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Returning to nursing

A shortage of nurses has serious implications for patient safety, not to mention the wellbeing of nurses themselves. This has been confirmed by research conducted by the Royal College of Nursing. The nursing workforce is ageing, which means that serious thought about the sustainability of the profession is definitley required.

One solution is to refresh the labour pool by training more new nurses. Yet it is also vital to maintain an experienced workforce. We are therefore encouraged by the growth of ‘return to practice’ programmes designed to help people re-enter the nursing profession.

The design of the return to practice programmes highlights the importance of refreshing and updating key clinical and theoretical skills. The provision of a mentor during training, and a preceptor following training, are also positive steps.

Mentorship has been associated with a range of positive career outcomes, such as career satisfaction and more rapid promotion. A mentor may also help to revive the professional identity of the individual who is returning to nursing practice. 

There is a lot that is positive about the programmes; nonetheless, it is important to highlight some issues that are likely to impact on the effectiveness of these initiatives. In essence the challenge is this: whenever we engage in training or other forms of learning, we typically do not retain 100% of what we have learned over the longer term. People often fail to apply what they have learned in training to their actual day-to-day work, potentially wasting resources spent on training. This is known as the transfer problem.

Fortunately, there has been extensive research into methods for improving the application of learning that can help returning nurses maximise the benefits of such programmes.

Crucial to successful transfer of training into practice is the motivation of the individual. Perhaps unsurprisingly, people who are both motivated to learn and to apply what they learn are more likely to follow learning with action. It is therefore important to be aware of the reasons why individuals are returning to nursing.

It is also crucial for returners to plan for the time when their re-training is complete. It may be tempting to believe that at the end of training, an individual will have acquired the necessary abilities. Yet research has shown that transfer of training is enhanced when individuals have the opportunity to practice what they have learned.

Research by Edgar Meyer and colleagues found that nurses training in critical care skills performed better when they were given some supernumerary time in order to practice their skills. Moreover, nurses also reported greater improvement when they had continued access to assessors in order to monitor the progress of skills development. Yet, the constraints of time and other resources in the NHS may well create a barrier for newly-returned nurses to practice their skills. Therefore while we see return to practice as an important programme, it is also vital that nurses are given time to practice.

In conclusion, we should welcome dedicated individuals back to nursing, and plan how to support their return.

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Welcome people back to nursing – and support them