Transition from student to qualified nurse – October Nursing Blog

Crossing the bridge

In the last few months in Scotland, (NQNs) newly qualified nurses joined the register and took up posts across health and social care. Although this year saw a further increase in applications to nursing programmes across the country, vacancies remain high and are increasing.

Making the transition from student nurse to registered nurse is something no nurse forgets; it is etched in their memory as one of the most terrifying and memorable times in their career. Imagine how it feels then to qualify in the ‘International Year of the Nurse’, in the middle of a global pandemic and no graduation ceremony.

The world was very different when I qualified. When all I thought about was how proud I felt to get my epilates and replace my 3 striped card nurse hat with the thick blue stripe that showed I was now a qualified nurse. I was also grateful when these were phased out soon after I qualified, as by the end of the shift most nurses looked like they had been dragged through a hedge backwards. Anyone out there who trained in the 80’s will echo this sentiment, I’m sure. This however meant I no longer could hide behind my student name badge with an expectation by patients, families and colleagues to be competent and confident to carry out this new role.

I felt that I had to know everything about everyone in an instant and I remember struggling to get my tongue around some of the conditions, terminology, and medications, feeling like I had to learn a new language, which I am glad to say I’m pretty fluent in now. Everyone else on the ward seemed so in control and confident with me the only NQN on that ward, which definitely added to the pressure. Back then I was confident that the staff had my back, we were a team and I was part of it. I had transformed into the nurse who held the keys on shift when my probation period was over.

My point in raising this is that everyone has been that nurse, although this time is exceptional for all staff, each nurse will understand your fears and it’s so important that you realise that being newly qualified doesn’t mean you will be left without support , and more importantly you can speak up. There really is no such thing as a stupid question when it comes to safeguarding patients and staff. Being assigned a mentor during this time to keep balance and perspective will allow you to grow and develop your skills alongside a preceptorship programme in place. Three or four years of study to get to this point, but no foresight could’ve prepared any nurse for what it would be like to be a NQN in 2020.

Unfortunately for our 2020 nurses who have just qualified, they are faced with a greater transition complicated by workforce issues, infection control and high-risk challenges at a time when even the most qualified of staff have real concerns and deficits. Working in an ever-changing landscape adds to the feelings of uncertainty. This is compounded by the potential for witnessing increased loss of life both for patients and for some, potentially colleagues too. Feelings of isolation and vulnerability although common are often overwhelming whilst ensuring adherence to the nursing codes, which highlight the pressures of accountability in clinical practice. The NMC describes Delegation and Accountability as “the principle that individuals and organisations are responsible for their actions, and may be required to explain them to others” (NMC, 2018b). There remains limited research in relation to transition but key areas are around the preparation for this change in identity, status and future career. Higher education institutions do and will continue to play a significant role by working with students to plan for a successful transition and develop strategies to better manage their work.

But this year we must recognise that there will without question be potential for work-related stressors. Complexities due to workplace changes will occur as a result of the pandemic and the physical exhaustion being felt by all staff are added to the requirement to keep working in the knowledge of this.

There are many interventions across the country being developed to ensure this transition results in improved staff retention and attainment of skilled practice. The STAR project funded by the Burdett Trust for nursing is an example of this. It is so important that all staff but especially NQNs at this time have a sounding board, a safe open culture and access to compassionate leadership to ensure the attrition rates improve, because we know this is significant within the first 3 years of post- registration. Professional socialisation is often stated as fundamental to limit staff stress, forming identity and understanding personal and professional beliefs and values that form a nurse identity. To ensure wellbeing and motivation at work, and to minimise workplace stress, recent research evidence by the Kings Fund (commissioned by RCNFoundation) suggests that people have three core needs:

  • autonomy – the need to have control over their work lives, and to be able to act consistently with their values  
  • belonging – the need to be connected to, cared for, and caring of others around them at work, and to feel valued, respected and supported 
  • contribution– the need to experience effectiveness in what they do and deliver valued outcomes.

In recognition of the strain on nursing staff during this pandemic there will be without question the need for extra funding to support staff well-being and mental health if we are to achieve the 2030 vision for nursing, and we can’t have our students or NQNs the greatest victims of this.

So many of our student nurses are going above and beyond, being involved in so many additional support networks, debates, demonstrating strong leadership skills well in advance of registering.

The hope is that this resilience will continue and create a real determination for the recognition of the job they do and more importantly, what they could do in the future to ensure sustainability of the profession.

