Protected funding and time for training is essential if nurses are to develop their careers and realise long-term health service plans, says Paul Cornforth
It is possible to do a lot with very little – rustle up a meal for four with a few leftovers, work a long day on two hours’ sleep, staff a unit with no staff at all. But when it comes to furthering nurses’ skills with limited post-registration training, this mantra no longer works.
How does the government expect there to be a constant stream of qualified nurses to fill advanced practice roles, when there is no commitment to guarantee funding towards this goal?
Largely, we sail by the seat of our pants and just manage to scrape through. But the lack of protected funding year-on-year makes basic fundamentals of leadership and management, such as workforce planning, totally impossible. In some cases, staff are so desperate to develop their skills, knowledge and career pathways, they will go into thousands of pounds of debt in order to fund their education themselves.
Why is the government unwilling to guarantee this long-term funding? Why is it failing to support those nurses who are eager to develop their skills and knowledge to take on the advanced roles they want to, in order to deliver the endless stream of new initiatives such as NHS walk-in centres?
It should dispose of its laissez-faire attitude to career development and, instead, offer a definitive career progression plan for such nurses. After all, what is on offer for qualified nurses other than working on the wards? There is nothing clearly set out in terms of options and there is no guaranteed funding or training opportunities for such development.
A colleague and I often talk about how lucky we were – we did our advanced practice qualification several years ago, were offered places in the first wave of NHS walk-in centres and funding to undertake a postgraduate course in our newly chosen clinical environments. These chats usually take place while discussing how we can attract funding for our many staff who are keen and hungry to develop within advanced and autonomous practice before retiring. So what is the way forward?
Once a defined career pathway has been developed for advanced and autonomous roles, nurses need to be told how to proceed in terms of experience and training, and what is available afterwards. I feel slightly stranded as a consultant nurse with three years’ experience in this role. What’s next? Where do I go? What is out there for me, other than other management posts?
The government needs to put its money where its targets are and provide a firm, long-term commitment for post-registration nurses, their education and career development. It also needs to provide a time commitment for staff willing to train and undertake autonomous practice roles – such as community matron, nurse practitioner and independent nurse prescriber – by giving a guaranteed funding commitment for study leave.
Imagine a manager telling a member of staff in the independent sector: ‘Oh yes you can do the course but you need to do it in your annual leave or your own time’. Regularly heard in the NHS, such conversations make it sound as if nurses are undertaking courses for fun rather than to develop skills and improve patient care. It is time to stop relying on our goodwill because that is drying up fast.
In addition, it is time to tighten up the standards of pre-registration nurse education and training because the quality of applicants sometimes leaves a lot to be desired. And if pre-registration is not right, then the issue of funding for post-registration education and career pathways will be somewhat academic because – assuming they actually make it through the course – the nurses qualifying will struggle to undertake ward-level posts, let alone anything with an advanced-practice focus.
Paul Cornforth is a consultant nurse in south-west London