth of knowledge and skill for assessment, teaching, counseling and using judgement concerning nursing competency limitations. In effect, this approach prepares the nurse to function as a nurse practitioner in the realm of primary care. However, we are also cognizant of the additional need to prepare some nurses to fill an extended role, where they are capable of performing tasks which are "normally" considered to be the purview of the physician.