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In the UK, student nurses, nursing associates and midwives are supervised by practice supervisors and practice assessors while completing the placement-based component of their training. Because of increased clinical commitments, staff shortages and rising student numbers, demands for the supervision and assessment of student nurses have increased in recent years and this was exacerbated by COVID-19. The Nursing and Midwifery Council's Standards for Student Supervision and Assessment separated the roles of practice supervisor and assessor, giving rise to opportunities to assess students in a different way. Some integrated care systems are exploring the new role of roaming assessor. Roaming assessors can fulfil the role of practice assessors while providing additional support for student nurses. This role could be expanded to other health professions. This article explores the use of practice learning facilitators as roaming assessors for student nurses in the UK and evaluates the potential benefits and limitations of this approach. Roaming assessors may provide a useful service to deliver practice assessments, increasing the reliability and availability of assessments. [ABSTRACT FROM AUTHOR]

Background: Health and care staff have limited opportunities to design, deliver and lead critical enquiry activities. Aims: To explore barriers and enablers of building capacity, capability and confidence of these practitioners who wish to undertake critical enquiry activity. Methods: A realist conceptual framework including the development of middle range theory allowed analysis of the scholarship process and outcomes. Data were collected through snap surveys, interviews (face to face and online) and project output (posters). Results: Nine scholars completed the programme and all participated in the study. They all experienced an increase in capacity, capability and confidence in critical enquiry activity. Six overarching themes arose from analysis of the interviews and snap survey data: value; expertise; attitudes; meaningful, responsive support; brain space; and skill and knowledge acquisition. Discussion: A combined focus on people and project while staff remained embedded in their work area was key for the growth of skills and knowledge and creating impact from projects. Guilt at having dedicated time to take part in the programme was a self-imposed barrier to building capacity and capability. Social capital (gained from bringing together individuals from different groups with shared values) facilitated bonding, which increased psychological safety and helped enable capability and confidence. Conclusion: The combination of theory and practice embedded in a real-world context led to positive outcomes for staff, patients, carers and the facilitation team as real-life changes were made in clinical environments. [ABSTRACT FROM AUTHOR]

Background: Redeployment in health care can have a negative impact on the mental wellbeing of staff. Advanced planning and provisions for wellbeing support for health professionals has been recommended following previous pandemics. At the authors' institution nurses were redeployed overnight from a specialist cystic fibrosis ward to a COVID-19 high-dependency unit. Aim: To evaluate nurses' wellbeing following this redeployment during the first wave of the COVID-19 pandemic. Method: A mixed online survey, consisting of both open and closed questions, based on literature, preliminary results of the Impact of COVID-19 on the Nursing and Midwifery Workforce (ICON) study and staff feedback. This was sent to 28 nurses to explore their feelings and experiences of redeployment to a COVID-19 environment. Purposive sampling was used to select study participants while thematic analysis and descriptive statistics were used to analyse the data. Findings: The survey had an 86% response rate. Using thematic analysis three key themes emerged: redeployment anxiety, lack of organisational preparedness and newfound teamworking. More than half (57%) of respondents expressed anxiety and concern when told of their redeployment; 52% reported that they did not receive adequate support from senior staff and management. However, 74% reported that they felt their nursing was positively influenced by support and teamwork from those in patient-facing roles. Twenty-five percent reported that they were looking for a new job or leaving their current role. Conclusion: This study examines the effects that redeployment to a COVID-19 environment has had on nurses. It highlights the need for further improvement to ensure redeployed staff are supported to safeguard their mental wellbeing. [ABSTRACT FROM AUTHOR]

Objectives: There is limited literature on the experiences of internationally educated nurses (IENs) who have joined NHS trusts in England in the past 20 years. The objectives of this integrative review included exploring and analysing the experiences of IENs in the NHS in England and identifying the cultural, pastoral and training needs of IENs during their first 2 years working in England and providing research-informed recommendations to better support IENs. Design: An integrative review of primary research studies using quantitative, qualitative, and mixed methods of data collection. Data source: CINAHL, British Nursing Index and Google Scholar. Results: Nine articles met the inclusion criteria for this integrative review. All articles contributed to the findings of three main analytical themes: expectations, challenges and belongingness. Conclusion: Limited research fully met the search criteria. This was concerning since IENs have been working in the NHS for decades, yet so few primary studies have been conducted into their experiences. The findings were in line with previous studies, which found that IENs faced challenges both in the workplace and in settling into an English way of life, and often reported feeling that they were not treated equally to their English counterparts. This integrative review raises issues and increases awareness of how the NHS in England can better support IENs transitioning into their new life and ways of working, to further aid recruitment and retention of the international nursing workforce. [ABSTRACT FROM AUTHOR]

The article offers information on the initiatives led by an experienced infection prevention and control (IPC) nurse during their career, particularly during the COVID-19 pandemic. Topics include improving standards of care for central venous catheters (CVCs), enhancing care for peripheral vascular access devices (PVADs), and developing a skilled and efficient IPC link workforce.

