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Making specialist nurses fill rota gaps is a ‘false economy’

Without adequate support, families often feel they have little choice but to take children to hospital at the first sign something is wrong.

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Specialist nurses are avoiding costs for their Trusts by developing innovative services that keep children with epilepsy out of hospital.

Advice lines and support for families, schools and young people, home visits and specialist clinics make managing conditions such as epilepsy easier for children and those who care for them.

Yet as the nursing shortage continues to bite, managers often think that specialist nurses can be moved to fill rota gaps, but this is a false economy as it deprives patients of their expertise and leads to unintended consequences, claims the Royal College of Nursing.

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Not only is this bad for patients, but it could also be putting pressure on other parts of the health and social care system, as well as schools.

Epilepsy can be extremely distressing for children.

Without adequate support, families often feel they have little choice but to take children to a hospital at the first sign something is wrong.

But specialist nurses such as Kirsten Johnson are pioneering ways of helping families manage epilepsy that cause less distress and disruption for children and parents.

Kirsten, who works at Sherwood Forest Hospitals NHS Trust, provides the first point of contact for families with children suffering from epilepsy, giving them access to the support they need to avoid hospital visits.

As part of an RCN leadership development programme, Kirsten undertook an economic assessment of her service which allowed her to demonstrate the value of her role to the trust.

A hotline service she set up to offer parents, young people, carers and schools immediate expert guidance now receives more than 1,200 calls and almost 2,000 texts per year. This alone has freed up almost £85,000 worth of resources in just one year. The hotline allows her to offer help when people need it most, and Kirsten’s timely advice means more episodes can be safely managed outside hospital.

Home visits offer another direct line of support to worried parents, and specialist clinics allow Kirsten to monitor medication and make sure it’s being administered correctly.

Closely managing epilepsy in this way helps to prevent distressing seizures, so Kirsten’s young patients can avoid as many emergency hospital visits.

When patients do have to go to hospital, Kirsten visits them on the wards to let them know about her specialist service and see if they need help.

The condition can be managed.

Kirsten Johnson, a specialist epilepsy nurses at Sherwood Forest Hospitals NHS Trust, said:“Epilepsy can be extremely frightening for children and their parents and often causes a huge amount of distress.

“But it is a condition that can be managed. If parents, schools and carers have specialist help just a phone call away, offering both reassurance and practical help, it gives them the information and confidence to care for a child with epilepsy effectively.

“I really enjoy my job, and seeing the difference it makes to children, young people, their families and the Trust is very gratifying.

“My role is an essential part of the epilepsy service here and would and like to see similar roles in as many Trusts as possible.”

Dr Ann McMahon, research and innovation manager at the RCN, said: “We know specialist nurses play a vital role in managing many conditions such as epilepsy, but this study has revealed the enormous benefits they bring not only to patients, but to the trusts they work for and the wider economy.

“It shows that investment in specialist skills could ease pressure on multiple parts of our health and social care system as well as offering better outcomes for patients.

“By empowering specialist nurses to demonstrate the value of their services in this way, we are in turn helping to secure and develop services for children and their families enabling them to live as full and independent lives as possible.”

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Education

One in six nursing associates drop out before qualifying, finds report

Despite this trainees showed “high levels of enthusiasm and commitment to the programme”.

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Only 65% of trainee nursing associates said they planned to work as a nursing associate once qualified.

An independent evaluation of the nursing associate role commissioned by Health Education England (HEE) has found that while there are “high levels of enthusiasm and commitment to the programme”, one in six nursing associates are dropping out before completing the course.

Attrition rates for trainee nursing associates fell slightly below that of student nurses, with 18% leaving before completing the course.

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While ill health and personal issues were some of the most common reasons for leaving the programme, nearly a quarter (23%) withdrew because they failed to meet the academic requirements of the programme – with numeracy skills cited as a key issue.

One trainee said they found the “attitudes towards the role and the negative feedback about Nursing Associates” challenging.

Only 65% of trainees said they intend to continue working as a nursing associate once qualified as the programme is often seen as a stepping stone to becoming a registered nursing.

Highlighting challenges.

Mark Radford, Chief Nursing Officer, Health Education England said the report “highlights some challenges that we must address to ensure that students such as ensuring the quality and oversight of placements, attrition and numeracy support.”

“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 MDT. 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.

Commenting on the report, Andrea Sutcliffe, Chief Executive and Registrar for the Nursing and Midwifery Council (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.”

“I look forward to seeing how nursing associates continue to develop and be supported in their work, long into the future.”

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Education

UCAS accused of having an ‘outdated’ view on nurses

They describe the nursing role to prospective students as looking after people when they are sick or injured.

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UCAS describes nurses as providing “support to doctors and other medical staff”.

The Universities and Colleges Admissions Service (UCAS) has been accused of having an “outdated” view on nurses after it described the profession as providing “support to doctors and other medical staff”.

UCAS describes the nursing role to prospective students as looking after people when they are sick or injured. Adding; “You’ll provide support to doctors and other medical staff, take blood and urine samples, and in some cases, you may carry out minor surgical procedures.”

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Nurses, alongside a multitude of other healthcare professionals, have taken to social media calling for the description to be amended so it “adequately reflects nursing in the 21st century”. They also criticised the article for failing to highlight a large number of health promotion and research roles frequently undertaken by the profession.

BJ Walto, a senior member of the Royal College of Nursing (RCN) commented that the description is “inaccurate, demeaning and totally misleading portrayal of nursing.”

Tom Wavlin, a Lecturer in Adult Nursing & Admissions Tutor at the University of Plymouth, suggested the description could instead read; “an autonomous practitioner of nursing who works closely with other healthcare professionals”.

In comparison, the Nursing and Midwifery Council (NMC) website reads; “Registered nurses play a vital role in providing, leading and coordinating care that is compassionate, evidence-based, and person-centred. They are accountable for their own actions and must be able to work autonomously, or as an equal partner with a range of other professionals, and in interdisciplinary teams.”

A spokesperson for UCAS said; “It’s clear that our current role profile for nurses doesn’t reflect the amazing work that nurses across the country do each day, and we welcome the feedback we’ve recently received.

“We want to make sure that students considering their future options have up-to date information about all different careers available to them.

“We’re currently updating all of our job profiles and are in touch with nursing experts to help us make sure that we better reflect the roles and responsibilities of nurses today.”

UPDATE (17/10/19 09:55): This article was updated to include a comment from UCAS.

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