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Setback for advanced nurses

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The government is turning a blind eye to compliance with the European working time directive – a move set to affect thousands of advanced nurse practitioners who have stepped into gaps left by junior doctors.

Officials have stopped monitoring whether trusts are complying with the directive to “limit” its impact on the NHS, the Department of Health has told Nursing Times’ sister magazine HSJ. The rule restricts staff to working a maximum 48 hour week and has applied to junior doctors since 1 August 2009.

The medical royal colleges had complained that the directive left junior doctors without enough time for training.

Many nurses have said they were left with bigger workloads and less time for basic care, while others found it gave them the opportunity to advance their practice by making clinical decisions normally carried out by trainee doctors.

It is widely believed that trusts will now unofficially extend the hours of junior doctors again, which may affect nurses who have moved into more advanced roles.

Swansea University nursing department head David Barton told Nursing Times that trusts may decide that asking junior doctors to work longer hours is more cost effective than employing advanced nurse practitioners on band 7 or 8.

A nurse on the lowest point of Agenda for Change band 8 earns £38,851, compared with the £22,400 rising to £27,800 received by junior doctors in their first two years of hospital training.

However, Mr Barton predicted this move would not be universally popular with senior doctors who had become used to working with experienced nurses.

He said: “If you talk to consultants, they say, ‘I’d prefer to have nurse practitioners because they’re more reliable.’ They bring high levels of communication, they’re very good at the bedside and are also coming in with diagnostic skills.”

He added: “Do we really want a trainee doctor working 100 hours a week? Advanced nurse practitioners bring with them a package of skills that a junior doctor probably doesn’t have.”

A Nursing Times survey in January found 60 per cent of respondents felt restricting junior doctors’ hours had led to the development of advanced practice roles.

More than half were more inclined to challenge medical staff as a result of the change.

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Readers' comments (1)

  • Kind of goes with the territory though doesn't it? Unprotected and unregulated roles with no definative educational / experiential prequesites ad hoc development and mentorship. Flexibility works both ways.

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