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A way forward for nurse recruitment

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VOL: 97, ISSUE: 37, PAGE NO: 35

Noreen Cushen, MSc, RGN, is nurse consultant (oncology), Princess Alexandra Hospital, Harlow

The recruitment and retention of nurses has long been in need of an overhaul. The profession is not attracting enough new recruits and valued members of staff are leaving in droves. In an attempt to remedy the situation, many UK trusts are embarking on recruitment campaigns that aim to lure nurses from abroad. While this approach may help in the short term, it will not resolve the long-term issues of recruiting and retaining staff.

The recruitment and retention of nurses has long been in need of an overhaul. The profession is not attracting enough new recruits and valued members of staff are leaving in droves. In an attempt to remedy the situation, many UK trusts are embarking on recruitment campaigns that aim to lure nurses from abroad. While this approach may help in the short term, it will not resolve the long-term issues of recruiting and retaining staff.

Members of the East Anglian cancer care forum believe that the problem needs to be addressed at grassroots level. As health secretary Alan Milburn said (2001): 'Real change cannot be imposed from above; it has to come from below. So the next step must be to shift the centre of gravity in the NHS to front-line staff.'

The forum, which was formed in February last year, has 50 members. It aims to:

- Share good practice;

- Disseminate information;

- Inform decision-making at regional and national levels.

Meetings are held three times a year and most members are nurses, although the forum plans to open up membership to all health care professionals working in cancer care.

The forum decided to run three workshops on how to improve the recruitment and retention of staff, with particular emphasis on cancer nursing. They were titled: 'Recruitment and retention', 'Education and training' and 'Leadership'.

Recruitment and retention
Although all the workshops were held independently, each group identified similar themes. Education and training for all staff appeared to be a priority and there was a strong suggestion that this, or the lack of it, had a significant effect on recruitment and retention.

The way forward for recruitment, according to this workshop, is that there needs to be:

- A nationally agreed plan for funding and study leave based on determined national competencies and standards;

- Greater emphasis on supervision and continual professional development in the clinical setting and a higher profile for secondments, deputy posts and training rotations;

- Increased representation for nurses and other health care professionals on any working party involved in role definition;

- Nationally devised competencies for health care assistants.

Education and training
This workshop concluded that emphasising the professional development of staff might help to keep them in the NHS. It was also suggested that, although many nurse specialists were well-educated, this was not the case for nurses working in generalist areas. The suggested ways forward were to have:

- Equity of access to and funding for courses and training;

- National core competencies for courses, which would enable greater flexibility in transferring between different educational institutions;

- Development posts that would include access to an educational facilitator in clinical areas;

- More innovative recruitment schemes, such as having a three-year rotational post between a teaching hospital, a district hospital and a community trust. Such a post would give the incumbent an insight into all three organisations and could help to attract staff.

Leadership
This workshop concluded that training in leadership skills should be integrated into all levels of cancer and general education programmes. Greater access to leadership programmes, such as LEO (Leading an Empowered Organisation) and that offered by the RCN, should be available to nurses at all levels. This initiative would need to be supported by management.

The group also suggested that nurses should be able to undertake secondments or shadow senior staff. This would give them the confidence they need to participate in meetings, write reports and analyse data.

The government recognises many of the issues raised in the workshops, and The NHS Plan asks nurses to take forward some of this agenda. This has also been endorsed by Sarah Mullally, England's chief nursing officer (2001).

The workshops' findings reflect the inequity of training in the region and its potential impact on recruitment and retention, and local education providers and forum members are already looking at career pathways for cancer nurses.

The aim of this collaborative work is to produce a programme that will incorporate clinical leadership and competencies for all levels of cancer nurses. It will be designed so that all nurses can achieve academic qualifications from diploma to master's level. It will incorporate integrated options for health care assistants that will help them to achieve NVQ qualifications in cancer care.

Conclusion
The members of the East Anglia cancer care forum believe that health care workers need to act on recruitment and retention. The main theme that emerged from the workshops concerned training and education and its impact on recruitment and retention. Some members are working with a local education provider to design a training programme that will meet the needs of cancer nurses at all levels.

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