I was taken aback last week when a furore erupted over the possibility of nursing associates being able to administer medication.
The concern expressed by both the media and several leaders in the nursing profession suggested that this was a departure from current practice. The implication was that only registered nurses could administer medication safely and nursing associates would be incapable of doing so.
I have some sympathy for the media commentators who may be unaware of contemporary practice with respect to administration of medication. I would hope for better from some nursing leaders who expressed such severe misgivings.
Let’s examine current practice. Right across the UK, healthcare assistants already administer medication in care and nursing homes, in domiciliary care and in some parts of the NHS. Many of these HCAs have not had any training or merely cursory training. Although, I hasten to add there are some employers that provide comprehensive training in the administration of drugs for their HCAs.
However, just last week there was extensive media coverage of the death of a patient who had been given diazepam by a healthcare assistant, against regulations.
It seems to me that people conflate the administration of medication with highly complex regimes such as the care of babies in neo-natal units. The reality is that every day people self administer medication and carers ensure their loved ones receive their medication in a timely and safe manner.
“We are being invited to believe that people who have been through an accredited two year programme would not be capable of ensuring that people receive their prescribed medication”
So why the criticism? Think about it, we are being invited to believe that people who have been through an accredited two year programme would not be capable of ensuring that people receive their prescribed medication.
I know that there is far more to medication management over and above the administration, such as recognising side effects, having the confidence to withold medication if there are concerns etc, I could go on.
”HCAs do carry out nursing care and many without a comprehensive education programme covering the fundamentals”
However, it seems to me that the eruption of criticism over the Health Education England pilot was more about tribalism associated with nursing than concerns over patients receiving timely, appropriate and safe treatment. I have not heard any of the critics expressing concern that HCAs are already carrying out tasks and procedures that are the province of registered nurses. Although HCAs do not have ’nursing’ or ’nurse’ in their job title, we cannot escape the fact that HCAs do carry out nursing care and many without a comprehensive education programme covering the fundamentals of nursing care.
I believe that we need well educated registered nurses and, as the healthcare needs of the growing population continues, we need to increase the number of registered nurses. However the reality is that there is a role for the nursing associate. Providing they have a programme that ensures they are competent we should support the development of this role.
”As a result of poor workforce planning over many decades we now have a major shortfall in the nursing workforce”
As a result of poor workforce planning over many decades we now have a major shortfall in the nursing workforce and it will take years to educate the number of registered nurses that will be needed. Overseas recruitment will be with us for years to come and the role of nursing associate will be essential in helping to bridge the gap in personnel in terms of numbers. I predict many nursing associates will go on to eventually qualify as registered nurses.
I call on the leaders of nurses to support this role in the interest of patient care.
Peter Carter is former chief executive and general secretary of the Royal College of Nursing