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    Be interesting to hear other people's opinions on the new role. Do you think it's a great idea? Or do you think nurse numbers will shrink and be replaced for cheaper banded staff?
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    a lot will depend exactly where the line is drawn in the sand, and if things that currently require 2 RNs for one or more stages of the process still require 2 RNs then the numbers won;t be droppign that much

    the line was drawn in the wrong places with ENs and then it go more and more blurred until by the time AfC came about there was no demarcation between RN and EN

    what we will see in every likelihood is a far fewer band 3s whoaren;t on a pathweay to Associate or RN
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    This is one of those things that in theory could be good because it gives HCAs further opportunities for career progression and it potentially opens up Nursing to people who otherwise wouldn't be able to do it because of financial constraints. But, and it is a big but, I don't have much trust in this Government and I suspect that the introduction of Nursing Associates is and attempt to fill staffing gaps without having to employ more RNs. i.e. It's a cost cutting thing.

    It very much depends on how clear we can be about the role of Nursing Associates, because if we have Nursing associates, without reducing the number of RNs, that would be a good thing as RNs could delegate to Nursing Associates and therefore have and easier time managing their case loads. The problems are going to come if/when Nursing Associates roles start overlapping with RNs. If jobs that now require two RNs can be carried out by one RN and one Nursing Associate then I think it's likely that we will see a drop in RNs on wards, which would be a bad thing for patients.
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    when the nmc was controlled by nurses then i would have believed that it would be controlled but now it will become nursing on the cheap. our unions need to be tough like the firemens union.
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    I think this is could be a negative for nursing, nursing associates will be nursing on the cheap.

    The problem nurses currently have, is their role is not attached to much in law. For example midwives can manage a birth independently.

    HCAs have been administering medication within carehomes for years and the reason why nurses trained were to ensure a higher level of knowledge and accuracy. Medication isn't the only thing HCAs do, they carry out injections, wound care and assessments. So nurses are providing a standard, you can expect a nurse to know these things already (well hope). So our role is under threat, unfortunately.

    Now this is where this could become a really positive move, if nurses now take a more expert role, which their training has given them instead of just wipping bumbs and dressing wounds. They could pass more mundane tasks onto the Associates. People say oh nurses should not be 'to posh to wash', I am not to posh to wash. Yet I learned how to wash myself by age 4 I don't need to go to university to learn to wash a person.

    So therefore nurses now need to look to move into prescribing and pinching more of the doctors tasks and carting out more high knowledge requiring tasks. They should also look to move into high management roles and providing expert advice on treatment, which most nurses have yet never use because they are washing a patient great use of money hey?
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    (Original post by Speed1987)
    I think this is could be a negative for nursing, nursing associates will be nursing on the cheap.

    The problem nurses currently have, is their role is not attached to much in law. For example midwives can manage a birth independently.

    HCAs have been administering medication within carehomes for years and the reason why nurses trained were to ensure a higher level of knowledge and accuracy. Medication isn't the only thing HCAs do, they carry out injections, wound care and assessments. So nurses are providing a standard, you can expect a nurse to know these things already (well hope). So our role is under threat, unfortunately.

    Now this is where this could become a really positive move, if nurses now take a more expert role, which their training has given them instead of just wipping bumbs and dressing wounds. They could pass more mundane tasks onto the Associates. People say oh nurses should not be 'to posh to wash', I am not to posh to wash. Yet I learned how to wash myself by age 4 I don't need to go to university to learn to wash a person.

    So therefore nurses now need to look to move into prescribing and pinching more of the doctors tasks and carting out more high knowledge requiring tasks. They should also look to move into high management roles and providing expert advice on treatment, which most nurses have yet never use because they are washing a patient great use of money hey?
    I guess it depends on how accountable nursing associates are going to be in their practice. The fact that the NMC is wanting to regulate the role is encouraging that they will be at least somewhat accountable for their actions and practice. I am concerned about the content of the course and how far the role will go into assessment and evaluation. If the nursing associate doesn't know the rationale behind what they are doing then it could be dangerous and see serious errors being made if RN's are going to be taking the foot off the gas to focus on other tasks and don't have to keep an eye on them from a distance, check and countersign their actions. Of course the RN is going to be ultimately accountable but doesn't mean they will take the brunt of it if things go wrong.

