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'We need more clarity on the nursing associate role'

  • 15 Comments

Nursing associates are the most controversial topic in the profession right now.

Some people think that they are the solution to the workforce crisis, others fear they are nursing on the cheap, many worry they will be used to substitute nurses and others feel that is a moot point while there are over 40,000 vacancies for registered nurses at present.

Views inside the first associate training camps are just as mixed – as revealed in our exclusive report. Because of the nature of the way the role is being piloted and rolled out, there are currently no finalised education standards in place from the Nursing and Midwifery Council.

As a result, there are mixed curricula and a lack of standardisation at present. I worry that these could become confusing once these nursing associates enter the employment market.

For example, taking one of the most thorny issues surrounding this role, some universities are teaching controlled drug administration and some are not – a topic covered in detail in our exclusive interview with the author of a key review of the nursing associate training programme.

It could be left up to individual employers to decide whether these new additions to their workforce should be able to administer them.

”Mixed attitudes persist in the way the new role is being received by existing nursing colleagues”

You can see how it might cause confusion, as this is a problem the profession already faces with advanced nurse roles.

When the initial cohort of nursing associates are ready to enter the workforce in 2019, the employers that trained them will no doubt hope to retain them.

But what if they want to go elsewhere – potentially, to a trust that trained their associates to do more complex tasks? Nursing associates might be willing but will they be competent enough if they have not received adequate training?

Meanwhile, mixed attitudes persist in the way the new role is being received by existing nursing colleagues. Some registered nurses are enthusiastic about gaining an extra pair of hands on their shift, while others are critical of the role.

Many trusts feel it will prove a useful support role as well as potentially creating a new route towards entering registered nursing itself. However, it is confusing and needs clarification before we go too far along creating a patchwork quilt of skills that will further confuse and divide the profession.

  • 15 Comments

Readers' comments (15)

  • The Nurse Associate role is the "rock that nursing will perish on". How is it possible that just 4 years ago we were talking about an all Degree profession! Now, because of lack of investment, poor pay etc. we are taking a "knee jerk" reaction to filling all of the vacant nursing posts with a role that is totally unclear to all concerned and places the Registered Nurse in a position where he/she now has to not only oversee the care of their patients etc. but the care of the Nurse Associate as well. I, for one, just see this as adding to my workload. When is nursing going to raise its collective voice and say ENOUGH!!

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  • What a shame and what a missed opportunity. In my eyes this could have been a way of putting another level into a struggling health service, and maybe relieved some of the nursing shortages. SENs were in place before.
    Had this been launched efficiently and with thought, organisation, commubication and clear standards, this would have led to a useful and coherent part of the workforce. However sadly it’s a shambles once again and what appears to be the result is that everyone is doing their own thing and hospitals and therefore wards not really knowing what roles and responsiblities these people are going to understate. Disgusting when will we learn

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  • Jane Cummings was asked by Jenni Middleton some time ago to give a clear outline of what was expected from the role. Her response was never received.

    As a band 5 nurse on a busy medical ward I cannot see how the associate will fit into the routine. If they were replacing the current HCA's that would be excellent as too often HCA's are given very little training yet expected to know how to look after ill vulnerable patients. I am sure this is not what will be happening.

    It also seems that the nurse apprentice and associate names are being confused suggesting it will be easy to progress from associate to apprentice, again this should not happen as it completely undermines the role of the RGN and is an insult to those who are currently paying for their training. It is a mess and senior nurses are partly to blame by pretending it will solve all problems. IT WONT.

