Leadership as a Newly Qualified Nurse

As part of the @BloggerNurse November challenge ‘The Newly Qualified Journey’ I thought it would be a good idea to share with you the reflective assignment I recently wrote for my preceptorship program at GHNST. This is a rather lengthy (non-blog) read, however, if it can help people better understand the ups and downs of being a newly registered nurse then I’m happy to share my journey with you the reader.

During the preceptorship, we had a focused session on decision-making through leadership and management. The aim was to help us recognise key features of effective decision making and delegation in the clinical setting. Therefore, this paper will critically reflect on experiences that have influenced my professional development against the four domains of the NMC, (2010) Standards in nursing education, using the Rolfe et al, (2001) reflective model ‘What? So, what? what now?’ template as a guide. I will specifically explore my professional limitations, conflicts in communication, problem-solving through initiative, and delegation in leadership. I will then set an action plan using SMART goals tool to support my development.

Modern scholars of leadership discuss various definitions of what leadership is, consequently, there is no concise definition of what leadership means. Nonetheless, despite these many definitions, certain traits can be recognised by most theorists as to what it is to be a leader. This derives from the fact that each leader will bring individual talents, for example, some leaders are decisive and self-assured while others are sociable and outgoing (Northouse, 2017). The Kings Fund (2015) discuss that leadership within healthcare must ensure direction and priority in an organisation shared vision, values and strategy to ensure that responsibility and commitment are established successfully within a team.

 

Professional Values

What?
I worked a particularly stressful and understaffed shift only 10 weeks after starting my job as a newly registered nurse, it was a night shift and due to sickness, the staffing levels for that night shift included myself, an agency nurse and one bank HCA to manage twenty-four acutely unwell patients. The shift involved multiple medical emergencies, alongside a complex patient load. This proved very difficult, as I was a junior level nurse left in charge of a night shift for the first time. Some of the complex patients at the start of the shift included an elderly patient with chest pain and palpitations, a patient who had a Vasovagal-syncope in the toilet followed by a fall and head injury, and a patient with a NEWS (National early warning score) of 10. My participation in managing the situation as a coordinator escalated quickly, as a small team we prioritised the patient’s needs and the roles and responsibilities between the three of us were quickly decided within our individual competence level. I called the site manager to insist that the level of safety on the ward was not acceptable, we negotiated that a permanent staff nurse from the trust would come from a better-staffed ward to help support us.
So, what?

The main significance of this issue was the potential in compromising patient safety and my own abilities in clinical competencies as a newly qualified nurse. The NMC, (2015) code of conduct requires me to preserve the safety of the patients and public while working within the limitations of my competency. Evidence suggests it is vital that I take responsibility in recognising and maintaining my junior status (Schober and Ash, 2012). Self-analysis and critical reflection in understanding my limitations are fundamental to provide a high standard of care to service users, also helping me to develop my practice and leadership (Reading and Webster, 2014). Although I am a junior level staff nurse I was still able to contribute to patient care as the nurse-in-charge under the supervision and guidance of the site manager and substantive staff nurse who came to support the shift. Upon reflection, I can now recognise that because of my forward-thinking in asking for help we could provide a safer service during that shiftUnderstanding my own limitations based on my professional boundaries and values is what enabled me to complete tasks autonomously while remaining aware of when to seek advice or refer to more senior professionals (Black, 2013). In addition, I showed leadership potential by recognising my own limitations by being open and honest and identify how to manage the situation. Siviter (2013) deliberates that regardless of how much experience you may or may not have, you have a responsibility and a duty of care to accept the limitations of your role as a staff nurse in charge, only working within safe parameters of care. Although colleagues were impressed and complimentary of my abilities to ‘step-up’ and act as a shift leader, this could cause implications for my role as a leader in the future and I must make certain people are aware of my junior status at all time, as the role of an experienced nurse is different (Wheeler, 2013). In contrast to Siviter’s discussion Gopee and Galloway (2017) converses that leadership can be utilised at all levels of competency, suggesting that leadership and management situations can be demonstrated by all members of staff in health and social care and not be limited to those in management roles, suggesting that good leadership comes from your priority and focus to provide patient-centred care and to deliver this with the best outcomes intended. However, Gopee and Galloway, (2017) continue to discuss that some leaders are reluctant to delegate tasks below their level of leadership, believing that juniors are unlikely to be able to perform them competently. The site manager saw me as a safe member of the team asking for help when it was needed, this showed good integrity, which has enabled me to take the lead of my own abilities to support my colleagues during the busy shift. Drawing all this information together, I refer to Belbin’s, (1981) philosophy of nine team roles. Belbin’s theory suggests a good balance of roles based on different characteristics determines the success of a team as it allows individuals to work to their personal strengths, creating high performances within the group. This can be linked to Gopee and Galloway, (2017) suggestion that everyone has a role to play in leadership based on the group’s situational needs.

 

Now what?

