Nursing Associates …

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