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Training and development experiences of nursing associate trainees based in primary care across England: a qualitative study
- Rachel King, Sara Laker, Sarah Alden, Tony Ryan, Emily Wood, Angela Tod, Michaela Senek, Bethany Taylor, Steven Robertson
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- Journal:
- Primary Health Care Research & Development / Volume 24 / 2023
- Published online by Cambridge University Press:
- 28 April 2023, e32
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- Article
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- Open access
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Background:
The nursing associate role was first deployed in England in 2019 to fill a perceived skills gap in the nursing workforce between healthcare assistants and registered nurses and to offer an alternative route into registered nursing. Initially, trainee nursing associates were predominantly based in hospital settings; however, more recently, there has been an increase in trainees based in primary care settings. Early research has focussed on experiences of the role across a range of settings, particularly secondary care; therefore, little is known about the experiences and unique support needs of trainees based in primary care.
Aim:To explore the experiences and career development opportunities for trainee nursing associates based in primary care.
Methods:This study used a qualitative exploratory design. Semi-structured interviews were undertaken with 11 trainee nursing associates based in primary care from across England. Data were collected between October and November 2021, transcribed and analysed thematically.
Findings:Four key themes relating to primary care trainee experiences of training and development were identified. Firstly, nursing associate training provided a ‘valuable opportunity for career progression’. Trainees were frustrated by the ‘emphasis on secondary care’ in both academic content and placement portfolio requirements. They also experienced ‘inconsistency in support’ from their managers and assessors and noted a number of ‘constraints to their learning opportunities’, including the opportunity to progress to become registered nurses.
Conclusion:This study raises important issues for trainee nursing associates, which may influence the recruitment and retention of the nursing associate workforce in primary care. Educators should consider adjustments to how the curriculum is delivered, including primary care skills and relevant assessments. Employers need to recognise the resource requirements for the programme, in relation to time and support, to avoid undue stress for trainees. Protected learning time should enable trainees to meet the required proficiencies.
Primary care trainee nursing associates in England: a qualitative study of higher education institution perspectives
- Steve Robertson, Rachel King, Bethany Taylor, Sara Laker, Emily Wood, Michaela Senek, Angela Tod, Tony Ryan
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- Journal:
- Primary Health Care Research & Development / Volume 24 / 2023
- Published online by Cambridge University Press:
- 09 January 2023, e3
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- Article
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- Open access
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Aim:
To explore higher education institution (HEI) perspectives on the development and implementation of trainee nursing associates (NAs) in the primary care workforce in England.
Background:Current shortages of primary health care staff have led to innovative skill mix approaches in attempts to maintain safe and effective care. In England, a new level of nursing practice, NAs, was introduced and joined the workforce in 2019. This role was envisaged as a way of bridging the skills gap between health care assistants and registered nurses and as an alternative route into registered nursing. However, there is limited evidence on programme development and implementation of trainee NAs within primary care settings and HEI perspectives on this.
Methods:This paper draws from a larger qualitative study of HEI perspectives on the trainee NA programme. Twenty-seven staff involved in training NAs, from five HEIs across England, were interviewed from June to September 2021. The interview schedule specifically included questions relating to primary care. Data relating to primary care were extracted and analysed using a combined framework and thematic analysis approach.
Findings:Three themes were developed: ‘Understanding the trainee role and requirements’, ‘Trainee support in primary care’ and ‘Skills and scope of practice’. It is apparent that a more limited understanding of the NA programme requirements can lead to difficulties in accessing the right support for trainees in primary care. This can create challenges for trainees in gaining the required competencies and uncertainty in understanding what constitutes a safe scope of practice within the role for both employers and trainees. It might be anticipated that as this new programme becomes more embedded in primary care, a greater understanding will develop, support will improve and the nature and scope of this new level of practice will become clearer.
