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Summary In community hospitals, and units for people with learning disabilities, the theoretical framework of Oxfordshire nursing services was used to examine the complementary roles of nurse and support worker. This framework proposes that the mix in nursing teams should be determined by the needs of patients/clients. The sample consisted of directors of nursing services, senior nurses/managers, nurses, support workers and patients/clients. Data were collected by utilizing a multimethod approach. Findings showed that in the deployment of grade‐mix the needs of clients/patients were overlooked. In the community hospitals the primary nurses were the main caregivers regardless of whether the patients needed the qualified input. Conversely, in the units for people with learning disabilities, the main involvement of direct‐care staff disregarded the fact that needs of many clients could only be met with a nurse's input. In their present supervisory role the primary nurses were posed with the problem of losing client contact.
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Ahmed et al. (1993) studied this question.
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