    Yes HCA's and carers can do things in the community such as medication. It doesn't take much skill to pop out medications from a blister pack and sign a MAR sheet. Even if they don't rely on blister packs, the MAR sheet will often tell the carer how many tablets or ml's to administer and will more often than not provide a description of the size, shape, colour and markings of the tablet. They don't know why they are administering those meds, the side effects of those meds or the dangers of those meds. In the acute setting, you have to know why you are giving that medication or why you shouldn't be giving that medication, the normal dose of the med, side effects etc. You actually have to require a lot of knowledge to dispense medication in the acute setting. There are certain drugs you should not give for certain conditions for example, anticoagulants and NSAIDs in a bleed or haemorrhage, nephrotoxic medications in AKI, what meds and insulin you should still give or should not give in hypoglycaemia, when you should or should not omit digoxin or beta blockers in bradycardia, when you should and should not administer IV fluids or certain types of IV fluids etc. The list is endless. In specialist areas such as paeds, ICU, HDU, renal, cardiology there are often a lot of drug calculations needed when administering meds for ALL administration routes. Doctors are not superhuman. They make prescribing errors and forget to cross off medication when it is contraindicated and are sometimes not aware of contraindications themselves. And yes, I have seen penicillin prescribed for someone with a true penicillin allergy aka anaphylaxis or ridiculous dosages prescribed for certain conditions. I have received patients from ED and other wards who have overdosed patients on sedatives given to settle patients down from acute delirium.

    I am also sick and tired of having to explain the importance of fundamental nursing care such as washing, feeding, turning, toileting, mobilising patients etc. No, it doesn't require a degree to do any of things. But when you are doing those tasks you can pretty much do all of your assessments and evaluations when doing those tasks. How can you honestly document a load of crap about a patient if you have not clapped eyes on them all day? Charts can say things but it doesn't mean they are accurate. I have seen inaccurate things documented about patients all the time. Fluid balance, diet, pressure areas etc. If I had a pound an HCA or student have documented pressure incorrectly when I know full well the patient has wounds and sores then I wouldn't quite be a rich woman but I would be quids in. Yes, an RN should not countersign something unless they have seen it themselves but are often too busy and take the HCA's word for it. Guiltily, I also admit to going on my 6pm drugs round only to notice my patient has only drank 100ml all day or their catheter bag hasn't drained any urine all day because no one has picked up on it and I have been too busy to check properly. It happens but it shouldn't. When I am the only trained nurse responsible for an entire side of patients I make it my business to know these things and I will wash, turn, toilet and feed. Obviously I cannot do this for every single patient and I do not expect RN's to be focusing only on these tasks when poor Betty in bed 2 has an EWS of 11 or I need to discharge/admit patients, do meds and IV's etc. but I do make sure all of my patients are safe, fed, watered and turned before I will sit down and do paperwork. It's my pin on the line if things go wrong and me that ends up in coroner's court. We have HCA's to assist us with those basic tasks and yes it doesn't require a degree to do so but it doesn't mean they are not important and that nurses should not be doing them. It's important to remember that whilst carers, HCA's and AP's can learn how to perform simple nursing tasks they do not possess the skillset to assess hence why the RN is solely accountable for this. If nursing associates are going to be accountable for these assessments and evaluations then great, it would definitely ease my mind and worries and allow me to focus on more RN tasks then I am all for it. But if not, then the role is pointless and will not solve anything. It's also important to remember that many hospitals debanded and took skills away from HCA's and also abandoned the AP role because of clinical errors being made which in the long run was not cost effective, hence why RN's have such ridiculous workloads, because they are the only ones accountable at the end of the day.

    Of course I want my fellow RN's to adapt and further their skills and knowledge. I would like them to possess more clinical skills. I want them to guide good patient care. I want them to progress in their careers. RN's are hungry for success and progression. But experience is also a key element in progression. It wouldn't be right to adapt the role of the RN if they have no bloody idea or experience of what they are wanting to do, implement, teach etc. I always teach my students, "never delegate a task that you wouldn't be willing to do yourself". It earns trust, respect and authority amongst your colleagues and is the key to maintaining high morale in areas which is a fundamental skill in nursing management that certainly makes your job a lot easier
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    (Original post by ButterflyRN)
    I guess it depends on how accountable nursing associates are going to be in their practice. The fact that the NMC is wanting to regulate the role is encouraging that they will be at least somewhat accountable for their actions and practice. I am concerned about the content of the course and how far the role will go into assessment and evaluation. If the nursing associate doesn't know the rationale behind what they are doing then it could be dangerous and see serious errors being made if RN's are going to be taking the foot off the gas to focus on other tasks and don't have to keep an eye on them from a distance, check and countersign their actions. Of course the RN is going to be ultimately accountable but doesn't mean they will take the brunt of it if things go wrong.

