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‘It’s time to articulate the value of registered nurses’

  • 20 Comments

A new role is to join the nursing family. The nursing associate position has been given the rubber stamp by the chief nursing officer for England, who publicly approved its introduction on the NHS England website last week.

She says: “The role is designed to enhance the quality of personalised care, strengthening the support available to registered nursing staff and reducing the reliance and dependency on registered nurses to undertake elements of care that others can be trained to understand and do.”

This is a role that has divided opinion more bitterly than any other issue, and that is in a year when we find ourselves with no shortage of issues in nursing over which to argue.

”This is a role that has divided opinion more bitterly than any other issue”

Much of the argument against the role has arisen through fear that it will be used to substitute graduate nurses. It was described by the outgoing head of nursing at Unison Gail Adams as “nursing on the cheap” at a recent round table at our Team Leaders’ Congress earlier this month.

I can sympathise with her view. 

But isn’t that a moot point right now? While many directors of nursing are crying out for registered nurses to fill their vacancies and struggling to provide care safely, you can’t really substitute what isn’t there. And right now there aren’t enough nurses, and safety and quality are being put at risk.

”This role has the belief and support of the government and nursing’s professional lead in England”

A solution, call it a quick fix if you like, was needed. This role has the belief and support of the government and nursing’s professional lead in England. Now it’s time to make sure it isn’t used to erode the graduate profession. 

What this profession and its leaders must do is keep a careful eye on what happens now. If the government starts hoodwinking the public into thinking nursing associates are registered nurses, then we have a problem. If trust finance directors start pushing for more nursing associates and fewer registered nurses to keep the pay bill low, then we have a problem.

There has never been a more important time to articulate the value of the registered nurse. And all those in the profession – and definitely those leading it – must do that to protect and preserve the graduate role.

 

  • 20 Comments

Readers' comments (20)

  • As a 2nd year student nurse I do have concerns about this new role in so much that it could de value the registered nurse role. I'm working extremely hard to achieve the position of a registered nurse and I do not want to be considered anything less. I agree that more staff are needed but perhaps if the government stopped their ludicrous behaviour on capping the wage tyen there would be more.

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  • Interesting piece but it isn't 'fear' that is galvanizing professional opinion against the 'associate nurse' but a down to earth realisation of just how this so called 'new' role is going to be used within the current healthcare market, given the reality of cost reduction, which is guiding almost all decisions within today's NHS trusts and private care providers. Anyone truly in touch with what's happening in UK health services can see this cleatly.You cannot let the Department of Health magic up a new role out of thin air like the 'associate nurse', where the postholders will be authorised to administer medication etc, then talk about preventing the erosion of the RN role. That's trying to close the stable door after the horse has bolted, and symptomatic of a weak profession that cannot govern itself. Imagine the outcry there'd be in the legal profession if paralegals were authorised to undertake the work of a solicitor or a barrister ? The legal outcry then would be discussed in terms of professional competence, corruption of ethics and protection of public safety. Those charged with leading this venture know very well that the bursary cuts will ensure the universities play along with training this 'new' role, as their income from students is very likely to decrease, when home grown talent cannot afford to train, or are averse to taking on debt, in order to enter a nursing degree. So the universities newly-funded to pilot the 'associate nurse' role are now very busy tarting up their old dip!oma nursing curricula, without really knowing what the competencies are for this 'new' role or who exactly will regulate it. What a crazy situation is that? And what true profession would allow the politicians (helped on mercilessly by politically subservient lackeys like the CNO and Bayliss-Pratt at al) to ride roughshod over their beloved profession? It's not rocket science to work out that this is all about cost saving, and cynically inflating the numbers in the workforce so ministers can claim political wins at the next election, and nothing very much to do with quality care, or what the current research evidence shows, which is actually that the more RNs you employ the better are the patient outcomes.

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  • I think it's called reinventing the wheel! Can't see how morale is going to be boosted by this. As an RN of 20 + years I am now very cynical of anything they try to expect us to believe!! However as always Nursing will do what it's told. We are not the best at sticking up for ourselves in my experience.

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  • We are trying, and have asked Jenni Middleton for help by passing on our comments to Jane Cummings ( see the article and comments on "New role will reduce reliance on nurses " says CNO.

    So far no comment from JM..

    Kevin sums up the situation perfectly.

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  • Jenni Middleton

    Sorry I was busy yesterday all day when I got your message yesterday Lesley, as we had the HRH reception for the finalists of the Nursing Times Awards during the day and then the Nursing Times Awards in the evening, so I didn't have time to call you. I talked to Jane about this when I saw her at the event last night, and told her I would email this link to her which I have just this second done.

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  • michael stone

    JENNI MIDDLETON 27 OCTOBER, 2016 4:05 PM

    Thanks Jenni, I also re-asked that question by reporting myself to NT earlier today. I hope Jane Cummings responds - will NT please 'clearly publicise any response from Jane Cummings' so we readers will find it if NT posts it somewhere ?

    As for not replacing RNs - it might have helped if you had not started your article with:

    'A new role is to join the nursing family'

    because the new role is called Nursing Associate and not 'something nurse'. Personally, I think a title which was a prefix to HCA would have been better - something like Senior HCA or Advanced HCA.

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  • Jenni Middleton

    Michael that is why I deliberately wrote they would be part of the "nursing family". Already, healthcare support workers and healthcare assistants are commonly called/considered part of the nursing family by registered nurses/healthcare professionals, but that doesn't mean they are nurses. This role would also be part of that family but not a registered nurse.

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  • michael stone

    Jenni, you didn't put 'nursing family' in quotes though: many of us, when using a term we think is a bit problematic, put quotes around things (the Neuberger review of the LCP placed quotes around 'pathway' after explaining that it didn't like the term).

    There is a lot of confusion around terminology in the NHS - for example, some guidance reserves 'carer' for unpaid carers ['family carers'] but normally people would think of nurses, doctors and HCAs as being involved in 'caring for patients': which means most laymen would see nurses as 'carers'. But various bits of core guidance, don't describe any of the professionals as 'carers'.

    And here on NT, I think you will get some objections to any 'implication' that HCAs 'are nurses'.

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  • Jenni Middleton

    But I don't believe that nursing family should be in quotes, it's what nurses call them. And I think the whole focus of the article was about articulating the value of registered nurses.

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  • Jenni Middleton

    As requested, I referred Jane Cummings to the comments on this site and sent her this thread, and she has asked me to post this link to her blog on the NHS England website in response. So here it is:

    https://www.england.nhs.uk/2016/10/jane-cummings-25/

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