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  • As a Trainee Nursing Associate in this pilot phase, I too am finding difficulty in receiving clarification on my role once qualified.
    I do think it is important to remember that we are recieving training to ensure we have the knowledge we need to look after patients and any additional skills such as controlled drugs will be taught trust dependant. I can see no difference with this and the additional skills a newly qualified RN is required to obtain competencies for after qualification (which I presume happens nation wide and not only in the trust I have been employed by for 7 years) ie Catheterision, Venepuncture, Compression bandaging, IVs etc. I do understand the concerns surrounding this lack of clarity, but I feel the Nursing Associate role has had an unnecessarily negative welcome to the NHS workforce from alot of existing staff. This has made juggling the WHOLE of the first 2 years of the nursing degree (which I believe there has been alot of misunderstanding regarding what education we are recieving) alongside working full time in new settings, in a new role alot more difficult. I think we have been given an amazing opportunity and genuinely believe that once up and running fully, we can contribute greatly. Please just allow us the chance to show that with a little more positivity.

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  • The nursing associate training is not a degree!!

    Could I ask anonymous above how they would see themselves fitting into a ward scenario "bridging the gap" between the HCA and qualified RGN.

    Why should a Band 5 on a ward have to start being responsible for assessing competencies of nursing associates in additon to already heavy workloads.

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  • To qualify as a nursing associate, we must achieve a foundation degree. We will then apply to become registered by the NMC as current RNs are.
    I believe a little of the confusion regarding the RNs responsibility for a qualified NA comes from the current working of a TNA. Much like a student nurse, we have to be supervised with certain procedures now. Once we qualify as a NA, we will have sufficient skills and knowledge and competencies (although as previously stated some of these may be post qualification, the same as a RN) to assess and manage a bay of patients independently. We will be registered with the NMC so will have accountability for our own actions; a RN working alongside a NA would have the same responsibility for the NA as they would if working with another RN.
    The NHS isn't working how it could at present, due to staff shortages. I'm still insure as to why there is so much negativity towards what is hoped will make the RNs role less stressful. NAs will never replace RNs, and there is plenty of jobs to go around.
    Wasn't there similar negativity when the SEN role was abolished? I see an awful lot of similarities between that role and the NA one...

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  • As a patient and a carer of a relative with complex neurological problems I would not be happy with a NA giving anything other than basic care. Mistakes happen too easily and without the depth of knowledge that RN training provides the risk is too great when lives depend on it. The inconsistent training with no educational standards is a serious misjudgement and is dangerous if workforce movement occurs. After issues in the past with HCA moving a temporary ventricular drain incorrectly and nearly causing catastrophe we would refuse care from an NA

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  • THE NURSING ASSOCIATE ROLE IS A DEGREE!! I begin my role next Tuesday the 16th January and I find the criticism of the role disgusting, I have worked in care for over 30 years and have a vast knowledge of care in and out of a hospital setting, I cannot afford to go to university for 3 years, give up working and layout £30,000 all be it in a loan or pay it myself. The assistant practitioner role is an amazing new way to train HCA's who by the way is the backbone of the wards. We work closely with patients on a daily basis and deserve to be trained to a higher standard. And I am not knocking the nurses, as we are a team and all work together to deliver high-quality person-centred care to every patient. The nurses I have spoken to think it is a wonderful way to train and they wish they had the same opportunities. I am undertaking a 2-year foundation degree and whilst training will be paid a full-time wage as a Band 3, this enables me to work for the NHS, look after my children, no debts and to train and support the nurses. We are not replacing the nurses and we have the utmost respect for them, it is a hard, demanding job for them and they welcome our support as an AP.
    Well done government, bring out more placements.

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  • This is a positive step for the NHS as an apprentice AP doing a 2-year foundation degree with over 20 years experience I would hope that I have the intelligence to understand my role and know my boundaries. The fact is you do not do a task unless you a competent, same as any other role!! I find it an insult the way nurses are running down HCA's, most of the qualified nurses started off as HCA. I am excited about the new post and deserve it. Fortunately, our hospital welcomes Band 4's and can't wait for them to help the Band 5. Bit more positivity would be good guys!! give us a chance. I can go on to do another year at University to become a Band 5. So we will be qualified!

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  • I think the person who had a bad experience with a NA now a HCA is a great example of NOT COMPETENT - DONT DO IT. I hope you took this further and complained, but not all HCA's are quite that stupid!

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