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Nursing Associates

Consultation on Modern-Day SEN or ‘Nursing Associate’ Launched by HEE

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In December 2015 the government announced plans to introduce a new ‘Nursing Associate’, compared to many as the modern-day State Enrolled Nurse or SEN – Health Education England (HEE) has now launched its consultation.

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This new role was announced by the Department of Health in December alongside significant changes to the routes and pathways into Nursing, it is claimed these steps will ensure there will be sufficient Nurses in the future to meet the ever-increasing demand and open up spaces for a more vocational style of study.

According to the HEE website, “The new role is expected to work alongside care assistants and registered nurses to deliver hands-on care, focusing on ensuring patients continue to get the compassionate care they deserve. This new role has the potential to transform the nursing and care workforce and making sure the role has a clear entry and progression point will be crucial in its development.

They also state, “Overall, we want to create a new type of care worker with a higher skillset to assist, support and complement the care given by registered nurses.

Unions have heavily criticised the role claiming it will lead to more confusion around and responsibilities to both the healthcare workforce and patients.

Both the NMC and RCN have made it clear that registration and regulation for Nursing Associates is paramount and maybe the key to the success of this new role.

Many Nurses have compared the new roles to that of the State Enrolled Nurse (SEN) that was abolished as part of ‘Project 2000’.

The consultation is open to anyone interested in the new role including; patients and users of health and social care, nurses, care assistants, employers, students, educationalists and healthcare organisations.

You can take part in the consultation by completing this online survey or by downloading a survey response form and emailing it to [email protected].

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NMC launches consultation on proposed standards for nursing associates

Under the plans nursing associates would also be subject to the same revalidation requirements as nurses and midwives when renewing their registration with the NMC as well as the same fitness to practise processes should something go wrong.

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The Nursing and Midwifery Council has announced the launch of the consultation the proposed approach to the regulation of nursing associates.

The Nursing and Midwifery Council (NMC) have outlined an approach to education including ambitious standards of proficiency for the role that will enable nursing associates to deliver first-class care.

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According to Health Education England (HEE), the Nursing Associate role is a new support role which will sit alongside existing healthcare support workers and fully-qualified registered nurses to deliver hands-on care for patients. The role is designed to bridge the gap between healthcare assistants (HCAs) and registered nurses.

2,000 trainee nursing associates are currently just over half-way through their two-year training programmes to become registered nursing associates and HEE has announced 45,000 extra places before 2027.

The NMC has set out how they expect the existing Code, with a new introduction, to apply to nursing associates as well as nurses and midwives, ensuring that the same high standards of professional behaviour and conduct will apply to everyone on the register.

Jackie Smith Chief Executive and Registrar of the NMC said: “This is a hugely exciting step on the road to regulation for this new profession and we want to hear the views of all those with an interest in the role.

“We think that our proposals will ensure that nursing associates are equipped with the skills they need to deliver excellent patient care and to support registered nurses and other health and care professionals throughout their careers.”

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Under the plans nursing associates would also be subject to the same revalidation requirements as nurses and midwives when renewing their registration with the NMC as well as the same fitness to practise processes should something go wrong.

Over the coming weeks, the NMC will be holding workshops across the country for trainees, registered nurses, employers, patients and the public. There will also be regular twitter chats and webinars with lots of opportunities for people to learn more about what regulation means for the new role and share their views.

The Consultation on the regulation of a new profession will run until 2nd July 2018.

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Nursing associates set to administer medications under PGDs

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Health Education England recommends that nursing associates be allowed to administer medications under patient group directions.

New medicines advisory guidance by Health Education England (HEE) has revealed that nursing associates should be allowed to administer medications without a specific patient-named prescription under patient group directions.

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The news comes only days after the Nursing and Midwifery Council (NMC) revealed a list of clinical skills nursing associates should be competent in.

What is a PGD? Patient Group Directions (PGDs) currently allow nurses to supply and administer prescription-only medicines (POMs) to patients using their own assessment of patient need, without necessarily referring back to a doctor for an individual prescription.

PGDs are used in both primary and secondary care settings, usually by nurses or pharmacists, for commonly used medications that pose a low clinical risk to patients.

Commonly included medications include; paracetamol, flu vaccinations, salbutamol nebulisation, oxygen, peptic and various laxatives – but included medications are dependent on the area of clinical practice and the scope of the practitioner.

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Currently, Nursing Associates, as a new profession, are not on the list of professions lawfully allowed to administer medicines under a PGD but HEE guidelines say this is likely to change.

In the document from Health Education England they state;

Providers consider Nursing Associates should be able to administer some medicines under PGDs as this would be advantageous to patient care without compromising on safety.

Once regulated, a Case of Need15 would need to be made by NHS England through the Department of Health Non-Medical Prescribing Board, to seek agreement from Ministers for a public consultation.

HEE added however that nursing associates cannot be added to the approved list until they formally become a regulated role and a public consultation should need to first take place.

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NMC reveals 90 skills nursing associates should be trained in

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The Nursing and Midwifery Council has unveiled a list of ninety skills that nursing associates should be trained in.

The NMC’s draft skills annexe contains around 30 communication skills and 60 clinical procedures, including medicines management, drug calculations, and clinical assessment skills that nursing associates should be competent in.

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2,000 trainee nursing associates are currently half-way through their two-year training programmes to become registered nursing associates.

In October 2017, the NMC released the draft standards of proficiency for nursing associates which will work alongside the annexe.

According to Health Education England (HEE), the controversial new role is intended to act as a bridge between healthcare assistants and registered staff. HEE has plans to train a further 45,000 nursing associates before 2027.

The list of skills include;

  • Manage the administration of oxygen.
  • Use appropriate nasal and oral suctioning techniques.
  • Manage inhalation, humidifier and nebuliser devices.
  • Manage airway and respiratory equipment.
  • Carry out drug calculations for a range of medications.
  • Administer drugs via oral, enteral, topical and inhalation routes.
  • Administer injections using subcutaneous and intradermal routes.
  • Observe and reassess a patients’ skin and hygiene status.
  • Manage catheters for both genders.
  • Provide stoma care.
  • Recording and interpreting vital signs.
  • Complete and interpret urinalysis results.
  • Complete and interpret blood glucose results.
  • Undertaking venepuncture and cannulation.
  • ECG recording.
  • Administer basic mental health and physical first aid.
  • Undertake wound care using aseptic techniques.
  • Appropriate escalation of clinical concerns.
  • Understand ‘DNACPR’ decisions and verification of expected deaths.

Other skills include the management of end of life care patients, infection prevention and management, managing falls and supporting nutrition, hydration and sleep and providing holistic care.

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Finally, nursing associates will be expected to have a knowledge of common conditions including anxiety, depression, diabetes, dementia, asthma, cardiac disease, chronic obstructive pulmonary disease, cancer, skin problems, immune deficiencies, psychosis, stroke and arthritis.

The NMC has reiterated that these are draft plans and remain subject to change – a new version for consultation is expected in April 2018

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