My Specific aim is to understand the changes in my limitations, transitioning from a newly qualified nurse to a more experienced nurse. I will measure my progress through discussions and documentation with the senior nurses on the ward, attaining this by dedicating time to research literature around differences in limitations from novice to expert nurse, whilst using resources, like my preceptor and new registrant review meeting to reflect on my development. Thomas et al, (2015) suggest now is appropriate to begin understanding my professional limitations as both a qualified nurse and clinical leader- This is relevant because I am already approaching my first six months of being a registered nurse. I aim to review this goal during my appraisal.

Communication and Interpersonal Skills

What?

I have recently cared for an overseas visitor who was a non-NHS funded patient, this situation has reminded me of some of the barriers we face in communication through different languages, after all, do we need words to express what care we require? I would like to take this opportunity to reflect on an incident I experienced as a student nurse during my elective placement in Sri Lanka last year, this helped shape the way I deal with language barriers today as a staff nurse. I attended an operation in Kandy teaching hospital in Sri Lanka, the patient was having a total vaginal-hysterectomy. The patient, Mrs X, had a regional spinal anaesthesia, no pre-operative tests were carried out to gauge the patient’s lower limb sensation. The operation began, and the patient was screaming in agony. Staff continued the operation, ignoring the patient’s cries for help. At first, I hesitated, but then quickly recognised the need to advocate the patient’s welfare and dignity. I was met with challenging and conflicting interests in the patient’s well-being when questioning what the staff were doing. Because I was working in a foreign environment, English was not the spoken language, and this created a communication barrier.

So, What?

The significance of this issue was to recognise that the distressed patient’s well-being and dignity were being compromised, it was necessary for me to advocate for the patient’s best interests and safety. Not only did this challenge my professional values, ethics and morals. I had a duty of care to protect the patient’s dignity and human rights by negotiating effective communication strategies to find resolution (Management Association, 2017). This is underpinned by the NMC, (2015) code of conduct requiring nurses to communicate clearly. On reflection, a positive outcome to this experience was my application of the 6C’s, all six elements were pragmatic in reaching the success of the patient’s welfare. This was a pivotal point during my development as a nurse, this was the first time I used my courage to speak up and do the right thing when I had concerns; this can represent personal strength and vision to provide patient-centred care and new ways of thinking (Department of Health, 2012). Meuter et al, (2015) suggest it is vital as a leader that you adapt communication styles to suit the situation. Regardless of the language barrier, I recognised the importance of providing Mrs X with compassionate, non-verbal communication, such as when I held her hand in support. An aspect to take forward for development would be my approach in delivering communication, avoiding conflict. My communication during that situation could have been perceived as abrupt and defensive. To help me assess my communication skills, I recently completed a communication questionnaire, which suggesting my preferred communication style is assertive and aggressive. Sully and Dallas, (2010) propose assertive communicators are clear and focused on communicating important messages, enhancing the quality and efficiency of the professional relationship. Whereas Riley, (2015) found that assertiveness is not always an appropriate response, bringing higher risks of personal injury and possibly creating a conflicting response. Though conflict is healthy and inevitable within healthcare, open conflict and vigorous discussions can be useful, as it creates self-criticism, change and innovation (Phillips, 2013). Nevertheless, the questionnaire suggests I also have an aggressive side in communication and although a healthy balance can be found between assertiveness and aggression, it is important to recognise that an aggressive style may distance people, provoking anger and resentfulness, perhaps leading to failures in communication and good patient outcomes (McIntosh and Rima, 2007). An example of a failure to tackle challenges of conflict was the Francis Report, (2013) for Mid-Staffordshire hospital where standards became unacceptable, leading to a public enquiry. As nurses, we must recognise our contribution to the service and health improvement initiatives to better our practice through effective communication and conflict resolution.

 

Now what?

Specifically, I would like to further develop my resilience in confronting challenging situations, and in addition, develop my emotional intelligence to have awareness of emotional motivation, understanding others’ views to create effective communication, avoiding conflict (Carragher and Gormley, 2017). I can see now how much this situation affected me and that I am still progressing from this learning experience through continually reflecting my current practice. I can measure my progression by reviewing and reassessing my communication style through the questionnaire discussed above. In addition, I can compare qualitative evidence from patient feedback that I received during my training and now as a newly qualified nurse. This goal has great relevance because I must continue to develop these capabilities in communication, so they become a part of who I am and my behaviour as a registered nurse, as I am entrusted with the management and leadership of delivering safe care (Ellis and Bach, 2015). This progression will change as a gain more experience and therefore, I would like to set incremental times to review my communication.

 

Nursing Practice and Decision-Making

 

What?

Looking back to another challenging shift, I was looking after a patient who had become aggressive towards other patients, relatives and staff. Whilst trying to problem-solve and help my colleagues defuse the situation, I ended up being punched in the face by the patient. Although I was shocked by this incident, I remained professional and instead of being angry, I had concerns about the deteriorating mental state of the patient. This was abnormal behaviour from the patient and my reaction was to recognise and interpret why he had acted in this way. After investigations and nursing assessments, the patient was diagnosed with vascular dementia. With the correct diagnosis, we could provide person-centred care to meet the full range of essential physical and mental health needs of the patient.