Investment in nursing is key to having a healthy workforce and a healthy population. NHS Chief Nursing Officers for Scotland, Northern Ireland, Wales and England Alex McMahon, Maria McIlgorm, Sue Tranka and Ruth May reflect on policies adopted over the past year aimed at developing the healthcare workforce [ABSTRACT FROM AUTHOR]

The professional nurse advocate (PNA) programme was launched in March 2021, which was towards the end of the third wave of COVID-19 and the start of a critical point of recovery. COVID-19 placed exceptional challenges and pressure on healthcare staff, with many experiencing feelings of stress and burnout. The role of the PNA emerged as a response to the impact this had upon the nursing workforce. PNAs are trained to facilitate restorative clinical supervision and to advocate education for quality improvement, resulting in improvements to patient care and staff wellbeing. The programme started with 400 critical care nurses; since then it has been rolled out to all specialties, with the aim to have 5000 PNAs integrated into the national workforce by April 2022. Criteria for the level 7 PNA training programme requires a registered nurse to be working in a patient-facing role, at band 5 or above, hold a level 6 qualification and have approval from their line manager. The training programme is typically 10 to 12 days in length over a 12-week period. This article explores the implementation of the PNA role in a critical care unit. [ABSTRACT FROM AUTHOR]

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses what stakeholders in health and patient safety want the next government to deliver [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic restricted face-to-face contact between students and educators, limiting continual assessment of student's clinical skill development. This led to rapid transformational online adaptations to nursing education. This article will present and discuss the introduction of a clinical 'viva voce' approach, which has been used at one university to formatively assess students' clinical learning and reasoning skills using virtual methods. The Virtual Clinical Competency Conversation (V3C) was developed using the 'Think aloud approach' and involved facilitated one-to-one discussion based on two questions from a bank of 17 predefined clinically focused questions. A total of 81 pre-registration students completed the formative assessment process. Overall, feedback from students and academic facilitators was positive and facilitated both learning and consolidation in a safe and nurturing way. Further local evaluation is continuing to measure the impact of the V3C approach on student learning now that some aspects of face-to-face education have resumed. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges faced by the social care workforce in the UK, including high turnover rates and difficulties in recruitment and retention. Topics include the economic impact of social care, the need for a person-centred approach in nursing education to prepare students for social care settings, and proposals to establish social care nursing as a recognized fifth field of practice.

Background: During the COVID-19 pandemic, healthcare organisations around the world had to optimise resources and redeploy staff to meet unprecedented demands on services. This service evaluation aims to establish the experiences of nurses redeployed to a COVID-negative Nightingale ward during the first wave of the pandemic in the UK. Methods: Purposive sampling using a survey was used to capture nurses' experiences. Data were extrapolated to meet the aims of the thematic line of enquiry and descriptive statistics used to analyse the data set. Results: The response rate was 34.0% (n=30). The majority of redeployees (76.7%; n=23) strongly agreed or agreed the trust induction had been beneficial. Informal learning, including from colleagues, was said to be very helpful by 50.0% (n=15) and helpful by 36.7% (n=10) of participants. Most (90.0%; n=27) agreed they were able to maintain safety, with 93.3% (n=28) satisfied with the quality of their care. Regarding giving the care they aspired to, 46.7% (n=14) strongly agreed and 40.0% (n=12) agreed they had been able to do this. Conclusion: The advanced clinical practitioner role was central to successful redeployment, in preparing redeployees through induction and education. These practitioners facilitated the acquisition of the knowledge and skills to deliver competent care, ensuring staff had the capacity and capability to undertake their job. Patient safety was not compromised by redeployment. [ABSTRACT FROM AUTHOR]

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers proposals to increase support worker numbers, which include taking a more co-ordinated approach and better training [ABSTRACT FROM AUTHOR]

The article considers the role of simulation-based learning in delivering a modern workforce, focusing on the benefits offered by a simulated approach, while considering some of the main issues in the healthcare sector in the United Kingdom (UK). Topics discussed include benefits of simulation, opportunity provided by the regular use of simulation in clinical practice, and importance of staff wellbeing to staff retention.

