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Economics of evidence about nurse specialization.

If nurse specialization is to flourish within the expected financial constraints then advocates will have to focus attention on research-based evidence about clinical practice that is relevant to clients. This article examines the kinds of evidence that might be sought and considered before decisions are made about the allocation of scarce resources to nursing services. It is suggested that reasoned decision making for health services in that context would require convincing evidence that each particular commitment of resources to nursing can be expected to contribute as a set of inputs towards the best possible achievement of overall objectives for health services within the anticipated constraints on resources available. If so, it would be reasonable to expect that those with resources to allocate will seek and will consider evidence about costs associated with nursing, including adverse risks, as well as that about relevant benefits from nursing. Advocates for nursing, or for specialisms among nurses, would then do well to demonstrate that they take evidence about both benefits and costs seriously when presenting their case, rather than dismiss either as being merely an annoying and unreasonable distraction.