 

So, what?

The significance of this was my ability to problem-solve by using my intuition to recognise and interpret signs of deterioration within the patients mental and physical health, in addition ensuring that the rights of the patient are at the centre of my decision-making process (NICE, 2016). The NMC, (2015) code of conduct requires me to recognise and assess signs of normal and or worsening mental and physical health of patients. Despite the aggression shown towards me, I could use my intuition and knowledge to recognise the deterioration of the patient’s mental health. Evidence suggests that good leaders use their intuition to enhance their decision-making (Marquis and Huston, 2009). The seminal work of Klein, (1999) discusses naturalistic decision-making, recognising the importance of making quick decisions based on intuition. It looks at the three-step process of experiencing and analysing the situation, then implementing the decision. Part of my decision-making during the situation was recognising that this behaviour was abnormal for the patient based on my previous experiences, and my priority was to maintain the safety of the patients, my colleagues and the public. Similarities can be found in Benner’s, (1984) pioneering decision-making theory, the intuitive-humanist model, exploring how clinical decisions can be enriched as the development of knowledge is gained through increased experiences and leadership. Consequently, both theories suggest this decision-making process enhances over time, it should be noted that I was still a novice in recognising and interpreting accurate assessments of the patient’s mental health needs. The implications of this experience were my naïveté in managing aggression through problem-solving and thus, the avoidable event occurred. (Dahlkemper, 2017). Evidence recommends nurses develop an awareness and ability to measure potential risks of aggressive behaviour. Aggressive behaviour rarely occurs without normal signs of impending hostility (Dolan and Holt, 2013). During this event I demonstrated my ability to assess the patient’s anxiety and confusion, consequently, I took lead of the situation by trying to move the patient to a safer environment. Nonetheless, due to a lack of leadership experience and confidence in my ability to problem-solve, I was unable to de-escalate the patient’s aggression and therefore my self-esteem and physical safety were at risk (Standing, 2017). Now I am becoming more experienced in dealing with violence and aggression in confused patients, I am further able to notice early signs of deterioration, acting proactively to be ahead in my assessments and thinking, thus enhancing problem-solving techniques and broadening my leadership potential (Thomas, 2012).

 

Now what?

Specifically, I want to gain the skills and experience necessary to apply effective problem-solving to enhance my leadership in decision-making. I will measure my personal development through my own critical reflections, acknowledging my growth as a leader and my ability to accept responsibility for making mistakes and learning from them (Aston et al, 2010). I can attain this by attending a problem-solving and decision-making workshop. In addition, I can consider using the Plan-Do-Study-Act (PDSA) cycle to create an action orientated plan for future situations based on my past experiences (IfHI, 2016). This is relevant because nursing encompasses lifelong learning and this area of development comes with knowledge and experience (Jeffreys, 2010). A realistic time frame is hard to set, due to the ongoing nature of this skill and therefore, I will review my understanding and application of problem-solving once I have gained further clinical experience.

 

Leadership, Management and Team Working

 

What?

I recently took part in the South-West NHS Military challenge which included a major incident simulation. My role during this simulation was to act as a nurse in a deployed medical team, working in collaboration with paramedics and doctors. During the simulation, I was observed by senior military medical staff in my ability to take lead in coordinating and delegating tasks to manage risk, executing patient care safely and effectively.

 

So, what?

The significance of this issue is recognising my responsibility as a leader to delegate and support safe care to be carried out by appropriate members of the team to achieve good and time effective health outcomes. The RCN (2015) states nurses have a duty of care and a legal obligation to delegate tasks appropriately to the most suitable trained member of staff. This is underpinned by the NMC, (2015) code of conduct which states registrants must be accountable for their decisions to delegate tasks. Stanhope and Lancaster (2014) suggest the skill of effective delegation is becoming increasingly significant because it safeguards competency and improves time management. NHS England (2017) suggest this could be because of falling numbers of nurses, and changes to healthcare policies and practice. Covey (2015) proposes delegation is both for individuals and organisations; we accomplish all tasks through either delegation of time or tasks set to people, suggesting transferring a task to another skilled professional enables us to focus on other complex activities. Moreover, delegation helps develop growth for personal and organisational leadership (Motacki and Burke, 2016). During the debrief sessions the military medical staff discussed my ability to safely co-ordinate, lead and delegate appropriate tasks to my team during the simulation. A core concept of management and leadership is the allocation of delegation to another person to carry out a specific activity (Karssiens et al, 2013). The seminal work of Kotter (1988) details that although leadership and management are distinctive and complementary in their application, leadership goes beyond the routine of following managerial processes, moreover leadership delegation drives the collaborative vision for people to act to fulfil tasks. Both are essential to ensure safe and successful delegation is implemented, the implications of a lack of delegation in a health care setting could impose a negative effect on patient safety (Künzle et al, 2010). New evidence by Horton et al (2017) suggests that nurses have different styles of delegation based on personality and levels of confidence. The most common style found through analysis was the ‘do-it-all nurse’ the study indicates that newly qualified nurses actively avoid delegation, due to a lack of confidence. The study concludes the importance of preceptorship education in communication skills, self-awareness and emotional intelligence to enhance junior nurse’s confidence from the start of their careers as registered professionals. Although my confidence was noted in my ability to lead and delegate tasks during the situations, I am aware that I fear failure and have a lack of self-belief, which could impede on my ability to lead effectively. To prepare myself to be a better leader, I must firstly enhance my self-discipline and confidence to manage my own abilities (Barr and Dowding 2015). Leaders that are self-assured can delegate better because they are comfortable in recognising other team members’ skills and knowledge. If you believe in yourself and your capabilities, other people will recognise your confidence and feel able to follow your lead, making delegation easier and more successful (Maxwell, 2007).

