Increasing demands on the skills of qualified nurses and a recognized shortage of personnel in the NHS emphasize the need to maximize scarce resources and realise the full potential of the nursing contribution. One strategy has been to introduce higher level support roles in line with the recommendations of the DoH (1997) report, often utilizing NVQ qualifications. This study using focused interviews explores the perceptions and experiences of a group of Health Care Assistants who had completed a development programme at level three NVQ. The transcribed interviews were phenomenologically analysed using a framework developed by Hycner in 1985. The emerging themes suggest that they view nursing and its role differently from nursing assistants, but similarly to that of previous State Enrolled Nurses. The development increased their sense of alienation from all other grades of nurse, but afforded improved job satisfaction. Questions are raised in relation to the impact on skill-mix and care delivery from a higher level of support, career progression and the effect on the qualified nurse's role. More research is required to assess the impact of developing higher level support roles and what might constitute the registered nurse's unique professional role, before new supportive or substitutory roles are developed on a larger scale in line with Government directives.
Copyright 2002 Published by Elsevier Science Ltd.