An evaluation of the roles and job satisfaction of adult and paediatric endocrine nurses in the UK

Endocrine nursing practice has been changing, with the advent of more autonomous roles, involving nurse led clinics and independent prescribing, with more complex clinical case management. However, recent research highlights the emphasis on optimum patient care, but scope of practice is not always clear, leading to unequal balance in skills and capabilities, qualifications, and Agenda for Change (AfC) bandings. This study explored the remit, job components, and capabilities of adult and paediatric endocrine nurses in the UK, alongside an appreciation of work setting and organisational factors influencing role development and performance. The survey was sent via email through Society of Endocrinology nursing networks and through social media. 155 responded, with 49% of respondents working solely in adult endocrinology, 26% in paediatric endocrinology, and a mixture (25%) working in both. 37% of Endocrine Nurse Specialists (ENS) have achieved BSc degrees, 28% MSc, and 1% PhD / Doctorate level: over a quarter of respondents have completed MSc level Independent Prescribing qualifications. Clinical work is dominant, with 74% of ENSs undertaking dynamic function tests, where the majority (67%) are testing for adrenal insufficiency (AI), and 74% undertaking nurse led clinics (NLC). There is a wide range of focus within NLC, such as AI, Precocious Puberty, or Thyroid care, with most of the care focusing on detailed patient education. There is stark contrast in levels at which ENS are employed in relation to their AfC bandings, with only half working as Band 7, 40% as Band 6, 3% at Band 5 and 7% at Band 8. Advanced level practice is worthy of a Band 8 proficient level, which is evident in UK ENSs practice, although this data shows that ENSs at this level are wholly underrepresented. More focus is needed in organisational planning in line with competency frameworks, nurse management, and multidisciplinary teams.