 

Now what?

Specifically, I would like to enhance my self-belief in my abilities to lead and competently delegate. I will measure this by reflecting on the comments made from this experience, and moreover my practice as a staff nurse on an acute medical unit. I must continue to re-evaluate my own strengths and weaknesses in my self-belief. I can achieve this by using the tool SWOT analysis which focuses on my strengths, weaknesses, opportunities and threats. This allows me to analyse the core issues of my self-belief (Cottrell, 2015). This is relevant because evidence proposes to be a leader, it is crucial to have a strong sense of self-belief which will enable people to follow my lead, making it easier for me to delegate tasks (Ellis and Bach, 2015). I aim to improve my confidence and self-belief through further experience in taking on the responsibly of coordinating more shifts at work.

 

In conclusion, this paper critically analysed my leadership development from my time as a student nurse to becoming a newly qualified nurse. We have explored and discussed my professional limitations, conflicts in communication, problem-solving through initiative, and delegation in leadership. I have set myself SMART goals to forward my development in each of these areas. From exploring theories of leadership to researching evidence in what makes an effective leader, I have discovered the importance of continually developing in my knowledge and expertise (Gopee and Galloway, 2017). The preceptorship has helped me recognise that the transition from student to newly qualified nurse is only the first step in my career; my abilities as a leader will depend on my willingness to learn and reflect on my experiences (Aston et al, 2010).

 

 

 

References

Aston, L., Wakefield, J. and McGown, R. (2010) The Student Nurse Guide to Decision Making in Practice. London: McGraw-hill Education.

Barr, J. and Dowding, L. (2015) Leadership in Health Care. 3rd ed. Los Angeles, Ca: Sage Publications.

Belbin, M. (1981) Management Teams. London: Heinemann.

Benner, P. (1984) From Novice to Expert: Excellence and Power in Clinical Practice. California: Addison-wesley.

Black, B.P. (2013) Professional Nursing: Concepts & Challenges [online]. 7th ed. St.louis, Missouri: Elsevier Health Sciences. [Accessed 30 August 2018].

Carragher, J. and Gormley, K. (2017) Leadership and emotional intelligence in nursing and midwifery education and practice: a discussion paper. Journal of Advanced Nursing [online]. 73 (1), pp. 85-96. [Accessed 30 August 2018].

 

Cottrell, S. (2015) Skills For Success: Personal Development and Employability[online]. 3rd ed. New York: Palgrave Macmillan. [Accessed 30 August 2018].

Covey, S.R. (2015) The 7 Habits of Highly Effective People [online]. Online: Mango Media. [Accessed 30 August 2018].2017

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Dahlkemper, T. (2017) Nursing Leadership, Management, and Professional Practice For the Lpn/lvn [online]. 6th ed. Philadelphia: F.a. Davis. [Accessed 30 August 2018].

Department of Health (2012) Compassion practice nursing, midwifery and care staff our vision and strategy [online]. London: Department of Health. Available from: https://www.england.nhs.uk/wp-content/uploads/2012/12/compassion-in-practice.pdf [Accessed 30 August 2018].

Dolan, B. and Holt, L. (2013) Accident & Emergency, theory Into Practice: Accident & Emergency. 3rd ed. London: Elsevier Health Sciences.

Ellis, P. and Bach, S. (2015) Leadership, Management & Team Working in Nursing. 2nd ed. London: Learning Matters/SAGE.

Francis Report (2013). The Mid Staffordshire NHS Foundation Trust Public Inquiry. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/279124/0947.pdf [Accessed 30 August 2018].

Gopee, N. and Galloway, J. (2017) Leadership and Management in Healthcare. 3rd ed. London: Sage.

Horton, K., Magnusson, C., Johnson, M., Ball, E., Evans, K. and Allan, H. (2017) An analysis of delegation styles among newly qualified nurses. Nursing Standard[online]. 31 (25), pp. 46-53. [Accessed 30 August 2018].

