I read with dismay the letter from Obrey Alexis (18 October) on the need for nurse consultants.

Are all nurses to be kept at the 'front line' with no real prospect of promotion and no dreams for their future career pathway?

How many nurses from the front line wishing to improve their prospects and their salaries have been lost to management?

At least they can see, in the nurse consultant role, a chance to retain patient contact, to continue to develop clinical expertise and to engage in clinical issues. Raising standards and ensuring high-quality evidence-based patient care is surely at the forefront of every nurse's aim.

The nurse consultant is in an excellent position to help raise standards and to act as a role model for less experienced nurses.

I do, however, agree that we need more nurses. We not only need to recruit more people into the nursing profession, but we need to be able to retain them once they have finished their training.

How do we encourage staff who have left the profession, and those who have moved into management, to think about returning to the clinical field?

Clinical roles must be seen to be on a par with management roles and paid accordingly.

In order to do this we need to raise the profile of nursing and to demonstrate that it has a distinct role to play, separate to that of the medical and managerial professions.

People entering nursing and those at the front line need to develop aims and objectives for their own personal career plan, with goals for their future learning needs and aspirations of what role they would eventually like to reach.

To condemn everyone to remain at the front line for ever and a day, just because we are short of nurses, would be a recipe for even fewer staff staying in the profession and a sure step to disaster.

The role of nurse consultant is a diverse, innovative and exciting one that offers the prospect of improving patient care through the development of nursing-led initiatives.

I believe everyone should be applauding this as step in the right direction rather than looking at it in a narrow and shortsighted way.

I also must protest that I am neither a mini-medical consultant nor a consultant's handmaid and I would be very concerned if this was a widespread view of the nurse consultant's role.

Carol Lloyd Nurse consultant Lincolnshire