Reflection on the Implementation of a Nurse Practitioner Training Programme in a Large Cardiothoracic Surgical Unit

Objectives: Driven by EWTD, junior doctors training and cost cutting, the nurse practitioner role was expanded with acquisition of new skills. Methods: 10 experienced cardiothoracic nurses with degree level education were appointed to work with the CT1’s on the wards. Although initially supernumerary this has become a fully independent practice with a 24hour shift pattern. Foundation training was given in e.g. history taking, physical examination and management of post operative complications. University courses were undertaken including non medical prescribing and CALS. Additional training was provided by the team of consultant cardiothoracic surgeons in house and at the medical school. Results: There have been challenges including role expedition, role acceptance, role blurring, and embracing computerised paperless management of patients. Also the challenges of achieving the academic requirement for the post should not be underestimated. Gradually our role has changed with ongoing support and training, and we have had the unique opportunity to develop the service. Patients and nursing staff have benefited from the continuity of care and there has been no conflict of interest between service and training commitment. Conclusion: Despite many challenges, the programme has been successfully implemented and continues to develop with increasing nurse-led audit and research.