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A further participant endorsed this: “I feel what we are saying is our role has got too big,

it’s too complex and that maybe it should be carved in two”. Participants added: “Then your associate would be based on your FTE because not every [one will need a fulltime one]”and “maybe a smaller area might have a 0.5”. For others in the group the interest was not so much in the specific title, but in having “an additional person there with the level of skill to support you”. Finally, a participant concluded:

Right at the beginning one of the comments we were discussing was the fact that we took on the CNL role because we thought we could do it. So you applied for it, you got it and you’re suddenly thinking where’s the support there’s no one to go to.

During meeting seven, the group finally committed to what they saw as the critical or key elements to the role of the CNL. This commitment came in response to my asking “What do we all think the key clinical components are to the role or the key components”? Some individuals in the group responded: “Leadership”; “leadership and management”;

p a t i e n t c a r e ; w h i l e o t h e r s d i s p u t e d t h a t i t c o u l d b e l e a d e r s h i p a n d m a n a g e m e n t o n i t s

own. Given this list, I asked whether it could be “Leadership and management and patient care”?

The group responded favourably to this suggestion with general agreement that “We really do have that responsibility to oversee that patient care”. This response led to a participant noting that, although the focus of hospitals is on patients, taking care of staff assists this focus.

If you turn the hospital upside down, the patient is the only reason

the

organisation exists and so quality, health and safety everything like that is there

to support our staff to look after our patients so if we get our patients looked after properly everything else should be there backing it up. Unfortunately it’s not, it tends to stand in the way of looking after patients and I think that’s one of

the big issues we have. And I think whether its making sure your staffing is OK and they’re getting annual leave so they’re not falling sick …. then it’s all about keeping your patients safe. Keeping your staff safe.

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