Introduction

Over the last 20 years there have been many changes within the scope of practice in gastrointestinal nursing. In particular, the development of endoscopic equipment has resulted in the demand for skilled nurses not only to look after patients in this area but also to perform endoscopic procedures. Historically, nurses were required to attend patients whilst the doctor conducted the procedure.

This changed significantly in the United Kingdom with junior doctors' hours being reduced (http://www.doh.gov.uk/juniordoctors/ accessed 8 May 2004). The UKCC confirmed role extension in nursing with a timely document The Scope of Professional Practice in 1992. This verified nurses as personally accountable for their own clinical decision-making and allowed for the development of nursing practice roles. The implication of this publication has been far-reaching in the speciality of gastrointestinal nursing, especially with the development of nurse consultants (NHSE 1999), clinical nurse specialists, nurse practitioners and nurse endoscopists over the last 10 years.

Nurses now commonly perform diagnostic tests and prescribe specific medications in gastroenterology which were previously the enclave of the medical fraternity (http://www.doh.gov.uk/supplementaryprescribing/ accessed 8 May 2004; NMC 2002a). Additionally, with an increased understanding of organic gastrointestinal conditions and the widespread recognition of the need for psychosocial support for gastrointestinal patients, in areas such as inflammatory bowel disease, advanced gastrointestinal nurse consultants, nurse specialists and nurse practitioners have evolved to deal with holistic patient care in these conditions.

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