Nursing Consultation: A step towards professional autonomy

Nursing consultation is an innovative system even if this way of taking responsibilities has been proposed as early as 1970 by stomal therapy nurses. Its current development is in close relation with the demographic situation, the progress of professional skills, and economic constraints. This work wonders about professional autonomy in the practice of nursing consultation, an aspect which has been little studied until now. This question is examined through the concepts of autonomy and responsibility. More precisely, in relation to the attributes of the concept of autonomy which are: to decide for oneself, to control one's environment, in a state of awareness, to manage one's dependencies. Thirteen semi-directing discussions have been conducted in five hospitals by nurses who practise consultation in different specializations. The remarks of these professionals are analysed by themes according to the attributes of the concept of autonomy. It turns out that, from the professional point of view, nursing consultation offers certain autonomy. As a matter of fact, the nurse, alone in front of the patient, takes initiatives, makes decisions, makes choices and assumes them. In case of difficulty, she does not hesitate to appeal to resource people. This practice requires a perfect knowledge of oneself and of institutional rules. It also requires some skills developed in the concerned specialization. Through the discourse of "consulting" nurses, each attribute of the central concept of autonomy is represented. Nursing consultation, through this study, concretely expresses the notions of autonomy and of responsibility inherent in its context of activity.