A nurse-led tissue viability service in Malta

Abstract

This article discusses the key issues I personally faced in setting up and running a nurse-led tissue viability service in Malta. I will highlight relevant areas that helped in the process: gaining knowledge and experience, developing an accessible service, working with professionals who are interested in working with you, creating a national and international network of support, being politically astute and taking hold of any opportunity to increase awareness of the service. I thought it is important to write about this experience because often these vital nurse initiatives are not documented and nothing is available for new nurses to go back to in order to learn about their predecessors’ journey. My hope is that this will not only shed light on some important elements that helped me in the development of a national service on Malta, but also will encourage other nurses who might be thinking about pursuing a similar journey. In recent years, both locally and internationally there has been a marked increase in the number of nurse-led clinics in a variety of specialties. Across Europe this has been brought about by, among other factors, shortage of doctors (or the changes to working hours), advancing and expanding nursing skills and filling the gaps in the healthcare service. However, the development of specialist nursing positions seems to be related to the culture and advancement of nursing in the specific country. For example, in Malta there is no shortage of doctors, nurses do not have prescribing powers and the role of the advanced nurse practitioner or physician’s assistant is still not realised. Therefore, the roles of nurses in Malta seem to expand and develop in areas that are considered to be the nurse’s domain such as wound care, stoma and incontinence care.