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Scotland to debate bill to drop caseloads for charge nurses

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Senior nurses in Scotland must be free to lead and manage their teams in order to ensure safe care, nursing leaders have said ahead of a key debate on new staffing law.

The calls come as members of the Scottish Parliament prepare to debate legislation that could ensure senior charge nurses (SCNs) in hospitals and the community no longer have their own caseloads.

“The SCN role is one of a leader, a manager and a clinical expert”

Jasmin Clark

The Royal College of Nursing in Scotland has been campaigning for all SCNs to be made “non-caseloading” and this is included in a staffing bill currently making its way through parliament.

It is one of a series of amendments to the Health and Care (Staffing) Scotland Bill due to be debated tomorrow.

However, there are fears the change – which was secured by the Green Party – could be dropped.

Ahead of the debate nurses have spoken out to highlight the importance of ensuring senior charge nurses – equivalent to ward sisters in England – have supervisory or supernumerary status.

Currently many senior charge nurses were “overloaded with competing demands”, explained Jasmin Clark, advanced nurse practitioner at NHS Lothian.

“The SCN role is one of a leader, a manager and a clinical expert,” she wrote in a blog for RCN Scotland.

”However, to carry out this role effectively the SCN needs to have not only the capability and capacity but the time to deliver this,” she added. 

In order to be effective, SCNs should be non-caseload holding, said Ms Clark, who is an RCN steward.

“The SCN should be an additional member of the team to provide clinical expertise, leadership and support – not counted in the team and allocated a number of patients to care for,” she added.

She claimed the “burden of expectation” placed on SCNs who are responsible for the overall standard of care in their department was deterring competent nurses for applying for such roles.

“Mistakes can be made and a lot time staff feel they are not being supported”

Lesley Clark

RCN representative Lesley Clark said it was “hugely important” for SCNs like her not to have a caseload.

“If staff are struggling or need support, I can help them,” she told the Daily Record newspaper.

“As an SCN you are a clinical expert and make sure experienced or student nurses are working well,” she added.

“Staff can come and speak to me about any concerns. If I have a caseload it is more difficult. Mistakes can be made and a lot time staff feel they are not being supported,” she added.

RCN Scotland’s campaign comes on the back of research that found caseloads and admin work were getting in the way of senior charge nurses fulfilling their role.

A freedom of information request to health boards in 2017 found that of 911 senior charge nurses only 115 were non-caseload holding.

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