Recent expansion of the NM role prompted all NMs, and
many of their staff, to comment that NMs’ substantial remits
limited the extent to which they could be involved in
EBPI. Role overload was often cited as a reason for lack of
effectiveness and fuller engagement with EBPI.
NMs often reported (and this was supported by documentary
analysis) that their remit covered not only vast
and clinically distinct areas of practice, but also large geographical
areas, encompassing several hospital sites. Their
knowledge of the clinical areas within their remit was often
limited, as it rarely reflected their own background or experience.
Role expansion had been accompanied by a perceived
management-practice gap where management was
seen as increasingly generalized and remote from practice,
and practice increasingly specialized and remote from general
management structures. All staff considered this gap
to be an impediment to NMs facilitating EBPI. To some
extent, there was an extra impediment for those NMs in
Case C who lacked a nursing background and this was
recognized by their Nurse Director.
NM involvement with EBPI was also related to personal
interest and expertise in EBPI, and the flexibility in roles
to develop personal areas of interest: