Specialist nurses promote and restore people’s health, and diagnose and care within a specific branch of the nursing field. Examples of such specialist nursing jobs include but are not restricted to; ambulatory care nurse, advanced practice nurse, cardiac nurse, dental nurse, community health nurse, forensic nurse, gastroenterology nurse, hospice and palliative care nurse, paediatric nurse, public health nurse, rehabilitation nurse, renal nurse, and school nurse. Specialist nurses are general care nurses prepared beyond the level of a nurse generalist and authorised to practice as specialists with specific expertise in a branch of the nursing field.
Specialist nurses work in a variety of healthcare settings, including hospitals, clinics, specialty practices, and research institutions. Depending on the specialty, they may work regular shifts or be on call. The role may involve exposure to challenging and emotionally demanding situations. Specialist nurses collaborate closely with patients, families, and healthcare teams.
Becoming a specialist nurse typically requires completing a master’s or doctoral program in nursing with a focus on the chosen specialty. National certification in the specialty area is often required or strongly recommended. Candidates also need to hold a registered nurse (RN) license and have a solid foundation in general nursing skills. Clinical experience in the specialty through internships, residencies, or practice is essential for gaining expertise.
ISCO skill level is defined as a function of the complexity and range of tasks and duties to be performed in an occupation. It is measured on a scale from 1 to 4, with 1 the lowest level and 4 the highest, by considering:
the nature of the work performed in an occupation in relation to the characteristic tasks and duties
the level of formal education required for competent performance of the tasks and duties involved and
the amount of informal on-the-job training and/or previous experience in a related occupation required for competent performance of these tasks and duties.
This knowledge should be acquired through learning to fulfill the role of specialist nurse.
Impact of social contexts on health: The social and cultural contexts of individuals` behaviours, and the impact on their health within their social and cultural context.
Specialist nursing care: The analysis of complex clinical problems, the diagnosis, initiation and evaluation treatment for patients in a multi-professional arena, within the field of specialisation.
Educate on the prevention of illness: Offer evidence-based advice on how to avoid ill health, educate and advise individuals and their carers on how to prevent ill health and/or be able to advise how to improve their environment and health conditions. Provide advice on the identification of risks leading to ill health and help to increase the patients’ resilience by targeting prevention and early intervention strategies.
Provide professional care in nursing: Provide professional care, adequate to the health and nursing care needs of the individuals, families and groups, taking into account the scientific developments, as well as the quality and safety requirements established in accordance with the legal/professional conduct regulations.
Promote a positive image of nursing: Present and preserve a positive image of nursing in specific environments of the healthcare and educational spectra.
Empathise with the healthcare user: Understand the background of clients` and patients’ symptoms, difficulties and behaviour. Be empathetic about their issues; showing respect and reinforcing their autonomy, self-esteem and independence. Demonstrate a concern for their welfare and handle according to the personal boundaries, sensitivities, cultural differences and preferences of the client and patient in mind.
Implement fundamentals of nursing: Implement the nursing theoretical and methodological fundamentals and principles, basic nursing interventions on scientific evidence and the resources available.
Deal with emergency care situations: Assess the signs and be well-prepared for a situation that poses an immediate threat to a person’s health, security, property or environment.
Provide health education: Provide evidence-based strategies to promote healthy living, disease prevention and management.
Promote human rights: Promote and respect human rights and diversity in light of the physical, psychological, spiritual and social needs of autonomous individuals, taking into account their opinions, beliefs and values, and the international and national codes of ethics, as well as the ethical implications of healthcare provision, ensuring their right to privacy and honouring for the confidentiality of healthcare information.
Manage information in health care: Retrieve, apply and share information among patients and healthcare professionals and across healthcare facilities and community.
Promote health in specialised care: Identify health promotion and education needs for patients within the field of specialisation and develop and implement strategies as appropriate.
Communicate effectively in healthcare: Communicate effectively with patients, families and other caregivers, health care professionals, and community partners.
Coordinate care: Coordinate care for patient groups, being able to manage a number of patients within a given amount of time and provide optimum health services.
Follow clinical guidelines: Follow agreed protocols and guidelines in support of healthcare practice which are provided by healthcare institutions, professional associations, or authorities and also scientific organisations.
Advise on healthy lifestyles: Promote healthy lifestyles, preventive measures and self-care by strengthening empowerment, promoting health and enhancing behaviours and therapeutic compliance, providing patients with adequate information in order to support compliance with and adherence to prescribed treatments, medication and nursing care.
Adapt leadership styles in healthcare: Adapt leadership styles and approaches to different situations concerning nursing clinical practice and healthcare.
Apply person-centred care: Treat individuals as partners in planning, developing and assessing care, to make sure it is appropriate for their needs. Put them and their caregivers at the heart of all decisions.
Advise on healthcare users’ informed consent: Ensure patients/clients are fully informed about the risks and benefits of proposed treatments so they can give informed consent, engaging patients/clients in the process of their care and treatment.