If you have a NQN – what are you doing to recognise their fears, their potential and ensure they feel part of the team? If you are a NQN – what do you feel you need to cope with this transition? It is important not to exploit newly qualified staff and although this is done often without intention, it is a real issue for some. I was saddened to hear through a friend that her daughter who had recently qualified as Mental Health Nurse was asked to stay on shift for an additional 2 hours on top off a 12hr shift because of staff shortages. This resulted in her missing her last train home, as she doesn’t drive. She had only started 15 days before in her new post and felt she could not say no. This is unacceptable on a number of levels and I do hope this is an exception.

We can’t extinguish the enthusiasm of our new staff; they have worked hard to get to where they are, and this is just the start. Remember not all staff have the confidence to challenge decisions or deal with conflict, it’s not easy for anyone to stand up for themselves when they feel vulnerable.

It is important to find your cheerleader, ensure you have a voice and start as you mean to go on,  as you have already shown by being a nurse in 2020 that you have what it takes and we can rely on you to achieve the 2030 vision.

Jacqui Neil

Transforming Workforce Lead

@TransformNurse

Cohort 2 open for Graduate Diploma in Integrated Community Nursing

We are delighted to advise that cohort 2 for the New Graduate Diploma in Integrated Community Nursing is due to open and we would welcome applications from care home nurses. There are currently no limitations on places therefore hope we can get a level of interest to ensure this funding continues. Please use the link to navigate the information and process for applicants: https://www.nes.scot.nhs.uk/our-work/community-nursing-graduate-diploma/

Please send the completed nomination sheet to [email protected] by Wednesday 4th November.

Care Home funding letter GDICN_Oct20

Seasonal Flu Campaign launches today – 8 October

Seasonal Flu Campaign Stakeholder Toolkit

The Flu is Serious Stakeholder Toolkit below outlines the overarching campaign, and contains campaign materials by eligibility group.

Due to the different ways in which the flu immunisation programme will be delivered this year and the increase in those that are eligible for the free vaccination we wanted to give you all the relevant information to help encourage uptake. The stakeholder toolkit contains assets by eligibility group, so please refer to this for further information.

The new health and social care worker myth busting video asset can be viewed here.

TV ad can be viewed here:

Purpose of the campaign

  • To highlight the seriousness of flu, especially with Covid-19 around and importance of getting vaccinated, as well as educate new eligible audiences including social care workers, household contacts of those that were shielding, and from December 55-64 year olds will also be eligible.

Key Messages:

  • Flu is serious: If you are offered the vaccine, please get it.
  • Protect yourself: Every year in Scotland, thousands of people are hospitalised with flu. It can be serious and life threatening, so getting vaccinated is the safest and most effective way to protect yourself.
  • Protect others: Reduce your risk of getting flu and spreading it to others, especially those who are most at risk.
  • Protect our NHS: Help our NHS avoid the pressure that a spike in seasonal flu would put on top of Covid-19.

Call to action:

  • For more information on eligibility and information on how to book an appointment we are asking the public to visit www.nhsinform.scot/flu or call 0800 22 44 88.

Please do share, and remember if you are offered the flu vaccine, please get it!

‘Compassionate Poetry Week’: 1-8 October

As we approach the final months of the International Year of the Nurse and Midwife , in light of the pandemic, can I suggest that we use the first week of October (1st – 8th) to reflect through writing on what this has meant in the context of compassion. Highlighting the need to be sensitive to the needs of the people we care for, picking up on the subtle signs that allow the human touch, that is key to individualised holistic care. The need to use PPE and distancing has without question altered how we deliver care and interact and this has had a significant impact on staff. There has been some research undertake over recent years to look at the benefits of learning through poetry writing and the benefits this can have as a way of learning and developing to be better nurses, but applies to all care staff.

Can I invite anyone who is involved in health and social care to make the first week of October, ‘Compassionate Poetry Week’ so we can share, learn from each other, and decompress as part of our response to self -care.

Look forward to reading all your thoughts. I’ll kickstart with my contribution below.

 

Jacqui Neil

Transforming Workforce Lead

@TransformNurse

Anaphylaxis learning module and guidance for registered nurses in health and social care

All registered nurses in health and social care can now access anaphylaxis training via a landing page on Turas Learn. This is not specific to care homes but for use across NHS and social care.  If staff are not already registered they can use the link below. This is an elearning module provided by NHS Grampian and can be used as an educational resource and will provide a print off completion certificate. This is not a competency certificate therefore current local arrangements would apply, as with any training. Hopefully this will assist staff training in advance of the commencement of the flu season however if staff have already undertaken the relevant training then there is no need to complete this module.

To register for a Turas Learn account in order to be able to access the NES resources including the anaphylaxis please click on https://bit.ly/3k8M4kz.

Please see below for more information on this module.


