Cottingham's Law: report from the working party on nursing expertise: defining nursing expertise has engaged the minds of many a fine nursing figure and filled many worthy but unread volumes. One local group offers its own take on this fascinating topic.

How to measure nursing expertise and nursing excellence? With apologies to nursing guru Patricia Benner and all those good people who've written up professional development recognition (PDRP) programmes and the like, we still really haven't got it, have we?

The Te Henga section of the Nurses' Marxist Union got together the other night and, by golly, I think we've just about cracked it. (For the purposes of this project we reconstituted ourselves into the Working Party on Nursing Expertise).

First of all, we accepted the Cottingham Criteria that we decided should become Cottingham's Law. That is: Nursing expertise increases exponentially the fewer patients a nurse works with and the longer that nurse has not worked with a patient. Oh, and the further away from patients a nurse is.

Now the thing is, we're nurses and we're on a working party. So we're not going to let a simple law, clearly stated, get away as easily as that.

Louise, the lecturer (who I suspect was taking it all a bit to heart), proposed Lou's Variation on Cottingham's Law. That is, the statement should include the phrase: Nursing expertise is the (usual but not quite) sole prerogative of nurse lecturers and educational administrators and professors.

This sub-clause is still under investigation. We were going to use Heideggerian Hermeneutics as a methodology, but Bill said Heidegger was de trop and Gadamer was the man. But Pat, the Public Services Association (PSA) rep who was our working party secretary, said he couldn't spell hermeneutics and it sounded a bit bourgeois.

Then Phil from forensics proposed the Initial Requirement. That is: Nursing expertise may be measured by the number of letters after a nurse's name. The more letters, the more expertise.

Len was a little reluctant about this, but I was all for it and so was the bottle we were on at the time, so in went that Initial Requirement. I was pretty pleased with that.

Olga, the intern, brought a really interesting perspective (thank you Olga!). She wanted to work on Olga's Amendment. Her point was that nurses who acted as expert advisers had, ipso facto, to be experts. We discussed this long and hard. Should we go on length, width or quality? Should it be the number of advisory positions? The time spent on them? Should there be a loading for being reported in the media while doing this?

No animals were harmed during this discussion, but we did probably stress our liver enzymes and maybe a few neurons were demyelinated. Anyway, Olga's Amendment reads: Nursing expertise may also be measured by the number of expert/advisory groups on which the nurse sits. Expertise is particularly well established if this (or these) groups are convened for scoping strategic directions in order to draft policy proposals. Expertise is further measured by the status of the body to whom the final report will be sent.

Whew! We really felt we were getting somewhere. Then Louise jumped back into the frame. We were getting a bit tired then, so there was less argument. Lou's Second Criteria for Nursing Expertise is therefore: Nurses who do research are expert nurses.

We had a bit of difficulty here. Lou really wanted to put: Only nurses who do feminist research are experts. But Olga, who's a bit of an idealist, wanted "only nurses who do kaupapa research are experts". But Phil (from forensics) said that, while we were in this formative state, and although he really thought that only nurses who did Tidal Model Research could be experts, he was willing to go blousy if the others did. So, Olga's original Amendment stands.

However, that got Phil going. He put up his Model Requirement. He proposed that: Only nurses who have fulfilled the above criteria and (this is the killer!) who have developed and published a nursing model can be expert nurses.

Well, that and the Soave had really knocked our socks off.

There was a nasty moment when Pat, from the PSA, asked about his wife who had been nursing in the medical ward in the local hospital for ten years. He was a little hesitant, but he said she hadn't been able to do much to fulfil the above criteria and conditions, what with kids and the mortgage and the student loan and so on. That really got len going. He said some unfortunate things about that being the very reason why nursing wasn't going anywhere in this country and what did people think they were doing not contributing to the growth and development of nursing as a profession, and why did people think their needs overrode that of supporting nursing education and policy formation and didn't Pat understand that his wife was typical of those bloody nurses who hadn't been inside a university for 10 years and didn't care and it wasn't good enough !?!?

We put him on single malts after that and gave him a milligram of Lorazepam. It sort of calmed him down.

So, for your future reference, and to aid in your career planning and professional development goals, here is Cottingham's Law of Nursing Expertise. An expert nurse is one who:

* has had less contact with patients for longer than other nurses;

* is employed in an educational institution;

* is employed in a managerial position;

* has more letters after their name than in it;

* has participated in policy/strategy/advisory working parties or acted as an expert adviser;

* has done research; and

* has developed a nursing model and written a book.

It was the unanimous opinion of our working group that these criteria constituted the sole criteria of nursing expertise.

It's about time we had some realistic standards for nurses in this fine country of ours.

* This is the first of a bi-monthly column of alternative (sometimes amusing or irreverent but always challenging) musings on our profession.

Chris Cottingham, RN, BA, MEd, DipSocSci, is a staff nurse at Moko Services, Maori Mental Health, Waitemata District Health Board.