Contributors
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- By Tod C. Aeby, Melanie D. Altizer, Ronan A. Bakker, Meghann E. Batten, Anita K. Blanchard, Brian Bond, Megan A. Brady, Saweda A. Bright, Ellen L. Brock, Amy Brown, Ashley Carroll, Jori S. Carter, Frances Casey, Weldon Chafe, David Chelmow, Jessica M. Ciaburri, Stephen A. Cohen, Adrianne M. Colton, PonJola Coney, Jennifer A. Cross, Julie Zemaitis DeCesare, Layson L. Denney, Megan L. Evans, Nicole S. Fanning, Tanaz R. Ferzandi, Katie P. Friday, Nancy D. Gaba, Rajiv B. Gala, Andrew Galffy, Adrienne L. Gentry, Edward J. Gill, Philippe Girerd, Meredith Gray, Amy Hempel, Audra Jolyn Hill, Chris J. Hong, Kathryn A. Houston, Patricia S. Huguelet, Warner K. Huh, Jordan Hylton, Christine R. Isaacs, Alison F. Jacoby, Isaiah M. Johnson, Nicole W. Karjane, Emily E. Landers, Susan M. Lanni, Eduardo Lara-Torre, Lee A. Learman, Nikola Alexander Letham, Rachel K. Love, Richard Scott Lucidi, Elisabeth McGaw, Kimberly Woods McMorrow, Christopher A. Manipula, Kirk J. Matthews, Michelle Meglin, Megan Metcalf, Sarah H. Milton, Gaby Moawad, Christopher Morosky, Lindsay H. Morrell, Elizabeth L. Munter, Erin L. Murata, Amanda B. Murchison, Nguyet A. Nguyen, Nan G. O’Connell, Tony Ogburn, K. Nathan Parthasarathy, Thomas C. Peng, Ashley Peterson, Sarah Peterson, John G. Pierce, Amber Price, Heidi J. Purcell, Ronald M. Ramus, Nicole Calloway Rankins, Fidelma B. Rigby, Amanda H. Ritter, Barbara L. Robinson, Danielle Roncari, Lisa Rubinsak, Jennifer Salcedo, Mary T. Sale, Peter F. Schnatz, John W. Seeds, Kathryn Shaia, Karen Shelton, Megan M. Shine, Haller J. Smith, Roger P. Smith, Nancy A. Sokkary, Reni A. Soon, Aparna Sridhar, Lilja Stefansson, Laurie S. Swaim, Chemen M. Tate, Hong-Thao Thieu, Meredith S. Thomas, L. Chesney Thompson, Tiffany Tonismae, Angela M. Tran, Breanna Walker, Alan G. Waxman, C. Nathan Webb, Valerie L. Williams, Sarah B. Wilson, Elizabeth M. Yoselevsky, Amy E. Young
- Edited by David Chelmow, Virginia Commonwealth University, Christine R. Isaacs, Virginia Commonwealth University, Ashley Carroll, Virginia Commonwealth University
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- Book:
- Acute Care and Emergency Gynecology
- Published online:
- 05 November 2014
- Print publication:
- 30 October 2014, pp ix-xiv
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five - The evaluation of public health education initiatives on smoking and lung cancer: an ethical critique
- Edited by Stephen Peckham, University of Kent, Alison Hann, Swansea University
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- Book:
- Public Health Ethics and Practice
- Published by:
- Bristol University Press
- Published online:
- 05 July 2022
- Print publication:
- 04 November 2009, pp 65-82
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Summary
The focus of this chapter is on ways in which public health information is communicated to the public. In particular it argues that the information concerning the relationship between smoking and lung cancer can convey the wrong messages. The authors’ research has shown that the lay public believe that cessation of smoking (or never smoking at all) is almost a guarantee that the individual will not contract lung cancer, and that if this is not the case, they feel in some way ‘cheated’. The empirical material demonstrates this very clearly. Their case is that, in order to be more ‘ethical’, the information given to the public should make it clear that smoking does not inevitably lead to lung cancer and that not smoking cannot guarantee freedom from the disease.
Introduction
This chapter considers the way in which public health education initiatives are evaluated. In particular, our concern is with such evaluation when it is done in terms of behavioural outcomes, such as how many people give up smoking. Our main claim is that this method of evaluation is scientifically and ethically flawed. We use the example of initiatives on smoking and lung cancer. This is because smoking is known to be a hugely important contributor to illness and to health inequality, and because there have been many such initiatives. However, the criticisms we make of initiatives relating to smoking and lung cancer apply equally to many other public health initiatives. Indeed, some criticisms might apply more forcefully to lung cancer initiatives, given that the epidemiological evidence for the link between smoking and lung cancer is stronger than that available for any other link between behaviour and an illness.
We begin the chapter by looking at how health education initiatives in the area of smoking and lung cancer are evaluated. We show that this is done primarily in terms of behaviour change, particularly rates of quitting. We suggest that this is because behaviour change is a good marker for future health benefits which might only accrue over many years: a drop in rates of smoking now could be expected to deliver significant health benefits in the future. However, we argue that looking at behaviour change alone is problematic, because it ignores the possibility of unwanted effects from a public health initiative. We give some evidence for such unwanted effects, based on our own empirical research.