06 March 2018
Theresa Shaw, FoNS CEO
The announcement that a new nursing associate role was to be established back in 2016 quickly provoked debate and divided opinion.
Like many, I was a little sceptical not least because as a nurse educator in the nineties, I supported several cohorts of enrolled nurses through the conversion course. I felt privileged to work with them and see them thrive and grow in confidence as they progressed through the programmes and achieved first level registration. So with the new proposal, I was also concerned that we may be stepping backwards, both ignoring the evidence base for care outcomes when nursing interventions are delivered by registered and graduate nurses and potentially opening the door again for two levels of nurse. Yet I also listened to many Nurse Executive Directors and Chief Nurses talk about the growing vacancy rates and concern that the skill mix of the existing workforce delivering care may not be adequate to meet care demands and the potential for care failures.
Last year, I was invited to chair a conference on the nursing associate role. I accepted in the main because I realised that beyond media reports and conversations, I knew very little about the role, the nature of nursing associate training and plans for regulation. I found the day really illuminating. There was some compelling evidence presented regarding not just the national but global nursing workforce deficits; some quite reassuring details about the training programmes and strong messages for ensuring robust regulation. What I found most heart warming was listening to presentations from trainee nursing associates themselves, hearing about their career journey to date, the value of the training and their absolute commitment to person centred care – in my mind these caring and articulate individuals could easily have been student nurses. Indeed, quite a number aspire to be graduate registered nurses but this is not an option for now for a range of reasons; some do not have the appropriate qualifications to enter graduate education at this time and for many, family and other commitments mean becoming a full time student is not an option (and of course the loss of the bursary is another factor … for a later blog perhaps!).
I came away from the day feeling much more comfortable about nursing associates and the value they could add to the nursing team within their scope of practice. Some of my worries now are not so much about the role but rather about the nursing associates themselves and how they feel they are perceived by the profession. Indeed, I have experienced a few somewhat surprised looks when I have said I think the role could be positive. So last week, when I saw the ‘Punch Line’ cartoon in the Nursing Standard, page 31 offering a nursing associate going on her first shift a flak jacket I felt compelled to write! Whatever the view of professional nursing with regards to this new role, it is here now, and I believe teams delivering care in the frontline of practice are going to be quite impressed with the level of skills, competence and compassion nursing associates will offer; but above all else I hope as a profession, we can be kind and welcoming.
Cartoon from Nursing Standard, Vol 32, No 27, 28 February 2018 page 31
I commissioned a small theatre company to develop a piece of theatre around the care of older people which they set in a care facility in the future (space age!). We wanted the theatre to be light-hearted and slightly removed from ‘real life’ but also for the audience to be able to relate to the interventions and behaviours (both helpful and unhelpful) of staff taken from real life scenarios. The piece of theatre they devised lasted approximately 15 minutes long and told the story of three different residents with different conditions and struggles (one lady with a severe cognitive impairment, one gentleman who wanted to go home, but was physically in need of help and one lady recovering from a surgical operation) in the care facility and the different interactions they had with one member of staff. Bearing in mind there were only two actors, there were a few scene changes and many changes of makeshift costumes! Once run, the theatre was repeated but this time the actor who was the staff member acted as a facilitator and interacted with the audience. He explained that they were going to re run the piece of theatre but if at any point any person in the audience wanted to suggest a different interaction based on their own experience, all they had to do was shout “stop” and then come up and show the actor the different intervention, as a film director might do. If that felt too difficult for people to do in front of an audience, they could direct the actor from their chair by “phoning in” their suggestion. So, let’s be clear this is not role play – this is sharing suggestions of things to say or do, based on their own experience, which they feel will be benefit the patient and staff member.
Thoughts from the Foundation of Nursing Studies 