Essential clinical skills

Abstract The everyday practice of delivering nursing care involves a range of clinical skills. These address the practical remit of nursing, and sit alongside the knowledge, interperso nal skills, observational skills, and professional values of individual practitioners. With developments in clinical technologies and interventions, the ever-changing nature of nursing roles, and growing numbers of advanced nurse practitioners and specialist nurses, the boundaries of what constitutes clinical nursing skills are changing. Specialist nurses may now perform clinical procedures once considered the sole remit of medical staff, such as diagnostic endoscopies, minor surgical procedures, or cardioversion clinics. Similarly, nurses working in critical or intensive care areas may be skilled in invasive procedures, such as the insertion of arterial lines or tracheostomy tubes. However, there remain a large number of clinical interventions and procedures which form part of the general adult nurse’s everyday work. Nurses normally learn to perform clinical skills through observation and supervised practice, guided by their tutors, supervisors, mentors, and senior colleagues. While some clinical skills appear complex, all are underpinned by the same knowledge base—knowledge of human anatomy and physiology, understanding standard infection control procedures, understanding the reasons for clinical interventions, good communication skills, timely and accurate documentation, and a degree of manual dexterity. All clinical procedures must always be performed with consent, whether verbal or written, and must ensure both patient and personal safety at all times. This chapter outlines the key principles of essential clinical skills likely to be part of the remit of general adult nurses.