The article focuses on the challenges faced by the National Health Service in aligning its workforce growth with the increasing demand for healthcare services, particularly due to factors such as an ageing population and vacancies. Topics include the importance of effective clinical placements for both learners and healthcare facilities in addressing workforce shortages, the factors contributing to learner attrition and strategies to enhance learner retention by fostering a sense of belongings.

The article focuses on the challenges faced by the public health nursing workforce in England, including recruitment, retention, increased workload, and demand. Topics discussed include the Professional Nurse Advocate (PNA) Advocating and Educating for QUality ImProvement (A-EQUIP) program, its role in enhancing workforce wellbeing and resilience, and the importance of implementing the model to support staff wellbeing in public health nursing teams.

The article reflects on the significance of International Nurses Day (IND) 2024, emphasizing the value of registered nurses and the importance of celebrating their contributions to society. It discusses the theme set by the International Council of Nurses (ICN) for IND 2024, focusing on the economic power of care and the need for investment in nursing. It highlights challenges such as underinvestment in the nursing profession, recruitment and retention issues.

An editorial commemorates International Nurses Day, acknowledging the profound contributions of nurses globally. It celebrates their unwavering dedication, resilience, and compassion, drawing inspiration from the legacies of nursing pioneers like Mary Seacole and Florence Nightingale. It emphasizes the importance of supporting nurses and prioritizing their wellbeing within healthcare systems to ensure the continuation of exceptional patient-centered care.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the issue of long-term workforce planning, focusing on England [ABSTRACT FROM AUTHOR]

The article focuses on the reliance of the National Health Service (NHS) on international recruitment to address workforce shortages, emphasizing the growing proportion of internationally educated nurses and midwives in the British healthcare system. Topics include the scale of international recruitment in healthcare, regional disparities in reliance on international staff, and the strategic investment in training, development, and retention efforts to ensure a sustainable healthcare workforce.

Simulation has become a core component of nursing curricular worldwide. Within a three-year, pre-registration degree typically students would not be exposed to disaster type situations and it was believed that a well-coordinated simulation exercise could replicate this. It was hoped that the simulation would require students to think quickly on their feet and transfer acquired skills. Worldwide disasters including the current novel coronavirus have, heightened the need for well-prepared resilient health professionals capable of responding to many different types of emergencies including mass casualty situations. The simulated event involved 80 adult field student nurses, 19 probationer police officers, 6 photojournalism students, 2 Welsh Ambulance paramedics, 5 staff from 203 Field Hospital, 2 St John Cymru Wales Officers, 1 community first responder and 6 Fire and Rescue personnel. All these individuals came together to undertake a simulated emergency response to a mass casualty incident. Behaviours and clinical skills were observed throughout the event along with interprofessional interactions [ABSTRACT FROM AUTHOR]

COVID-19 and rising student numbers are affecting healthcare education, particularly access to clinical placements. As healthcare education is increasingly supported by technology and non-traditional teaching methods, educational experiences gained through clinical placement also require new approaches. This article explores and discusses the use of a simulated clinical placement for a dietetic student cohort. During this virtual placement, students were able to explore and experience a virtual clinical setting and immerse themselves in a placement experience. A vast range of virtual resources were linked to the online placement portal, including statutory and mandatory training, dietetic resources, patient journeys and interprofessional communication. Advantages of this approach include that all students experience a given situation, unlike in traditional placements where workloads, variety and engagement vary; there is also no risk to patient safety. The aim is to enhance the learning experience to create effective, efficient clinicians. This virtual placement for dietetics is part of a bigger project to develop and evaluate the use of a virtual placement framework in a range of professions. The concept of virtual placement may have been brought forward by the COVID-19 crisis but was inevitable with the move to more technology-enhanced learning tools. [ABSTRACT FROM AUTHOR]

This article describes nurse education with the Open University in Scotland (OUiS). Although there are problems with nurse recruitment and retention across the UK, in Scotland the landscape is somewhat different, with greater support for students required in remote and rural areas. Despite these challenges, the OUiS continues to recruit to the commissioned numbers of places. OUiS nursing students are primarily health care support workers who are a key group within the health and social care workforce but historically have faced many challenges in developing clear career pathways into nursing. At the heart of the OU is the fundamental recognition of distance online pedagogy, complemented by work-based learning support by employers. Partnership working between the OU, employers and education commissioners is crucial to its success. [ABSTRACT FROM AUTHOR]

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the report of the Times Health Commission, which looked at all aspects of the NHS [ABSTRACT FROM AUTHOR]

The article focuses on the ASPIRE project, which addresses nursing shortages in the United Kingdom by offering a fast-track education program for healthcare assistants to enter the second year of the Bachelor of Science (BSc) Nursing course in Mental Health and Learning Disabilities. Topics include the project's initiation, its emphasis on practical experience and recognition of prior learning, and the positive impact observed on both healthcare workforce expansion and professional development.

