Literature Review


The Institute of Medicine of the National Academies (2011) reports that the nursing workforce can effect wide reaching change, and can function to bridge the gap between coverage and access. As well, the Commission on the Reform of Ontario's Public Services (2012) advocates that physician role functions that also fall within nursing scope of practice should be performed by nurses, in order to enhance nurses' roles and to control public expenditures. A search of the literature has identified the need and importance of nurses working to their full scope of practice. With health care professional shortages, recruitment and retention issues, and waning job satisfaction, now is the time to shift the focus to  maximizing nurses’ full scope of practicei.

Underutilisation of nursing skills and knowledge may result in compromised quality of careii. Therefore, it is vital that nurses strive to practise to full scope, and efforts to minimize practice barriers should be addressediii. Research has revealed the benefits of a maximized scope of practice for nurses, however, several studies have found that nurses are still underutilized in the healthcare systemiv. Allard et al. (2010) found that 61% of RNs surveyed felt they were working to full scope, and it has been noted that researchers, providers, and managers feel that now is the time for change.

  • A Cochrane review found that nurses with the appropriate education can provide the same high quality care as primary care physicians and produce the same patient outcomes.
  • In addition to nurses, the public also appears ready for such a change.
  • Their readiness may be due to the level of trust placed in nurses and their acceptance of nurses providing routine care.
  • It is important to note that maximizing the scope of the nursing role serves to complement, rather than replace the roles of other health professionals.