Towards a nurse-led service?

recent years, there have been many changes in nursing, particularly in specialist areas. In the 1990s, posts emerged in secondary care with the titles of nurse practitioner, advanced practitioner and nurse consultant. Nurse practitioners diagnose, refer, prescribe and provide complete episodes of care for clients with undifferentiated health problems. Nurse practitioners are undertaking the roles of junior doctors within neonatal units and pre-admission clinics, whereas other nurse practitioners work across the primary-secondary care interface and can prescribe following protocols for conditions such as asthma and hypertension. In units where specialist fertility practitioners demonstrate a higher level of clinical decision-making, the role of nurses has developed as their experience has been recognized. Nurses are able to monitor and improve standards of care through supervised practice, clinical nursing audit, developing and leading practice, contributing to research, teaching and supporting professional colleagues. This article will focus on the changes in fertility nursing over the years, which have placed nurses in a position to provide a holistic service for subfertile individuals. Motivated and experienced nurses within the area of fertility are fundamental to high quality patient care, and they can deliver a seamless service from primary to tertiary care, with appropriate support services made available when and if required.