International Nurses Day 2020: The value of nursing associates

On International Nurses Day 2020 (May 12), Denise Baker, Head of School of Allied Health and Social Care at the University of Derby, reflects on the growth of the pioneering nursing associates training programme and the value of the role in such unprecedented times as these. 

Back in 2015, the government announced plans for a new addition to the care workforce to enable healthcare professionals to develop their skills to become a registered nursing associate, complementing care provided by healthcare assistants, registered nurses and other allied health professionals. 

Eleven sites across the UK were chosen to deliver the first wave of training, run over a two-year period, and the University of Derby was one of them. 

In January 2017, more than 100 trainee nursing associates arrived at the University. Six months earlier, organisations from across the East Midlands including educational institutions, care homes, acute, community and mental health trusts and hospices, had come together to agree a consortium approach to the nursing associate training programme and four training providers had worked fast and furiously to develop curricula for them to study. Partnerships had been forged where none existed previously and new ways of working had been developed at pace. No one knew exactly what the outcome would be but, almost like pioneers, we all felt it was territory that needed to be explored. 

Looking back, that day is filled with a mixture of memories for me. It had been an intense six months; initially there was a team of two and we knew we needed to teach four cohorts across two sites. It was new, it was unknown and, already, I felt part of something which would fundamentally alter how healthcare would be shaped in the future.

On the first day back in January 2017, there was a buzz of excitement. Videos of welcome from Health Education England were played, guest speakers came to talk about the importance of the nursing associate role, trainees were encouraged to get to know each other and local senior NHS staff were on hand to offer their own support. But no one really knew what the next two months would bring, let alone the next two years. 

Fast forward to 2019, the first cohort of trainees had completed their foundation degree and were ready to enter the professional register as a nursing associate. Some had stepped aside during that time, but the majority had blossomed. There have been national events where trainees have spoken about their experiences, there has been national debate and scepticism about the role, there have been happy and sad tears, but throughout, there has been determination; determination to succeed, to make their families proud, to make a difference to people’s lives because they can offer care differently to before – determination to be pioneers. 

All education is an opportunity for personal development, as well as a time to acquire new knowledge and skills. Working on the development of the health and social care support workforce, however, has been a personal career highlight. Many students have come into university feeling they weren’t good enough, were too old, didn’t have the right IT skills, had been ‘failures’ at school or just thinking that it was too late for them now. Foundation degrees and higher apprenticeships have enabled us to challenge those perceptions and provide learning opportunities for hundreds of support workers, either as nursing associates or assistant practitioners. 

One quality which higher apprentices definitely do not lack is enthusiasm. Their confidence increases week by week and by the time the first module is nearing completion after eight weeks, the majority have settled into university and are well into their stride. Yes, it’s challenging – they have demanding jobs,and busy lives and now they are taking on a full-time course of education. However, they bring so much into the classroom. The majority recognise this as their one opportunity to get a promotion, make a difference to their lives and to move forward on a journey they had only dreamed of being able to take.

Those 100+ pioneers were of a variety of ages and backgrounds. There were people who had been support workers for years, others for months. Some had fallen into healthcare by accident and found they loved the role and wanted to do more. Some had started their lives in other parts of the world or had taken a career change. A few had masters degrees already, some had nothing more than the few qualifications they had gained at the age of sixteen.

Many trainees saw the development of the nursing associate role as a step towards their goal of becoming a nurse, but circumstances had perhaps conspired against them, and the removal of the bursary from September 2017 onwards meant that some were unwilling to take on the debt.

Here was an opportunity, and although the path ahead was uncharted, we all embarked on a voyage of discovery. There were many twists and turns along the way, but that only made the culmination of the journey so much more memorable. Here were a group of trainees, lecturers, clinicians and managers who had worked together towards a common goal – it was like nothing I had experienced in the past or anything I am ever likely to again.

The first cohort of trainee nursing associates have continued to inspire. Some have progressed with their dreams of becoming registered nurses, while others have embraced the associate role and made it their own. Some of our current trainee nursing associates are helping to support the efforts in beating the Covid-19 pandemic. On International Nurses Day 2020 we have so much to be thankful for and I will always be proud of the small part I have played in this part of 200 years of history.