Following handover on a cold and wintery Monday morning, I was chatting to one of my patients while waiting for his coffee to cool down enough for him to drink.
I asked him how his weekend had been. He sighed and said it was okay but there had been a lot of agency nurses on who didn’t know a lot about the ward and the patients. This meant he had not been able to get up until lunchtime because the agency nurses were not competent in all the management procedures.
I have never done any agency shifts as I like where I work. I like the stability and I’m not confident enough to walk into a different ward each shift. I did work bank shifts for a few months but that was in the hospital where I had worked. I knew the policies, the environment and the paperwork. I really enjoyed those shifts and learnt a great deal, refreshing my knowledge of orthopaedic care for adolescents, but it took me a couple of shifts to settle in.
I must have asked about a hundred questions on my first shift, which probably drove everyone mad as it is a busy unit, but thankfully the nursing staff were very welcoming and invested their time for me to be an effective member of the team.
It must be very challenging to do agency nursing in specialist areas as you cannot know everything, and you cannot be expected to be able to do all the tasks in the way an experienced and competent member of the nursing team can.
So how do we make it easier for agency nurses and ultimately our patients?
For me, it is all about investing the time at the beginning, which isn’t easy when wards are busy and the buzzers are going off. But if we invest the time to make agency nurses feel wanted and valued, there is a greater chance that they will return and continue to increase their knowledge and skills – making them a more effective member of the team.
First impressions on both sides will have an impact on the way the agency nurse works with permanent staff. We need to welcome them to our wards and show them where essential equipment is (such as crash trollies and hoists); where the staff toilet and staff room are; and signpost them to who to talk to if they need assistance during the shift.
“We need to focus on what the agency nurse can do and use their skills and knowledge efficiently”
It is also vital that we show patients that agency nurses are a part of the team as it must be very difficult when patients make it clear they are not impressed that they are being looked after by the agency nurse.
Due to high vacancy levels, wards have to use bank and agency staff at times that can be challenging for everyone, but we either do our best to make our wards a friendly and inviting place to work, or we struggle to manage everything with not enough nurses.
That said, agency nurses need to be open to learning new skills and adapting to the different care interventions that patients require.
We need to focus on what the agency nurse can do and use their skills and knowledge efficiently. In fact, we may learn something from them as well as teaching them new skills.
Sian Rodger is health coaching nurse facilitator at the London Spinal Cord Injury Centre