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Warning that lack of training and support leaving nursing directors unprepared for role

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There is a severe shortage of experienced and skilled directors of nursing, because of a lack of development to help support nurses move into executive roles.

That was the view of the audience at a fringe event organised by the Royal College of Nursing Executive Nurse Network held at the RCN’s annual congress in Liverpool last night.

“They are in shock, and I am not exaggerating about that”

Irene Gray

Speaking during a panel debate, network chair Irene Gray said: “Nursing directors: heroes or modern-day scapegoats?

“I coach new directors of nursing when they come into the role and as they realise that all roads lead to them they are in shock, and I am not exaggerating about that,” she said.

She said that new directors of nursing have to get to grips with a range of accountabilities around quality, infection control and outcomes and often have had no prior support in understanding these responsibilities.

Matthew Hodson, chief nurse at Virgin Care, agreed. He said it was imperative that a trust chief nurse was regarded as equal to everyone else on the board, but that senior nurses were not given support to move into executive roles.

“The average life expectancy of a director of nursing at a trust is three to four years”

Tom Sandford

Staying in these roles was made harder by the lack of experience, according to several chief nurses in the room.

Heather Caudle, chief nurse at Ashford and St Peter’s NHS Foundation Trust, said: “These jobs are hard.

“We need to deliver safe care and leave people feeling happy and looked after in hard circumstances,” said Ms Caudle, who will soon be leaving her trust to become NHS England director of nursing for improvement.

Other speakers highlighted the risk that nursing directors could become scapegoats for performance issues.

Ursula Gallagher deputy chief inspector for primary care at the Care Quality Commission, said: “When things are less functional in some organisations, it is a quick fix to get rid of a couple of people.”

Chairing the debate, Tom Sandford, director of the RCN England, noted that nursing directors lost their jobs a lot more regularly than other members of the board.

Ashford and St Peter’s NHS Foundation Trust

NHS England recruits trust chief nurse and RCN director

Heather Caudle

“The average life expectancy of a director of nursing at a trust is three to four years,” he said.

In addition, Ms Caudle said that black and minority ethnic chief nurses could feel invisible on some boards.

“The psychology of stress is that you scapegoat someone who is visibly different,” she said. “I talk a lot about the anxiety of individuality. It can feel like isolation if you are visibly different to your board.”

Responding to a student’s point that there should be more leadership and management skills given in nurse education, there were also calls for more continuing professional development (CPD).

Jackie Smith, chief executive and registrar of the Nursing and Midwifery Council, said: “If we are not developing our students to become the future leaders, we really have not got this right. We have to support these people to get that right.”

Kath McCourt CBE, a former RCN chair of council, agreed: “The point of registration is not the end of the learning journey for nurses. It must be the start of the CPD journey.”

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