Institute for Healthcare Improvement (IfHI) (2016) Plan-Do-Study-Act (PDSA) Worksheet. Available from: http://www.ihi.org/resources/pages/tools/plandostudyactworksheet.aspx [Accessed 30 August 2018].

Jeffreys, M.R. (2010) Teaching Cultural Competence in Nursing and Health Care[online]. 2nd ed. New York: Springer. [Accessed 30 August 2018].

Karssiens, A.E.A., Van Der Linden, C. and Wilderom, C.P.M. (2013) Feeling responsible vs acting responsibly: contributions of a leadership programme. Journal of Management Development [online]. 32 (8), pp. 914-928. [Accessed 30 August 2018].

Klein, G.A. (1999) Sources of Power: How People Make Decisions. London: Mit Press.

Kotter, J.P. (1988) The Leadership Factor [online]. Online: Free Press. [Accessed 30 August 2018].

Künzle, B., Kolbe, M. and Grote, G. (2010) Ensuring patient safety through effective leadership behaviour: a literature review. Safety Science [online]. 48 (1), pp. 1-17. [Accessed 30 August 2018].

Management Association, (2017) My Library My History Books on Google Play Healthcare Ethics and Training: Concepts, Methodologies, Tools, and Applications: Concepts, Methodologies, Tools, and Applications [online]. United States of America: Igi Global. [Accessed 30 August 2018].

Marquis, B.L. and Huston, C.J. (2009) Leadership Roles and Management Functions in Nursing: Theory and Application [online]. 6th ed. London: Lippincott Williams & Wilkins. [Accessed 30 August 2018].

Maxwell, J.C. (2007) The 21 Indispensable Qualities of a Leader: Becoming the Person Others Will Want to Follow [online]. United States of America: Thomas Nelson Inc. [Accessed 30 August 2018].

McIntosh, G.L. and Rima, S.D. (2007) Overcoming the Dark Side of Leadership: How to Become an Effective Leader by Confronting Potential Failures. revised ed. United States of America: Baker Books.

Meuter, R.F.I., Gallois, C., Segalowitz, N.S., Ryder, A.G. and Hocking, J. (2015) Overcoming language barriers in healthcare: a protocol for investigating safe and effective communication when patients or clinicians use a second language. BMC Health Services Research [online]. 15 (1), pp. 1-5. [Accessed 30 August 2018].

Motacki, K. and Burke, K. (2016) My Library My History Books on Google Play Nursing Delegation and Management of Patient Care [online]. 2nd ed. Missouri: Elsevier Health Sciences. [Accessed 30 August 2018].

National Institute for Health and Care Excellence (NICE) (2016) Recognising and responding to physical deterioration of patients within a mental health and learning disability NHS Foundation Trust using a physiological track and trigger system. Available from: https://www.nice.org.uk/sharedlearning/recognising-and-responding-to-physical-deterioration-of-patients-within-a-mental-health-and-learning-disability-nhs-foundation-trust-using-a-physiological-track-and-trigger-system [Accessed 30 August 2018].

NHS England (2017) Delegation of healthcare tasks to personal assistants within personal health budgets and Integrated Personal Commissioning. Available at: https://www.england.nhs.uk/wp-content/uploads/2017/06/516_Delegation-of-healthcare-tasks-to-personal-assistants_S7.pdf [Accessed 30 August 2018].

Northouse, P.G. (2017) Introduction to Leadership: Concepts and Practice [online]. United Staes of America: Sage Publications. [Accessed 30 August 2018].

Nursing and Midwifery Council (NMC) (2010). Standards for pre-registration nursing education. Available from: https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-for-pre-registration-nursing-education.pdf [Accessed 30 August 2018].

Nursing and midwifery Council (NMC) (2015) The code: professional standards of practice and behaviour for nurses and midwives. London: NMC

Phillips, A. (2013) Developing Assertiveness Skills For Health and Social Care Professionals. London: Radcliffe Publishing.

Reading, S. and Webster, B. (2014) Achieving Competencies For Nursing Practice: A Handbook For Student Nurses. Berkshire, England: McGraw-hill Education.

Riley, J.B. (2015) Communication in Nursing. 8th ed. St. louis, Missouri: Elsevier Health Sciences.

Rolfe, G., Freshwater, D. and Jasper, M. (2001) Critical Reflection For Nursing and the Helping Professions: A User’s Guide. London: Palgrave.

Schober, J.E. and Ash, C. (2012) Student Nurses’ Guide to Professional Practice and Development. Florida: CRP Press.

Siviter, B. (2013) The Student Nurse Handbook. 3rd ed. London: Elsevier Health Sciences.

Standing, M. (2017) Clinical Judgement and Decision Making in Nursing [online]. 3rd ed. London: SAGE. [Accessed 30 August 2018].

