Burdett STaR project final report published

We are very pleased to announce that the final report from the STaR (Supporting transition and retention of newly qualified nurses) project is published. You may obtain a copy of the final report to download at this link and the executive summary is available here. As Baroness Bottomley of Nettlestone, the Chancellor of the University of Hull, says in her foreword to the report: ‘The project focuses on a critical period in nursing and in nurse education – the transition as nurses move from final year students to becoming registered and qualified health practitioners.’

The project involved nearly 300 final year nursing students from three consecutive cohorts at the University of Hull. The aim was to find out what they considered to be the positive aspects of their final year as students and their first year as a Registered Nurse that helped them in this transition. We also report on the perspectives of employers in the NHS and private sector and educationalists about this important transition period.

During the project we developed and piloted an online toolkit designed specifically to help nurses make the transition from nursing student to Registered Nurse and you can view the toolkit at this link. We have received very positive feedback on the toolkit, and we were very pleased that most students participating in the project made use of the resources available in the toolkit in their final year.

Among our main recommendations from the project is that education providers and future employers should work more closely together both in the period leading up to registration and in the immediate post-qualification period on seamless and bespoke transition plans for individual nurses. One thing that final year nursing students considered very useful was visits to and opportunities to work in the clinical area where they intended to work. Of course, our project is only one of many contributions to the problems around the transition to practice of nursing students. We look forward to continuing to investigate this and evaluate the impact of the STaR project in the years ahead.

The project team would like to thank the Burdett Trust for Nursing for funding this project. We also wish to thank out colleagues at the University of Hull who assisted with the project and all colleagues in the NHS and beyond who cooperated and tool part in interviews. Finally, our project advisory group members and student ambassadors deserve special thanks.

Professor Roger Watson, Dr Jane Wray, Dr David Barrett, Dr Helen Gibson and Jo Aspland

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Establishing a Nursing Community

By Sam Kitchen, second year Learning Disability (LD) Nursing student, Course Representative and creator of Hull University’s first Nursing Society and member of the We Student Nurses Twitter team.  

There are huge numbers of nursing students in each year across the different fields – Adult, Child, Mental Health and Learning Disability at the University of Hull. While there were around 150 students in the Adult field in my first year, there were only 12 of us in LD and because there are so few of us, our community and the peer support we receive from each other is so important.

Through my role as a Course Representative and champion of the All Our Health framework (a call to action to embed prevention within practice by using educational materials, tools and resources), I connected with nursing students from other years and the other fields. I noticed the support they received from their peers was very different to my experience within the smaller cohort of LD nursing. While other students were communicating well through WhatsApp groups but struggling to learn each other’s names in their classes, my group were able to focus on getting to know each other’s background, interests and what inspires and motivates us outside of our role as a student nurse.

From top left: Ellis Pulford, Events Officer; Laura Greaves, Social Media Officer; Chantelle Collier, Events Coordinator; Sam Kitchen, President; Naomi Broadhead, Secretary

I decided to start Hull University Nursing Society to create links between all nursing students, from all years and all fields and help create a sense of community belonging. I gained so much knowledge and support from my fellow LD nursing students which benefited my role as a student nurse but also enriched my life. Every nursing student has a beautiful story of why they got into nursing and experience to go with it, which I believe we can all learn from. Sharing these stories and creating a sense of community and support is what the Nursing Society is all about.  The society aims to cater for all student nurses (all years and all fields), which we reflect in our committee. We have one committee member only officially beginning their student nursing journey two weeks ago, with another embarking their final year as a student nurse. We’ve already found huge value just between ourselves as a committee; we’ve been able to seek reassurance from someone who could tell us from experience, (everything was going to be okay) but also reignited that passion we had when we first started by talking to a new student.

Connecting with others, giving and receiving support, advice and encouragement is central to our nursing community. Despite being a new society, we’ve almost reached 100 members from every year and every fields which demonstrates that there was a need for this type of community.  We launched officially on 9 August 2020. Since then we have had a stall on campus at the Societies & Volunteering Fair where students from all fields and year groups came to find us to say hello, expressing how glad they were the society was setup and how important peer support was to them. Peer support is especially during the current time while all learning is taking place online and face to face meetings are not available. It’s not been easy creating a new society in a global pandemic with uncertainty about when (and if) we can host events in person, but just knowing how many students’ experiences have already been improved just by knowing this community exists, it will all have been worth it!

The Hull University Nursing Society is open to all University of Hull students. Membership is available to buy online from the Hull University Union website: https://hulluniunion.com/join-in/societies?a=364.

