Abstract:
Aim: The aim of this study was to examine the role of the stroke Clinical Nurse Specialist (CNS) in Aotearoa New Zealand and explore the components of the role. Factors affecting role development were also explored. Methods: Self-identifying stroke CNSs were recruited from a national stroke network register of lead stroke nurses. A sequential mixed methods design was used. The first phase consisted of an online anonymous questionnaire. Participants were then invited to participate in the second phase of the study which consisted of a one to one, semi-structured interview. Results: On average, participants spent the most time undertaking the clinical components of the stroke CNS role, however if they worked part time (0.7 FTE or less) they focused more on a managerial component of the role. Providing advice and support to patients and whānau appeared to be a prominent aspect of the stroke CNS role, with 92.3% of participants indicating that they did this frequently. When comparing the stroke CNS role to the National Stroke Network (NSN) job description, this appears to be a relevant description of the stroke CNS role. This is important as some participants indicated that their managers did not have a clear understanding of their job description, and often stroke CNSs were provided with generic job descriptions. While participants indicated they positively affected patient outcomes, they had no means of measuring this. Role ambiguity, inadequate FTE and increasing workload were some of the identified barriers to role development. Conclusion: The stroke CNS role makes a unique contribution to the stroke service with a focus on patient centred care. Despite this, having a stroke CNS as part of an organised stroke team is not formally recommended by the NSN, contrary to international recommendations.