Anaphylaxis: Learning module and guidance for Registered Nurses in health and care settings  

  • By undertaking this module, you agree to read and consolidate the information below, which highlights important considerations in the context of your work place. 
  • NHS Grampian have kindly shared open access to this resource, developed to enhance staff knowledge in responding to acute needs when a person develops anaphylaxis.  

Learning Aim: 

Recognition and treatment of anaphylaxis is required to ensure that people receive a high standard of care from trained and competent practitioners, in line with legal and professional requirements. 

Learning Outcomes:  

  • Define the term anaphylaxis; 
  • Identify triggers that could cause an anaphylactic reaction; 
  • Describe the signs and symptoms of an anaphylactic reaction; 
  • Describe the management of a patient with an anaphylactic reaction; 
  • State the dose and route of adrenaline (epinephrine) to be administered to an adult; 
  • Know how and where to gain safe and appropriate access to  Adrenaline.

Successful completion of this learning module indicates you have met the learning objectives.  It supports increasing your knowledge regarding how to deal with an anaphylactic reaction in an adult.  You may wish to discuss the associated learning outcomes alongside any local, relevant issues with your peers.   

This resource should be viewed in tandem with local policy in the facility within which you are based and in conjunction with standard guidance for managing a deteriorating person/ cardiac arrest.   

Links at the base of this page can guide you to supplementary resources. 

In this context, it is important that a registered nurse in any health and care setting 

  • Always functions within their scope of professional practice
  • Can respond effectively in a potential emergency, following local protocol to manage an emergency situation
  • Is current with recommendations for access to and administration of emergency medication such as adrenaline within the facility they are based
  • Knows where and how to access such medication 

This eLearning module was developed by NHS Grampian, in accordance with guidance from the Resuscitation Council UK.  It refers to NHS Grampian regarding access to medication (Adrenaline) and administration in an emergency situation. Any such references should be replaced by  local policy in your care facility. 

Useful learning resources: 

  1. Resuscitation Council UK: Emergency Treatment of Anaphylactic Reactions   https://www.resus.org.uk/sites/default/files/2020-06/EmergencyTreatmentOfAnaphylacticReactionsPPT.pdf 
  2. Recognising a deteriorating person; guidance regarding how to respond when an adult deteriorates can be found at the following link
    https://learn.nes.nhs.scot/28267/coronavirus-covid-19/assessment-and-care-of-people-with-covid-19  

Return to practice programmes

Return to practice programmes – Things have now got easier.

We recognise that staff leave the register for a number of reasons and often later regret this. If you are thinking about returning to nursing practice then consider returning to work within social care nursing on a paid placement? The programme is provided by Glasgow Caledonian University (GCU) and The Robert Gordon University (RGU).

Take advantage of the Gov. supported initiative perhaps for some #lifechangingwork in a care home.

For more info check out

https://nes.scot.nhs.uk/education-and-training/by- discipline/nursing-and-midwifery/careers-and-recruitment/return-to-practice.aspx 

https://learn.sssc.uk.com/careers/

Funded places available – Graduate Diploma in Integrated Community Nursing

There are 200 funded places available in this year’s intake of the new 2-year part-time work-based Graduate Diploma in Integrated Community Nursing (GDipICN) which is designed for nurses working at level 5 of the Career Framework for Health (Agenda for Change Band 5 equivalent).

NES has commissioned two universities to deliver the programme; Queen Margaret University (east and north regions) commencing in September 2020 and the University of the West of Scotland (west region) commencing October 2020.   See Appendix 1 for NHS Boards associated with each region.

It is expected approximately 150 places will be allocated to nurses from district nursing teams, 50 places to nurses from care home and prison healthcare settings and 40 places to nurses working in general practice.

More information about the programme is available at:

 https://nes.scot.nhs.uk/education-and-training/by-discipline/nursing-and-midwifery/careers-and-recruitment/transforming-nmahp-roles/graduate-diploma-integrated-community-nursing.aspx

Below is a letter from Jane Harris, the Head of Programme detailing more information on funding. There is also a spreadsheet for providers to complete with details of all individual nurses who require funding.

Completed spreadsheets must be returned to [email protected]  by 24th July 2020.

Mental Health Week – 18 -24 May

This week is Mental Health week and its important we recognise that fact that the times we are living in is having significant impact on people of all ages.

The theme this year is kindness .

Below are some links that you may find helpful resource to support you , friends , work colleagues and family to remain positive during these challenging times.

https://www.bbc.co.uk/newsround/52557800

https://www.time-to-change.org.uk/get-involved/get-your-workplace-involved/resources/mental-health-calendar

https://www.mentalhealth.org.uk/campaigns/mental-health-awareness-week

https://www.itv.com/news/meridian/2020-05-18/mental-health-awareness-week-looking-after-you/