If you want to get in touch with the society, email us. You can find out more on Twitter (@hullnursingsoc) and through our Facebook Page.

Our toolkit is available for comment

Don’t forget our toolkit is available here and you can still comment or provide feedback on this until 18 Sept but thought we would share with you the following:

The STaR toolkit is an essential aid, a ‘one stop shop’ for all nursing students and newly qualified nurses, plus the nurses and organisations that support them. The toolkit brings together existing resources to help student nurses plan their early careers giving them the means to make smart decisions and get the best start possible. For those in preceptorship it provides links to competencies, supervision and re-validation. Packed with experiential and reflective accounts, the toolkit directs students and nurses to interactive and e-media sites to engage and enthuse them about the journey ahead. Having experienced the highs and lows of early career nursing I cannot recommend this toolkit enough.

Haley Jackson Clinical Effectiveness and Research Nurse

Humberside Teaching NHS Foundation Trust

And see what people have been saying on Twitter about us here.

Preceptorship – an essential part of the successful transition from student to newly registered nurse. But……

Jane Wray, STaR project and Senior Lecturer in Nursing

Supporting newly Registered Nurses during the early months of their nursing career is key to the development of safe, competent and confident practitioners. Supportive frameworks such as: preceptorship; clinical coaching; transition to practice programmes; residencies; and internships help embed knowledge and practice experience gained during pre-registration programmes (Brook et al. 2019). The NMC (2020) has recently published Principles for Preceptorship and this is welcome guidance for new nurses, midwives and nursing associates who have recently joined the register and are starting their careers. These principles focus on five key areas: Organisational culture and preceptorship; Quality and oversight of preceptorship; Preceptee empowerment; and Preparing preceptors for their supporting role and the preceptorship programme.

Underpinning these is a clear narrative that it is in the best interest of individual nurses, employers, organisations and patients to support newly qualified health care professionals to successfully make the transition from student to autonomous practitioner. The benefits of a ‘good’ preceptorship programme are many: increased competence; development of professional skills; a positive impact on stress levels and satisfaction; and longer term benefits to the organisation such as retention (Ke et al. 2017). It is also reassuring to see that the NMC have chosen to go beyond the ‘newly registered’ and recognised the applicability of these principles to those that may be returning to practice, internationally educated nurses or professionals who are adapting to a new or different scope of practice – including during the Covid-19 pandemic.

And the but…. Preceptorship has been around for quite some time. Staffing deficits and workload pressures have compromised organisations’ ability to consistently deliver this successfully in practice (Adams & Gillman 2016, Lewis & McGowan 2015). That is not to say there is not good practice out there – there is – and there is also substantive commitment to the principles of preceptorship. But the presence of principles, or a framework is not sufficient to guarantee implementation and significant commitment is required from clinical staff and organisations to make this a reality. This may be difficult to prioritise during the current pandemic. Finally, although there is considerable value in having access to a preceptor it is important to recognise that preceptorship is the responsibility of the whole team – not just the preceptor.

The STaR Transition toolkit has a selection of resources on preceptorship and supporting newly qualified nurses. This toolkit can be accessed here.

References

Adams, J.E., Gillman, L., 2016. Developing an evidence-based transition program for graduate nurses. Contemporary Nurse: A Journal for the Australian Nursing Profession 52 (5), 511-521.

Brook, J, Aitken, L, Webb, R, MacLaren, J, Salmon, D, 2019. Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: A systematic review. International Journal of Nursing Studies 91 47–59.

Ke, Y.T., Kuo, C.C., Hung, C.H., 2017. The effects of nursing preceptorship on new nurses’ competence, professional socialization, job satisfaction and retention: A systematic review. J Adv Nurs 73 (10), 2296-2305.

Lewis, S., McGowan, B., 2015. Newly qualified nurses’ experiences of a preceptorship. British Journal of Nursing 24, (1), 40-43.

The Nursing and Midwifery Council (2020) Principles for Preceptorship. Available at https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-principles-for-preceptorship-a5.pdf.

Transition toolkit consultation

As we approach the end of the STaR Research project we want to start sharing our findings and outputs.  One of our project objectives was to ‘Develop an evidence-based toolkit that enables newly Registered Nurses and their employers to identify, implement and evaluate a co-produced individualised approach to transition and retention’.   This week we are launching the toolkit so I thought I would take the opportunity to tell you a little more about it and the process that we went through in compiling it.

