Developmental phases and factors influencing role development in diabetes specialist nurses: a UK study

Abstract

Abstract

This paper is a report of a nationwide study of diabetes specialist nurses (DSNs) which explored experiences engendered during their role development and factors influencing this process.

The role of the clinical nurse specialists, including that of the DSN, has been described as advanced, flexible and multifaceted. They experience a role development process before being able to function with maximum effectiveness, although limited work exists in the literature which explores this process.

The study was underpinned by Hamric and Taylor’s role development model which includes seven phases: orientation, frustration, implementation, integration, frozen, reorganisation, and complacent. A postal questionnaire combining quantitative and qualitative approaches was sent to 653 DSNs working in Great Britain. The response rate was 51% (n=334). Quantitative data were analysed using the SPSS statistical package and qualitative data were analysed using content analysis.

Respondents reported positive and negative experiences engendered during their role development. An additional phase, transition, emerged from respondents’ comments and reflected experiences of expert DSNs moving to a different post. Barriers and facilitators to role development were also identified.

Role development is a complex process and is influenced by factors deriving from the work setting, personal characteristics and the nature of the DSN role. Based on findings, strategies are suggested for successful role implementation and for minimisation of the negative developmental phases. Further research is required to examine the relationship between developmental phases and role performance