    Yes HCA's and carers can do things in the community such as medication. It doesn't take much skill to pop out medications from a blister pack and sign a MAR sheet. Even if they don't rely on blister packs, the MAR sheet will often tell the carer how many tablets or ml's to administer and will more often than not provide a description of the size, shape, colour and markings of the tablet. They don't know why they are administering those meds, the side effects of those meds or the dangers of those meds. In the acute setting, you have to know why you are giving that medication or why you shouldn't be giving that medication, the normal dose of the med, side effects etc. You actually have to require a lot of knowledge to dispense medication in the acute setting. There are certain drugs you should not give for certain conditions for example, anticoagulants and NSAIDs in a bleed or haemorrhage, nephrotoxic medications in AKI, what meds and insulin you should still give or should not give in hypoglycaemia, when you should or should not omit digoxin or beta blockers in bradycardia, when you should and should not administer IV fluids or certain types of IV fluids etc. The list is endless. In specialist areas such as paeds, ICU, HDU, renal, cardiology there are often a lot of drug calculations needed when administering meds for ALL administration routes. Doctors are not superhuman. They make prescribing errors and forget to cross off medication when it is contraindicated and are sometimes not aware of contraindications themselves. And yes, I have seen penicillin prescribed for someone with a true penicillin allergy aka anaphylaxis or ridiculous dosages prescribed for certain conditions. I have received patients from ED and other wards who have overdosed patients on sedatives given to settle patients down from acute delirium.

    I am also sick and tired of having to explain the importance of fundamental nursing care such as washing, feeding, turning, toileting, mobilising patients etc. No, it doesn't require a degree to do any of things. But when you are doing those tasks you can pretty much do all of your assessments and evaluations when doing those tasks. How can you honestly document a load of crap about a patient if you have not clapped eyes on them all day? Charts can say things but it doesn't mean they are accurate. I have seen inaccurate things documented about patients all the time. Fluid balance, diet, pressure areas etc. If I had a pound an HCA or student have documented pressure incorrectly when I know full well the patient has wounds and sores then I wouldn't quite be a rich woman but I would be quids in. Yes, an RN should not countersign something unless they have seen it themselves but are often too busy and take the HCA's word for it. Guiltily, I also admit to going on my 6pm drugs round only to notice my patient has only drank 100ml all day or their catheter bag hasn't drained any urine all day because no one has picked up on it and I have been too busy to check properly. It happens but it shouldn't. When I am the only trained nurse responsible for an entire side of patients I make it my business to know these things and I will wash, turn, toilet and feed. Obviously I cannot do this for every single patient and I do not expect RN's to be focusing only on these tasks when poor Betty in bed 2 has an EWS of 11 or I need to discharge/admit patients, do meds and IV's etc. but I do make sure all of my patients are safe, fed, watered and turned before I will sit down and do paperwork. It's my pin on the line if things go wrong and me that ends up in coroner's court. We have HCA's to assist us with those basic tasks and yes it doesn't require a degree to do so but it doesn't mean they are not important and that nurses should not be doing them. It's important to remember that whilst carers, HCA's and AP's can learn how to perform simple nursing tasks they do not possess the skillset to assess hence why the RN is solely accountable for this. If nursing associates are going to be accountable for these assessments and evaluations then great, it would definitely ease my mind and worries and allow me to focus on more RN tasks then I am all for it. But if not, then the role is pointless and will not solve anything. It's also important to remember that many hospitals debanded and took skills away from HCA's and also abandoned the AP role because of clinical errors being made which in the long run was not cost effective, hence why RN's have such ridiculous workloads, because they are the only ones accountable at the end of the day.

    Of course I want my fellow RN's to adapt and further their skills and knowledge. I would like them to possess more clinical skills. I want them to guide good patient care. I want them to progress in their careers. RN's are hungry for success and progression. But experience is also a key element in progression. It wouldn't be right to adapt the role of the RN if they have no bloody idea or experience of what they are wanting to do, implement, teach etc. I always teach my students, "never delegate a task that you wouldn't be willing to do yourself". It earns trust, respect and authority amongst your colleagues and is the key to maintaining high morale in areas which is a fundamental skill in nursing management that certainly makes your job a lot easier
    Well said! Is there anyway you can be cloned? Regarding HCA's and the associate nurses, they should be providing care alongside a RN. Whatever happened to
    "doing a round" Oh that's right, It was labelled as regimented and task based.Now things don't get done because the only routines are for Obs and meds and as you say, the RN who has accounatbility often never sees a patients bum, heels etc for days. With the RN to patient ratios nowadays unfortunately I think there needs to be more "routine" on the wards.
 
 
 
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