Stanhope, M. and Lancaster, J. (2014) Public Health Nursing: Population-Centered Health Care in the Community [online]. 8th ed. United States of America: Elsevier Health Sciences. [Accessed 30 August 2018].

Sully, P. and Dallas, J. (2010) Essential Communication Skills For Nursing and Midwifery [online]. 2nd ed. London: Elsevier Health Sciences. [Accessed 30 August 2018].

The Kings Fund (2015) Leadership and Leadership Development in Health Care: The Evidence Base [online]. London: Faculty of Medical Leadership and Management. Available from: https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/leadership-leadership-development-health-care-feb-2015.pdf [Accessed 30 August 2018].

The Royal College of nursing (RCN) (2015) Accountability and delegation A guide for the nursing team. Available at: https://my.rcn.org.uk/__data/assets/pdf_file/0006/627216/004852_HP-A-and-D_pocketguide_June2015.pdf [Accessed 30 August 2018].

Thomas, C.M., McIntosh, C.E. and Mensik, J.S. (2015) A Nurse’s Step-by-step Guide to Transitioning to the Professional Nurse Role [online]. Canada: Sigma Theta Tau. [Accessed 30 August 2018].

Thomas, J. (2012) A Nurse’s Survival Guide to Leadership and Management on the Ward[online]. 2nd ed. London: Elsevier. [Accessed 30 August 2018].

Wheeler, H. (2013) Law, Ethics and Professional Issues For Nursing: A Reflective and Portfolio-building Approach [online]. London: Routledge. [Accessed 30 August 2018].

 

 

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#FundOurFuture Nurses

The RCN committee and I launched a campaign in early October calling on the UK Government and NHS England to #FundOurFuture nurses by putting a minimum of £1bn a year back into nursing higher education, as part of the long-term plan for the NHS. This would go some way to replace the funding lost when the bursary was removed back in 2016.

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Nursing students are unique. Their courses, unlike many other degree courses, are longer and on top of studies, they must spend additional time on clinical placements working all hours of the day and night for no wage. When on placements student nurses should be having learning opportunities, but due to the current shortages of staff in the profession, they’re being used to fill workforce gaps and caring for patients before they are qualified to. This isn’t fair to nursing students or mentoring staff and it isn’t safe for patients. Due to lack of funding and hours required on placement many nursing students are struggling financially because they don’t have the time or energy to work in addition to their full-time placements, or are finding themselves working 50-60-hour weeks just to get by, this is causing exhaustion and some students to quit their courses. Its therefore no surprise then that since the changes to nursing degree funding in 2016, there are almost 1,800 fewer nurses due to start at university.

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The NHS is currently planning its priorities for the next 10 years. The Government has announced additional funding for this during the recent NHS 70 celebrations. Now is our opportunity to act so we can get our voices heard not only as the nursing workforce but as members of the public too. The cost of becoming a nurse is turning people away, just when we need them the most. Right now, the NHS in England is short almost 42,000 nurses and the RCN estimates by 2023 this will rise to almost 48,000 we cannot allow this to continue. It’s vitally important that we get this right now, for the sake of all the public and our future health
You can still email your MP today about the work we are doing and why it is so important. You can share your personal experiences and tell the government why it’s important for them to support the #FundOurFuture campaign.

https://rcn.eaction.org.uk/fundourfuture

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On Wednesday 21st November, RCN students presented the case for the Government to invest in nursing recruitment and training, the need to prioritise nursing on the political agenda is essential. Higher education funding for nursing is a primary pipeline into the profession. The RCN commissioned a new economic modelling to develop two options for Government to choose from, and which must be affordable for nursing students, as well as for Government, in further development and implementation.

This report provides costed alternatives for higher education funding in England to encourage more people to study nursing: FUNDING REPORT

During the debate in Westminster on funding in higher education for nursing, I am very proud to say that the room was full of RCN student members and committee. I would just like to say a huge thank you for all your hard work in promoting the campaign and speaking with MPs and ministers about the need for bespoke funding for nursing students. I am absolutely thrilled to say that it is because of you, the RCN students, that we have secured a public commitment from Government to consult on our specific proposals for investing in nursing supply through higher education. In addition, there was also a public commitment to address the nursing supply in the Long-Term Plan and through funding.

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https://www.rcn.org.uk/news-and-events/news/health-minister-pledges-to-work-with-the-rcn-on-future-funding-for-higher-nurse-education

Watch the debate here: https://parliamentlive.tv/event/index/88368124-7dc6-42eb-a7c8-9ee332dd13c0

This is only the beginning, but we are certainly on the right path! 

https://www.rcn.org.uk/get-involved/campaigns/student-funding-fund-our-future

 

So why am I the MINT: Men in Nursing Brand Ambassador?

Following our first ever MINT: Men in Nursing Together meeting yesterday, I wanted to write a short blog post about why I am supporting this new network…

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For a long time now, it has been almost expected that if you were a nurse then you were most likely a female. Efforts to promote and support gender equality in the workplace are on the increase, however, the number of men joining the nursing profession is still very low. There are only 11.4% of registered nurses in the UK that are Male (NMC, 2017).