Implement scientific decision making in healthcare: Implement scientific findings for evidence-based practice, integrating research evidence into decision-making by forming a focused clinical question in response to a recognised information need, searching for the most appropriate evidence to meet that need, critically appraising the retrieved evidence, incorporating the evidence into a strategy for action, and evaluating the effects of any decisions and actions taken.
Comply with quality standards related to healthcare practice: Apply quality standards related to risk management, safety procedures, patients feedback, screening and medical devices in daily practice, as they are recognized by the national professional associations and authorities.
Listen actively: Give attention to what other people say, patiently understand points being made, ask questions as appropriate, and not interrupt at inappropriate times; able to listen carefully the needs of customers, clients, passengers, service users or others, and provide solutions accordingly.
Apply nursing care in long-term care: Enable the promotion and the development of nursing care in long term care, co-morbidity and in situations of dependency in order to maintain individuals’ personal autonomy and relationships with the environment in each moment of the health/illness process.
Solve problems in healthcare: Carry out actions, by previously identifying and analysing problems, that facilitate seeking the most beneficial solution for the patient, the family and the community, reaching objectives, improving outcomes and keeping the quality of their work.
Use electronic health records in nursing: Use electronic health records to document nursing assessment, diagnosis, interventions and outcomes based on comparable nursing classification systems and nursing taxonomy.
Apply health sciences: Apply a broad range of bio-medical, psycho-social, organisational, educational, and societal aspects of health, disease, and healthcare to improve healthcare services and to improve quality of life.
Manage personal professional development: Take responsibility for lifelong learning and continuous professional development. Engage in learning to support and update professional competence. Identify priority areas for professional development based on reflection about own practice and through contact with peers and stakeholders.
Operate in a specific field of nursing care: Operate within an extended practice role in order to carry out advanced treatment, diagnostic and invasive interventions as related to the field of specialisation.
Adhere to organisational guidelines: Adhere to organisational or department-specific standards and guidelines. Understand the motives of the organisation and the common agreements and act accordingly.
Plan nursing care in a specialised field: Lead and coordinate the treatment of patients in the field of specialisation to ensure continuous care of a consistent high quality.
Analyse the care quality: Analyse the quality of care in order to improve the own professional practice as a general care nurse.
Delegate activities: Delegate activities and tasks to others according to the ability, level of preparation, competence and legal scope of practice. Make sure that people understand what they should do and when they should do it.
Address problems critically: Identify the strengths and weaknesses of various abstract, rational concepts, such as issues, opinions, and approaches related to a specific problematic situation in order to formulate solutions and alternative methods of tackling the situation.
Promote inclusion: Promote inclusion in health care and social services and respect diversity of beliefs, culture, values and preferences, keeping in mind the importance of equality and diversity issues.
Interact with healthcare users: Communicate with clients and their carers, with the patient’s permission, to keep them informed about the clients’ and patients’ progress and safeguarding confidentiality.
Provide treatment strategies for challenges to human health: Identify possible treatment protocols for the challenges to human health within a given community in cases such as infectious diseases of high consequences at the global level.
Ensure safety of healthcare users: Make sure that healthcare users are being treated professionally, effectively and safe from harm, adapting techniques and procedures according to the person’s needs, abilities or the prevailing conditions.
Have computer literacy: Utilise computers, IT equipment and modern-day technology in an efficient way.
Coach individuals in specialised nursing care: Keep abreast of technological development and educate nurses, other health professionals and patient groups about advancements in the field of specialisation.
Contribute to the advancements in specialised nursing care: Contribute to the continuous development of the field of specialisation and research-based practice, participating in continuous professional development and research programmes, when appropriate.
Apply context specific clinical competences: Apply professional and evidence-based assessment, goal setting, delivery of intervention and evaluation of clients, taking into account the developmental and contextual history of the clients, within one`s own scope of practice.
Evaluate nursing care: Evaluate nursing care assessing mechanisms and processes for continuous quality improvement in nursing care, considering the scientific, technical and ethical development.
Refer healthcare users: Make referrals to other professionals, based on the healthcare user’s requirements and needs, especially when recognising that additional healthcare diagnostics or interventions are required.
Work in multidisciplinary health teams: Participate in the delivery of multidisciplinary health care, and understand the rules and competences of other healthcare related professions.
Carry out nurse-led discharge: Initiate and lead the discharge process of patients, involving all relevant professionals to expedite discharges. Assist bed and capacity management across the whole hospital.
Accept own accountability: Accept accountability for one`s own professional activities and recognise the limits of one`s own scope of practice and competencies.
Implement nursing care: Implement nursing care when treating patients in order to improve professional practice.
These skills and competences are sometimes, but not always, required for the role of specialist nurse. However, mastering these skills and competences allows you to have more opportunities for career development.
Prescribe medication: Prescribe medications, when indicated, for therapeutic effectiveness, appropriate to the client`s needs and in accordance with evidence-based practice, national and practice protocols and within scope of practice.
Employ foreign languages in care: Communicate in foreign languages with healthcare users, their carers, or services providers. Use foreign languages to facilitate patient care according to the needs of the patient.
