Page 3303 - Week 12 - Tuesday, 18 September 1990
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This refocusing of emphasis for the career structure, as outlined in the report, supports the original aims and objectives of the structure's design which sought to encourage devolution of authority and decision making by moving those functions towards the lower levels of the structure, thereby enhancing the desired independent role of the professional nurse.
The report recommends 61 changes to the structure, covering a broad variety of significant related issues including leadership principles, promotional issues, impact of the structure on service delivery, future education requirements, professional development for nurses and the need to align the career structure with service delivery needs. Also recommended is a major reduction in the number of positions at senior levels, the amalgamation of functions and the development of new processes for movement into positions at the base of the structure.
In the chapter on community nursing, the review panel specifically documents concerns regarding the numbers of senior positions within the community nursing service which supports a total nursing staff of 150.2 full-time equivalents. Again, I quote:
The Community Nursing Service in the ACT is composed of a Director of Nursing recently reclassified at Level 5; six Level 4.2 Assistant Directors of Nursing, two Clinical, two Education, one Management and one Resource Management; thirty seven Level 3 nurses -
and so on.
Approximately 30 per cent of the total staff, therefore, are engaged in management activities, with a consequent reduction in positions available for hands-on care. In this regard the panel further notes - and they are talking here about the base grade - that:
... a high level of individual practitioner expertise is expected of nurses in the community setting. This is reflected by their Level 2 classification.
This identifies the fact that nurses at level 2, who form the base grade nurse in community nursing, are experienced practitioners and should require minimal supervision within the career structure model. The panel further elaborates in relation to community nursing that:
In the process of implementing the Career structure in the complex organisation environment of the Community Nursing Service ... it is apparent that there has been a significant resource shift from client services to service management and non-client specific community education.
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