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A student nurses' view on the new nursing associate role

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The new role is said to have been developed in order to bridge the gap between registered nurses and healthcare assistants. Student affairs editor, Anthony, considers its implications.

Recently I was invited to take part in the Nursing Times roundtable event discussing the nursing associate role. Healthcare assistants, band 5 nurses and student nurses came together to discuss the role with representatives from Health Education England and the Nursing and Midwifery Council.

It was an interesting discussion and one which I, obviously, went into with a preconceived agenda.

Personally, I do not support the introduction of the nursing associate role and while I think that my reasoning is supported by evidence and an understanding of the precarious position in which nursing currently finds itself, that doesn’t mean that I do not think we have to provide more training and routes into nursing.

I think this point is being missed by nurses and students like myself at the moment.

We are very strong, as can be seen on nursing groups on social media, at declaring what we are against and why. We are weak, however, on finding a positive resolution to the problem of providing more training and routes into nursing for experienced healthcare assistants and future applicants to nursing who will no longer be able to afford a traditional degree (essentially everyone).

“How long before the funding for nursing associates is scaled back?”

My major concern with the nursing associate role is one I think should exist for patients, staff and employers - it removes the financial safeguard that protects the educational standards of our healthcare workforce. Nursing associates’ funding will come entirely from local governmental funds via their NHS trusts.

How long before the £22 billion of underfunding, which has already seen band 5-9s’ continuing professional development (CPD) funding reduced, affects the CPD funding for bands 1-4?

How long before the funding for nursing associates is scaled back? Probably when the experienced band 2s and 3s have already graduated and aspiring nurses who can’t afford to undertake a degree are trapped in a system that can’t afford to train them to a safe standard but will undoubtedly punish them when they fail to practice safely.

Either insidiously or incompetently, our government and nurse leaders are, in my opinion, creating the breeding grounds for another scandal over patient safety and it is horrifying to think that it will be a scape-goated nursing associate who is blamed for the system that was set up for them to fail within.

“It seems impossible to foresee a scenario in which nursing associates won’t be reclassified in future “safe staffing” guidelines”

The new role is being introduced at the same time as the NHS bursary is being removed, we’re potentially losing over 30,000 EU workers and who knows how many non-EU international staff due to Brexit, as well as having one in three nurses ready to retire in the next 10 years.

It seems impossible to foresee a scenario in which nursing associates won’t be reclassified in future “safe staffing” guidelines to give them greater autonomy and responsibility over the next 10 years. We have too many vacancies and a professional voice that is inadequate to the challenge of standing up to both the government, the media and our trust’s managers.

“We need more nurses and investing in nursing associates within the current global context is not going to help us improve patient safety ”

We all know why we are necessary, but the rest of society doesn’t seems to.

Graduate registered nurses reduce patient stays, mortality rates and the risk of complications. This message should be plastered across Health Education England’s twitter feed as it is an unarguable fact. We need more nurses and investing in nursing associates within the current global context is not going to help us improve patient safety but in my opinion will in fact remove the very concept of a graduate nurse altogether.

What I think we should actually aspire to is a system where NHS students’ funding comes directly from a dedicated central fund that is planned by independent workforce experts who were not appointed by government but the NHS. These NHS students should be paid and work for the NHS but the hours they work should be signed off towards their registration.

They should be trained to degree level by higher educational institutions and both the courses and the students should be regulated by the NMC.

“I will never be as experienced as the healthcare assistant I met on my first placement”

This may sound similar to the current system, but in fact it will override the fragmented nature of our NHS, which is what I think allows for such a chaotic situation as the nursing associate, apprentices and student loans to be introduced simultaneously. This is why I think that we need to have centralised planning for the UK’s entire healthcare workforce. Delegating and devolving it is just an excuse for the government to transfer the responsibility and the blame.

I think that this productive vision for workforce planning is what needs to happen from all students and staff who want to enter the discourse around the nursing associate. Otherwise, we are not only appearing to stand in opposition to better training and support for our less privileged colleagues but actually stopping them from doing that.

I will never be as experienced as the healthcare assistant I met on my first placement who had been working for 30 years and was about to retire. She worked hard to ensure that I could have the best learning experience possible during my time there, the least I can do is fight for people like her to have the same opportunities.

What do you think?

Join Anthony and Nursing Times editor Jenni Middleton in a Twitter debate on the nursing associate role on Wednesday 30 November at 7:30pm. Follow #NTtwitchat to join the debate, ask questions and share your views.

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Readers' comments (2)

  • Excellent comment.

    I hope Jane Cummings and Lisa Bailey- Pratt get to read it, and more importantly start listening to their frontline staff instead of cosying up to the government .


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  • As was said at the round table meeting, this will happen regardless of how people feel about it because they have to try something??? In the interest of public safety and health outcomes is this really a gamble that they want to take? Watch this space.

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