Aleeza Khan

The National Health Service (NHS) Workforce roles have undergone changes since 1948 such as the ‘Auxiliary Nurse’ (1960), ‘State Enrolled Nurse’ (1960’s) ‘Clinical Nurse Specialist’ (1970), ‘Nurse Consultant’ (2000) and ‘Nursing Associate’ (2017). This thesis focuses on the Nursing Associate (NA) role introduced following the Shape of Caring Review (2015) recommendation for a Foundation Degree development route for unregulated support workers to bridge the gap between the RN and the Healthcare Assistant. The Nursing Associate role was piloted in 2017 by Health Education England and acquired registered status by the Nursing and Midwifery Council in 2019.
The argument of this thesis is that the NAs experience a professional identity crisis about how their role is understood and therefore used within the workforce leading to differences in deployment. It reports a phenomenological enquiry exploring the professional identity of the Trainee nursing associate (TNAs) and registered NAs. The findings represent five themes that are used to explain the crisis of identity and belonging within a ‘no man’s land’ that results in movement either progressing to an RN role or leaving healthcare work altogether.
The implication of this study is that for the NA professional identity to be stable it requires acceptance from other professionals and facilitated by broader education to the healthcare workforce about the role. Recommendations include: 1. the NMC considering defining the scope of practice for NAs as the regulatory body, 2. Utilising social media to enhance the awareness of the NA role and 3. Implementing professional identity workshops pre and post registration.

The nursing associate (NA) role was introduced in 2017 with a pilot programme of trainees, and in 2019 became regulated by the Nursing and Midwifery Council (NMC). The role bridges the gap between the healthcare assistant (HCA) and registered nurse (RN), allowing RNs to focus on complex care. With over 9000 NAs on the NMC register and more in training, it is important to understand RN perceptions of the NA professional identity. The findings of a qualitative survey of RNs (n=23) identified the following themes: NMC standards and scope of practice; The 'cheap nurse'; Skills development and progression; A supportive bridging role. Although valued, the role was perceived as a threat, ambiguous and inconsistently implemented. The implications are that the role ambiguity and lack of standardisation need addressing and a clear understanding of these must be articulated for the professions and public alike.The nursing associate (NA) role was introduced in 2017 with a pilot programme of trainees, and in 2019 became regulated by the Nursing and Midwifery Council (NMC). The role bridges the gap between the healthcare assistant (HCA) and registered nurse (RN), allowing RNs to focus on complex care. With over 9000 NAs on the NMC register and more in training, it is important to understand RN perceptions of the NA professional identity. The findings of a qualitative survey of RNs (n=23) identified the following themes: NMC standards and scope of practice; The 'cheap nurse'; Skills development and progression; A supportive bridging role. Although valued, the role was perceived as a threat, ambiguous and inconsistently implemented. The implications are that the role ambiguity and lack of standardisation need addressing and a clear understanding of these must be articulated for the professions and public alike.

As a Senior Lecturer teaching students who have worked fulltime and on the frontline in the NHS and social sector during the pandemic, I have witnessed how it has affected their learning. Understandably, these students were fatigued, anxious and witnessed traumatic events as Trainee Nursing Associates. These students were well-supported in terms of personal tutoring as well as signposting to Life lounge and other external agencies; however, I feel as lecturers we need to embed wellbeing into the curriculum and modules.