The article focuses on the need to expand placement capacity in healthcare education to include social care and other settings, amidst challenges in recruiting registered supervisors and assessors. Topics include the development of a new practice education model to support placement expansion, fostering collaboration between educational institutions and placement providers, and the importance of supporting clinical staff interested in teaching and research roles.

The article introduce a series on advanced level practice which describe the frameworks that outline advanced practitioner roles and explain how the roles affect patients, services and organisations. It mentions about facilitating research and evidence-based practice, improving practice within both the clinical and education sectors, and clinical proficiency for offering better care to patients.

Preventive care was recently identified as a Government priority, which is likely to affect pressure ulcer (PU) preventive care in the NHS. Contemporary economic analyses of PU prevention interventions are undermined by factors including methodological challenges and poor inter-rater reliability of PU risk assessment tools. Healthcare demands on the NHS created by PU prevention remain unclear, although the burden is high, with litigation costs rising continuously. The poorly understood economics of PU prevention may create variation in practice. Patient expectations of PU prevention may be influenced by mainstream media, national awareness campaigns and the varied information and advice offered by professionals. Patient expectations and low levels of functional health literacy may create confusion and unrealistic expectations. This article critically examines the impact of recent changes in Government priorities related to PU prevention, considering the effects of healthcare demand, economics and patient expectations. [ABSTRACT FROM AUTHOR]

The preceptorship period is of great importance in the career of a nurse, as he or she moves from being a student to a competent, accountable professional. Problems with the current preceptorship system for preceptors include not receiving adequate training—particularly in providing constructive feedback to preceptees. In addition, when a small number of nurses are repeatedly assigned preceptees to mentor, this can lead to burnout. Preceptees can feel overwhelmed by their first months as a newly qualified nurse (NQN) and can feel unsupported if a preceptor's teaching style or personality is unsuited to them. This can lead to attrition in the nursing workforce, a current problem. This article suggests a new way of organising preceptorship, by allowing preceptors to opt in to the scheme, providing a pool of energised and enthusiastic preceptors. In turn, NQNs could initially work with the pool of nurses before being given the choice of which preceptor to work with individually. [ABSTRACT FROM AUTHOR]

The article highlights the persistent challenge in nursing education, emphasizing the disconnect between theoretical learning and practical application. It addresses the increasing importance of simulated learning environments, as acknowledged by the updated Nursing and Midwifery Council standard, to bridge gaps caused by limited clinical opportunities.

An introduction is presented in which the editor discusses articles in the issue on topics including the critical issue of rising staff illness within the NHS, attributing the alarming increase to unrelenting pressures, emphasizing the urgent need for improved working conditions.

The article argues on the devaluation of the contribution of restorative nurse assistants (RNA) in the definition of nursing by the Royal College of Nursing (RCN). It views that the nursing associate role is conflated with the role of the healthcare support worker. It calls for the acknowledgment of nursing associates, rather than put them in a limited or marginal relevance, if the expectation is for them to deliver high-quality care.

The article offers information on the historical journey of the NHS in England, highlighting its growth and expansion over 75 years. It discusses current challenges in the healthcare sector, such as nursing workforce shortages and the impact on patient care, emphasizing the need for collaborative efforts to address these issues and enhance the wellbeing of healthcare professionals.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the data indicating over-referrals to fitness-to-practise processes for certain groups [ABSTRACT FROM AUTHOR]

Jennifer Arnold, Prostate Cancer Nurse, Luton and Dunstable Hospital (jennifer.arnold2@nhs.net), runner-up in the Urology Nurse of the Year category of the BJN Awards 2023 [ABSTRACT FROM AUTHOR]

The article focuses on advanced clinical practitioners in haematology and oncology. Topics include the team complete several clinical procedures including bone marrow biopsies, central venous access device (CVAD) insertion, ultrasoundguided lumbar punctures and skin biopsies for patients with suspected graft versus host disease, and the competency documents were devised for all clinical procedures alongside clinical guidelines and standard operational procedures.