An interesting twist to all of this, of course, is that there are in fact more men are in leadership positions. This is definitely another topic for discussion! But personally, my current focus is that we have a 42,000-nursing shortage that is predicted to increase!

Nursing shortages have been driven by various factors, an ever-growing population, better access to health care, advances in medicine and more effective treatments. I am happy to say that the demand for men to take up a career in nursing is on the rise, this is mostly due to the increasing demand for more nurses in general. I think it is important to note that a lack of men in nursing is not only a UK wide issue, it is also a global concern, which just reaffirms the need to take action. I am a firm believer that we must act on the issues we are facing with our current recruitment crisis NOW. How can we succeed in bridging the staffing gap if we are only recruiting from half a population? We have a duty of care to provide our patients and the public with safe staffing, timely and effective care for everyone. It is vital that we act to increase our workforce to assure we can deliver competent and quality care. Not only should we be driving more men and women into the nursing profession, but we should be as a society supporting and giving more opportunities to different ethnic minorities in nursing, moreover the more diverse our workforce is the better we can represent a culturally diverse population.
This brings me back to why I said yes to representing MINT as their brand ambassador, I am a newly qualified nurse working in an acute medical unit, I see day-to-day the struggles in being able to provide my patients with the best quality care, due to staff shortages, under-resourcing and undervaluing of the profession. I am looking to remove the stigma which is ingrained into us all from such a young age that nursing is ‘women’s work’ and that all ‘Doctors are male’. There should be no mark of disgrace in being a caring professional, regardless of your gender. If you are a competent and skilled individual, with a passion to save lives, then YOU should be a nurse. Gender is irrelevant to saving lives, nursing should have no gender.

 

 

#FundOurFuture

I have just written to my MP Mark Harper about funding our future student nurses!

You can support us nurses by writing to your local MP on our behalf!
‘Hello, my name is Charlotte Hall I am a newly qualified registered nurse, I work in Gloucester Royal Hospital in the acute medical unit. Alongside this, I also work in the surrounding community health care services. I am writing to ask you to support a new campaign led by the Royal College of Nursing, it is called #FundOurFuture. The campaign is calling for the Government to make sure the new Long Term Plan for the NHS in England prioritises investment in nursing higher education.

Right now, the NHS in England is short almost 42,000 nurses and the RCN estimates by 2023 this will rise to almost 48,000. Put simply, without enough nurses your constituents won’t receive the care they need in the future. I am desperately struggling to provide that safe care now and I am exhausted. I very rarely leave my shifts on time due to the patient care load and short staffing. We often have to skip our unpaid breaks to complete legal documents, provide personal care, vital medications and talk to relatives, as there is not enough staff on duty to take over the workload.

Government reforms to nursing higher education have failed.

Since reforms were introduced in 2016 we’ve seen numbers drop year on year and it’s no surprise that there are 1800 fewer nurses with a place due to start at university. The cost of becoming a nurse is turning people away, just when we need them the most. Nursing students urgently need more financial support if the government is ever going to tackle the workforce crisis.

Nursing students are different from other students. I barely made it through the degree due to financial hardship. my partner and I had to live with my parents just so I could afford to continue studying.

Student nurses spend 40-45 weeks on their course – up to 50% more than other students. This means they don’t have time for a part-time job to earn extra money to support ourselves. They also spend 50% of their time in placement, learning in a hospital or out in the community. Sometimes wards are so short staffed they’ re used to plug the gaps and have to look after patients before they feel ready to. This is not safe or fair!

I have only been working less than a year as a registered nurse and I already fully understand why nurses are leaving this profession. Working conditions are becoming unbearable, Morale is at an all-time low. I absolutely love my job, and I want to do the job more than anything, however it’s continuing to be physically and mentally draining on a day to day basis, during and after my shifts I am left to feel like I am failing the patients as I am not able to meet their needs safely. I feel that nurses are not currently supported by this government to implement safe care to our patients. Please consider the dangers of underfunding nursing education for our future, and I say our future because it affects all of us, including you.

We need you to support nursing students.

As your constituent, I’m asking you to write to Simon Stevens, and the Secretary of State for Health and Social Care, calling on them to invest a minimum of £1bn a year back into nursing higher education.

I hope I can count on your support.’

Here is a helpful tool to help you structure your letter:

https://rcn.eaction.org.uk/lobby/fundourfuture?fbclid=IwAR3yDBz1yPwiFZ8hqYdbZKDw3wLDr-i13ieHWoYPgXcp2nGprFyGGY785Bs

 

 

The 1st RCN SIO UK Conference

I am very excited to be announcing our first ever SIO UK Conference.

This event is a celebration of the history of students in the RCN and 50 years of the student nurse’s voice.

