Extended roles and the dietitian: community adult enteral tube care

Authors


Correspondence

A. M. Borthwick, Faculty of Health Sciences, University of Southampton, Room 2023, Building 45, Southampton SO17 1BJ, UK.

Tel.: +44 (0)2380 595904

Fax: +44 (0)2380 597900

E-mail: ab12@soton.ac.uk

Abstract

Background

Role flexibility is considered central to a health policy agenda stressing workforce redesign measures and professional role boundary change. Extensions in health professionals' role boundaries may involve the incorporation of new or ‘vacant’ roles, as well as the competitive acquisition of others. In the present study, the experiences of dietitians with extended roles in home enteral tube feeding (HETF) were explored and considered within the context of workforce role transition.

Methods

Six semi-structured interviews conducted with dietitians specialising in HETF were undertaken and the emergent role development for dietitians in HETF was explored.

Results

Dietetic HETF roles emerged as a form of diversification, occupying a task ‘vacancy’, commonly on an opportunistic basis. Role overlap in these community based tasks was negotiated with community nurses, privately funded industry nurses and other medical staff. Notably, role conflict was encountered only with nutrition nurse specialists.

Conclusions

To date, a lack of role exclusivity in a small and confined speciality field with multiple potential competitors has resulted in surprisingly little role conflict. Financial constraints within the National Health Service are considered likely to favour a privately funded service model of delivery, and this may have implications for dietitians specialising in this field. Dietitians also perceived an increase in professional status as a result of extended roles.

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