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Nursing associates: Negative attitudes from colleagues is ‘major challenge’

Negative attitudes from colleagues including nurses is a ‘major challenge’ for trainee nursing associates, an independent evaluation of the role has found. 

Some trainee nursing associates feel nurses see them as a threat to their jobs and as ‘nurses on the cheap’, leading consultancy firm Traverse - who carried out the evaluation commissioned by Health Education England (HEE) - to recommend that more awareness be raised around the role. 

Suggestions included launching standardised uniforms, public information campaigns and a nursing associate ambassador’s scheme, the latter of which HEE is currently working to deliver.  

 

The evaluation, which tracked the progress and experiences of the 2,000 nursing associates on the two-year pilot, found high levels of enthusiasm and commitment to the programme overall.

But it raised concerns around the16% of trainees who dropped out of the programme. Of those, 23% said they did so due to not passing academic assessments – representing 4% of the total number of people who had started training as of September 2018.  

To address the issue, the evaluation said HEE should explore introducing pre-application numeracy programmes 'to help applicants secure the necessary competence to begin the course'.

Likewise, it urged HEE to consider introducing a part-time trainee nursing associate programme to reduce workload challenges, as just 60% of respondents branded the workload manageable.

A lack of protected learning time – which varies across home and placement settings - exacerbated the problem and trainees had to undertake much of their academic work during evenings and weekends.  

However, nearly nine in 10 (85%) of trainee nursing associates said they felt prepared to enter the workforce as they neared the end of the programme, while seven in 10 said they were satisfied with the programme.

Most (76%) of trainees were also satisfied with their placement setting but some felt they had been used as a healthcare assistant to fill rota gaps. 

‘Some trainees felt that this had limited their exposure to learning opportunities that could have further developed their skillsets,’ the report explained.  

‘Steppingstone to nursing’  

Seven in 10 trainees surveyed applied to the programme to progress their careers and develop their skills and capabilities.  

The evaluation found the role is widely seen as a steppingstone to nursing as nursing associates are able to put their training towards a shortened nursing degree. 

Close to half (47%) of respondents said they intended to enrol on a pre-registration nursing degree programme within three years of qualification. 

Meanwhile, two-thirds (65%) said they intended to continue working as a nursing associate in their current setting in the next year, while a fifth (19%) said they would continue as a nursing associate in another setting.  

Mark Radford, chief nursing officer for HEE, said the findings show that trainees are motivated and have been given an opportunity ‘progress their careers’, but added that HEE must address issues including attrition and numeracy support.  

He continued: ‘We also recognise that further work and research is required to ensure that the profession is supported and utilised in the workforce of health and social care as part of the multi-disciplinary team.  

‘I am pleased to be able to report that we are in the process of identifying candidates to be considered as NA ambassadors across England.’ 

Lisa Bayliss-Pratt, pro vice-chancellor at the University of Coventry, who developed the role for HEE, said that the trainee nursing associate role is becoming ‘an intergral part of the health and care workforce’.  

She added: ‘It is also pleasing to see that the role is being considered as a steppingstone to becoming a registered nurse, as was originally intended when the role was created.’ 

Andrea Sutcliffe, chief executive and registrar for the NMC said: ‘Having had the pleasure of meeting many nursing associates across the country, I am continually inspired by their enthusiasm and dedication for providing care and they should be very proud of the difference they make for the people they support.’ 

The trainee nursing associate role was designed to bridge the gap between healthcare support workers and registered nurses. 

It also aims to support the career progression of care assistants, increase the supply of nurses and enable nurses to undertake more advanced roles.  

The trainee programme is a two-year foundation degree that includes a total of 3000 hours of work-based and academic learning.  

Trainees must complete a minimum of 675 hours in placements across three health and care settings: hospital, at home, and close to home settings.  

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