 

STUDENT LOGO 2018

We are delighted to announce that our keynote speaker is Christie Watson, the author of The Language of Kindness: A Nurse’s Story, which has been described as “an astonishing account of a profession – defined by acts of care, compassion and kindness”. Some of you may have heard Christie speak at Congress last year. She was an inspiration.

This day is about you, how the RCN can support you, and how you can get more involved.

We will be holding a live Congress debate, hustings for the student member of Council, and there will be a Q&A session about all those questions that keep us all awake at night. We will also be launching our new student development programme.

In the evening we will be celebrating nursing students and we will be hearing from a number of members who are particularly well known for their achievements as student nurses.

Places are free but limited so please get your application in as soon as you can.

 

Check out the Agenda here!

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We are looking forward to seeing as many of you as possible.
Please note this event is open to Student Information Officers only.

 

https://www.rcn.org.uk/news-and-events/events/student-information-officer

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https://www.youtube.com/watch?v=-HymZ2pwi9o

 

#Hellomynameis

Hello, my name is Charlotte Hall and I am a newly qualified Nurse, I qualified from the University of the West of England with a 1st class honours in Nursing (Adult) general field of practice. I joined the NMC register in February 2018 and I am currently in my first staff nurse rotation job at Gloucestershire Royal Hospital NHS Foundation Trust based in an Acute Medical Unit and Endocrine ward. I am proud to be a part of Gloucestershire hospitals journey to outstanding #J20.

RNHALL
Currently, I am the RCN Student member of Council and chair of the student’s committee. I founded the @BloggersNurse twitter platform, encouraging healthcare professionals to share their learning and experiences, both good and bad. I am a proud ambassador for NHS Horizons helping to transform the perceptions of nursing and midwifery and I have recently become a #Lead2Add champion for NHS England.
I have a strong commitment to meeting the needs of patients and helping their families, by providing them with patient centred holistic care. One of the most important things I have learned as a newly qualified nurse is to never take my position as a professional lightly, we are privileged to be able to provide people with care when they are at their most vulnerable. I particularly enjoyed being a nurse activist and I am always seeking out new challenges to improve practice by being resourceful, economical and responsive to change. I am currently working on a school project with the RCN Students, where we aim to improve retention and recruitment of nurses by going into schools and demonstrating to young people what a dynamic and viable profession nursing is, we also aim to improve gender stigma in nursing.

Have you considered standing for the role of RCN Student Member of Council?

What inspired you to stand for election to RCN Council?

I started off as an RCN student information officer and it made me even more determined to want to influence change. I wanted to be on the RCN Students Committee but couldn’t as I was at the end of my degree. So I rang the RCN and asked if there was anything more I could do. That’s when I was told about the Council role and I thought “wow”. It seemed a lot of responsibility, but also very exciting. Representing 40,000 students on a national scale is incredible. I was scared at first but now I’m so glad I didn’t take the safe route.

What has the experience done for you?

It’s helped me grow personally and professionally and deepened my self-belief. I never stood for the role for my own self-purpose but it’s benefitted me in ways I never anticipated. I’ve met so many people and worked alongside some amazing colleagues as well as MPs, Lords and health campaigners – people bursting with knowledge and wisdom.

What have you had the opportunity to influence?

So much. I don’t know where to start. I was a huge part of the campaign to scrap the cap on NHS pay and have fought for the rights of students at every opportunity. We may not have always had the outcome we desired but we had the drive and we put the work in and for that I am so proud.

What’s the best advice you’ve been given?

Experience isn’t everything. Not all good leaders have vast experience and not all great activists have years and years behind them either. What they do have is a passion to advocate for those who can’t express their voices. I remember being in terrible fear of not having the answer to everything but that’s actually not relevant – in my role, you are there to put forward what members want and you don’t have to have all the answers. Sometimes your job is to ask the questions.

Why should students, and all members for that matter, engage with RCN Council?

We say a lot that the RCN is its members but people often don’t realise it’s them. It’s you reading this – every single person that takes action on anything – be it rehydration and the RCN’s healthy workplace initiative or campaigning to change perceptions of nursing, it’s all important. It’s everyone’s responsibility to make the profession better and that’s the goal of the RCN.

What would you say to someone considering going for your position?

Forget your doubts and go with your gut. You only get the chance once – you won’t lose by doing it but you will lose a once in a lifetime opportunity by not doing it. We need more people who are new to the profession to bring their unique perspective.

Could you be next?

RCN Council oversees the running of the RCN. It’s made up of 17 members elected to provide leadership and direction for the organisation. Charlotte will step down from her role in December and nominations to replace her are open now. If you’re keen to be the next student member of RCN Council, fill in a nomination form by 4.30pm on 1 October. It’s your chance to influence RCN strategy on student issues and nursing education.

If you are thinking of standing and have questions I would be more than happy to have a chat with you! Get in touch!

 

https://www.rcn.org.uk/magazines/bulletin/2018/september/five-minutes-with