The toolkit is an online resource and was designed for students, newly qualified nurses, employers, preceptors, clinical educators and other healthcare staff involved in supporting newly qualified nurses during transition. We have been developing this over the last two years and it was informed by the interviews we conducted with students, NQNs, clinical staff and academics; the rapid evidence assessment and through discussion within the team and with our partners in practice. As part of the work we have been doing, we have connected with many others also undertaking excellent work supporting NQNs – and we have included some of their resources too, as well as ones specifically developed by the STaR project.

The toolkit is divided into the following five key sections which broadly map the journey from final year student through to qualified practitioner at 12 months post registration:

Section 1: General information

Section 2: First Job Planning

Section 3: Preparing for the Transition

Section 4: Induction Period

Section 5: Post Induction/preceptorship period

In each section, users can find links to information, advice and tasks to complete that are relevant to each particular stage in the transition journey.  It also includes a section containing resources and further information aimed at helping the user to ‘keep learning and stay connected’.  We also included links to relevant key resources by several organisations including: the Royal College of Nursing; the NHS and Health Education England; and social media links that were useful or relevant that had been identified during the lifespan of the project.

This final version has been refined following feedback from members of our project advisory group, nurse educators at the University of Hull and NQNs from an online forum. Feedback was sought on the design and layout, content, accessibility and overall presentation of the toolkit. We hope that you enjoy using the toolkit and that you find it useful.  It can be accessed by clicking here.

We would welcome your thoughts, comments or feedback on this toolkit and so please do contact us.  The opportunity to suggest amendments to the toolkit will be available until Friday 18^th September 2020.

Supporting the Transition from Student to Newly Qualified Nurse: Some ‘Top Tips’ for Academic staff supporting final year nursing students

Our final blog in the ‘Top Tips’ series is specifically aimed at colleagues working in higher education and supporting students who are due to complete their pre-registration programmes.  You can find our previous two ‘Top Tips’ documents via the following links;

Supporting the Transition from Student to Newly Qualified Nurse: Some ‘Top Tips’ for NQNs

Supporting the Transition from Student to Newly Qualified Nurse: Some ‘Top Tips’ for Clinical staff

These ‘top tips’ have been mainly generated from the semi-structured interviews undertaken in the earlier stages of the project with nursing students, NQNs, academics and clinical leads.  This is another resource from our STaR project toolkit which will be available on this website later this year.

If you would like a copy of this flyer, or our previous ones for NQNs and Clinical staff, please email the STaR project.

 

Supporting the Transition from Student to Newly Qualified Nurse: Some ‘Top Tips’ for Clinical staff

As part of our series of blogs sharing the resources we have developed in our project, the next ‘Top Tips’ document is for staff in clinical practice supporting NQNs or nursing students in the final stages of their programme. This is another resource that will be available in our toolkit which is currently being finalised and will be shared later this year via our website.

These ‘Top Tips’ emerged from our interviews with nursing students in the final semester of their programmes, newly qualified nurses at 1 month and 9 months into practice, academics with an interest in transition and retention from across the world and clinical leads and managers supporting NQNs. You can read our ‘Top Tips’ for NQNs in our previous blog .

If you would like a copy of this flyer or our previous one for NQNs please email the STaR project (star@hull.ac.uk).

Please note this is free to share and re-use under our Creative Commons license

Supporting the Transition from Student to Newly Qualified Nurse: Some ‘Top Tips’for NQNs

As part of our project we conducted 40 semi-structured interviews to gain a better understanding of the challenge students and newly qualified nurses face during the transition phase. This included nursing students in the final semester of their programmes, newly qualified nurses at 1 month and9 months into practice, academics with an interest in transition and retention from across the world and clinical leads and managers supporting NQNs. We have presented our findings nationally and internationally and discussed these with conference attendees and debated them with colleagues and peers via our Twitter®feed (@starnursehull). Our project advisory group of newly qualified nurses, students clinicians and service users have provided us with advice and feedback on our work and we have collated this into our project toolkit which will be shared later this year (watch this space!). The toolkit comprising a wide selection of resources (information, advice and tasks to complete) that are relevant to each particular stage in the transition journey and is designed to be used by students, newly qualified nurses, employers, preceptors, clinical educators and other healthcare staff involved in supporting newly qualified nurses during transition. We thought we would start by sharing some of resources we have developed during the lifetime of the project and this is the first in a series of blogs focused on‘Top Tips for NQNs’.

