The CNL is responsible for the running of a clinical area with a DHB formal position description attached to the role. This position description is a document that serves to both outline function and measure performance within the CNL role. Their responsibilities include, but are not limited, to walking alongside patients throughout their health journey, contributing the nursing perspective of patient care to the multidisciplinary team and guiding nursing staff in clinical standards. This guidance incorporates the organisational expectation of performance management of the nursing staff, as well as rostering of the same staff to allow for up to 24 hour cover of the inpatient area. The role also carries a traceable accountability to quality and risk initiatives of the organisation as well as the ward budget.
The DHB is responsible for employing the CNL and the written expectations of their role contained within their position description. The main insight this project offers for the DHB where it was undertaken is that much can be done to improve both the CNLs’ and the DHB’s understanding of each others perspective. Discussion between the CNL and the DHB can take place and collaborative inquiry can be undertaken going forward with a collective responsibility to key issues. To reiterate, the CNLs involved in this research agreed the role was about leadership, management and patient care and that individually in interviews and as an action research group patients and nursing staff were very important to them. This point of overall responsibility for patient care is significant. The organisation would benefit from establishing if the role of CNL, across all areas, does govern clinical standards and is totally responsible for patient care.
Collectively, the DHB and the CNLs need to extensively review the position description and the number of nursing staff each CNL is responsible for, and look at the potential for scoping an associate CNL dependent on the size of the area. There have already been encouraging beginnings as the DHB has endorsed the group’s proposal relating to the professional development model at its early stage including the establishment of an intranet site and, more recently, the creation of a Senior Nurse Lounge.