Although the focus on service provision in response to the COVID-19 pandemic has mainly been on acute and particularly intensive care, it is important to consider other services that are still needed. This is especially the case for vulnerable patients with long-term conditions, such as those under the care of an adult congenital heart disease (ACHD) service. The authors conducted a survey of ACHD nurse specialists in centres across the UK to acertain what they were planning in terms of the redeployment of nurse specialists. The results showed a range of plans with an average of half of nurses per centre being moved, but with 65% of the workforce planned to be redeployed to deal with the pandemic. The telephone advice service at the authors' own level 1 centre showed a significant increase in patients seeking advice when compared with the previous year, with large peaks following major Government announcements. Access to specialist advice for patients with complex conditions is of vital interest, for those in a wide range of specialities. [ABSTRACT FROM AUTHOR]

The article focuses on effective clinical supervision is an essential component in the development of advanced clinical practitioners (ACPs). Topics include the multi-professional framework for advanced clinical practice in England, and the refers to the need for regular constructive clinical supervision to be part of the workforce organisational structure, which will help support and facilitate has advanced practice to flourish effectively.

Claire Osborne, Paediatric Advanced Practitioner, Oxford University Hospitals (Claire.Osborne@ouh.nhs.uk), reflects on the reasons behind the nursing strikes and the level of support for action [ABSTRACT FROM AUTHOR]

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some major patient safety reports published in 2022, and considers the lessons to take away from them [ABSTRACT FROM AUTHOR]

Menopause is a natural transition affecting most women between the ages of 45 and 55. Three-quarters of women will experience mild to moderate menopausal symptoms and a further quarter will report them as severe. Symptoms can include night sweats, hot flushes, poor concentration, tiredness, poor memory and lowered confidence. The workplace can exacerbate these symptoms and for some women can influence their decision to stop working earlier than previously intended. The need for support and understanding from managers is crucial and can make a major difference to how a woman deals with her menopause. Many women enter the menopause at the peak of their productive lives. These women have valuable skills, knowledge and experience that employers need to retain, so they should be developing resources to help navigate this normal and natural stage of the ageing process. [ABSTRACT FROM AUTHOR]

The 7th National Infusion and Vascular Access Society (NIVAS) conference was held in Manchester, 12–13 June 2019 [ABSTRACT FROM AUTHOR]

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers how World Health Organization documents can point the way to improving nursing and midwifery education [ABSTRACT FROM AUTHOR]

The article discusses the importance of addressing the nursing shortage in Europe to improve the provision of care to patients with non-communicable diseases (NCD). It describes a think piece on overcoming the crisis developed based on a literature review and with insights from the European Federation of Nurses Associations and the Royal College of Nursing. It outlines recommendations from policymakers, such as improving nurses' pay and working conditions.

The author discusses the "NHS Long Term Workforce Plan" published by the British National Health Service (NHS). Described as essential in overcoming the workforce crisis, the plan focuses on the areas of training, retention and reform with a commitment to substantially grow the number of medical personnel and support staff. The author notes the significance of the absence of proposals to address the challenges in social care.

The article focuses on the National Health Service Blood and Transplant (NHSBT) Therapeutic Apheresis Services (TAS) provide treatment for both adults and children across a range of clinical specialties. It mentions the TAS workforce consists of more than 90 frontline staff, made up of lead nurses, nurse practitioners and unit assistants; and also mentions that NHSBT has a robust quality management structure and TAS has a culture that supports ongoing quality improvement.

Chief Nursing Officers for Northern Ireland, Scotland, Wales and England Jean White, Charlotte McArdle, Fiona McQueen and Ruth May all agree that, although plans to mark International Nurses' Day are on hold, we must still find time to celebrate nurses across all specialties who have responded with speed and flexibility [ABSTRACT FROM AUTHOR]

Adnan Yaqoob, Assistant Professor, Lahore School of Nursing, The University of Lahore, sets out his vision for the future of nursing in Pakistan [ABSTRACT FROM AUTHOR]

This article discusses the evolving role of advanced clinical practitioners in outpatient clinics and investigates required competency and governance and how this translates into patient care. Until recently, there has been little clear guidance in terms of how to cultivate and develop staff to the level of practice required for autonomous management of the patient pathway. This has been variable, dependent on the employing organisation and the enthusiasm for advanced practice at a senior level. The current frameworks and competency documents available are identified and how the competent practitioner can provide safe, effective care. The authors use their own practice within gynaecology as an example. [ABSTRACT FROM AUTHOR]

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers strategies for reforming social care and recognising and rewarding the work of nurses in the sector [ABSTRACT FROM AUTHOR]

The author offers observations on staff shortages and recruitment crisis in the United Kingdom (UK). Topics discussed include findings of the National Centre for Social Research's (NatCen) British Social Attitudes (BSA) survey taken between September 7-October 30, 2022, decline in overall public satisfaction with the National Health Service (NHS), according to The King's Fund and Nuffield Trust analysis, and importance of addressing the major problems with staff retention.