Please note this is free to share under our Creative Commons Licence:

https://creativecommons.org/licenses/by/4.0/

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State of the World’s Nursing: investing in education, jobs and leadership

Even before we begin to delve into the immense detail of the document – one thing stands out: nurses make a huge difference wherever they are supported in their practice. Around the globe nurses are impacting on the health and well-being of individuals, communities and populations. Nurses are the largest professional group in health care globally – 27.9 million strong making up almost 59% of the health care workforce.  We matter – a lot!  The WHO, ICN and Nursing Now report provides a wealth of information – pages and pages of data that will take weeks to absorb, but from first glance the following seem particularly important issues to me.

First, there are already a lot of nurses – but we need more. The report identifies the need to add at least 5.9 million nurses to the global workforce. This increase is to meet the evolving health needs of diverse populations and to help progress towards sustainability goals. However, this takes investment and planning. Volume is important but the need to refocus nursing programmes toward primary care and public health is also important. The report makes the point about a necessary joining up between nursing preparation programmes and health system demands but does not shed much light on how this can be achieved. In terms of increasing the workforce the report highlights to ongoing gender differential in nursing – attracting more men is an important aspect of planning for a future workforce.

Second, and linked to the point above is the need for lots more to be done to make nursing an attractive career. Globally the increased workloads, poor staff and growing demands place pressure on nurses. The report stresses the need for workplace health and safety interventions to prevent nursing burnout and attrition. It also makes the point that nurses are often very poorly remunerated for their work – and that this needs to change if we are to grow the profession. This economic issue would also help with the issue of nursing as a migrating workforce. The report recognises we have yet to strike a balance between nurses being able to use their qualification to seek a better life and the dangers of depleting a nursing workforce where it is most needed. We need to be better at retention too.

Third, I was surprised and a little disappointed at the lack of a clear message about the importance of graduate education for nurses. The evidence for the value of this is clear and the report could have been more emphatic about this matter. However, the importance of science-based training and the value of inter-disciplinarily learning in nursing programmes is highlighted. The need for well-designed specialist preparation programmes for nurses is also stressed in the report – developed to recognise the huge value nurse practitioners bring to patient care outcomes. What was conspicuous by its absence in the report is the importance of nurses as researchers and the need to grow the global nursing evidence base. This seems like a missed opportunity to me.

Finally, the report makes a very important statements about nursing leadership. Only by nurses being involved in the highest echelons of government can we ensure that our profession grows and develops safely and securely. It is at the highest levels of health policy decision making that the nursing profession needs to make its mark and ensure the contribution of nursing is recognised and rewarded. This is the key areas for the development of nursing in the next decade. An essential part of this is the necessity to continuing to produce the evidence for the effectiveness of nurse led interventions. We are quite good at this at the individual patient care level – but we need to be far better at demonstrating, with rigour, the differences nurses can make at community and population level. We also need to gather more evidence of how nursing can be linked to other sustainability goals such as environmental health, structural inequality and economic impact. So – more work to do – but this report is a helpful contribution to the development of our profession.

Extraordinary times and extraordinary measures

The present situation regarding the coronavirus has clearly been disrupting for nursing students, especially those in their final year. All students making the transition from being a final year student to a Registered Nurse need support. But right now they will need more support than even. The current set of final year nursing students are in a unique situation and, with any luck, this will probably never be repeated.

The NMC and the RCN have both issued guidance to explain what is happening. The RCN guidance New measures for nursing students will enable more to help during COVID-19 crisis  states:

• first-year nursing students will continue with their degree programme, with clinical placements paused for the duration of the emergency. These nursing students may volunteer or undertake paid work in a clinical setting in their spare time, while they maintain their academic study. However, volunteering or paid work will not be counted towards the practice hours and experience required to complete their pre-registration course.

• all other nursing students, including postgraduate diploma and masters students, but excluding third-year students in their final six months of their undergraduate degree will be invited to opt-in to an arrangement where they may spend 80% of their time in clinical practice, which will be remunerated and count towards practice hours. These students will spend 20% of their time in academic study during this emergency period to ensure structured, regular contact with their approved education institution.

The NMC has issued a comprehensive set of guidance and proposals: Information for students and educators. Under emergency standards they state:

• enable student nurses and midwives in the final six months of their programme to complete their training in appropriate placement settings
• give educations institutions and their practice learning partners more flexibility to ensure students get appropriate support and supervision
• enable students to use their knowledge and skills appropriately during this time of crisis to support the care of people

Please seek support when you need it if you are a student; colleagues in education and practice, please be aware of what is happening to students in your clinical areas. Above all, for the duration of these extraordinary measures, support each other.