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Preface

The Nursing Associate’s Handbook of Clinical Skills has been written for trainee nursing associates, whose numbers are continually growing. Those who have contributed to the 59 chapters are experienced clinicians and academics. The text aims to help trainee nursing associates develop and hone their skills in order to demonstrate proficiency as they offer care and support to people.

The nursing associate, in England, is a new member of the nursing team. The role has been devised in order to help bridge the gap between the health and care assistant and the registered nurse; it is a stand‐alone role providing a progression route into graduate‐level nursing, should the nursing associate desire this.

The nursing associate works with a variety of people of all ages and in a range of settings in both healthcare and social care. A review undertaken by Health Education England (2015), the Shape of Caring Review, revealed a discrepancy in skills and knowledge between healthcare assistants and registered nurses. In England, the creation of a new healthcare role was announced – the nursing associate. The role helps to meet the changing health and care needs of patients and the public. In July 2018, the Nursing and Midwifery Council (NMC) became the legal regulator for the nursing associate, and on 28 January 2019, the nursing associate part of the NMC’s register was opened.

By law, the NMC was required to set standards of proficiency for nursing associates, and they did this (NMC, 2018a). The nursing associate is required to demonstrate proficiency in these standards in order to join and remain on the register. The standards set out what nursing associates are required to know and what they can do when they join the register. These standards are the minimum that are necessary to join the nursing associate part of the register.

This book is framed around annexes A and B of the proficiencies (NMC, 2018a). There are two parts reflecting the NMCs annexes, with subdivisions/units and the chapters. Providing the information in this way will make the parts, units and chapters easier to relate with and help the student make links with their programme of study; this is a core text.

In annexe A, the nursing associate is required to demonstrate communication and relationship management skills. At the point of registration, the nursing associate must be able to communicate effectively, with sensitivity and compassion, and to manage relationships with people which are key requirements to the provision of safe, high‐quality person‐centred care. The proficiencies must be adapted to ensure that they meet the needs of people across their lifespan, and in order to do this, the nursing associate requires a diverse range of communication skills and strategies that will ensure that individuals, their families and carers are supported to be actively involved in their own care wherever this is appropriate.

Annexe B of the proficiencies (NMC, 2018a) focuses on procedures that are to be undertaken by the nursing associate. The nursing associate is required to demonstrate proficiency in being able to carry out the procedures that have been described in this book in order to gain entry to the NMCs register along with an awareness of how requirements for procedures can differ across various health and care settings.

The nursing associate must apply evidence‐based best practice with all procedures that they undertake regardless of the care setting. The ability to carry out these procedures safely, effectively, with sensitivity and compassion are key requirements outlined in the NMC’s Code (NMC, 2018b).

The nursing associate contributes to most elements of care provision, including delivery and monitoring, the registered nurse takes the lead on assessment, planning and evaluation. Nursing associates contribute by reassessing, re‐evaluating and reviewing.

In demonstrating the procedures, the nursing associate must do this with an awareness of variations that may be required in different practice settings and for people across the lifespan. In doing this effectively and with expertise, the procedures are carried out in such a way that they reflect cultural awareness and ensure that the needs, priorities, expertise and preferences of people are always valued and incorporated into care provision.

The chapters engage the reader by using a range of teaching and learning tools. Tools include pre and post‐test questions, take note boxes and supporting evidence features that steer you towards the appropriate literature or provide links to electronic resources. Integrated throughout the chapters are the NMC proficiencies (NMC, 2018).

At the point of registration, the nursing associate must demonstrate cultural awareness when caring for people, ensuring that the needs, priorities, expertise and preferences of people are always valued and taken into account. Where appropriate, there are a series of flags that are used to highlight the fact that the nursing associate offers care and support to a number of people, in various settings. These flags are used to draw your attention to key issues. Red flags denote serious pathology; orange flags represent the equivalent of red flags for mental health and psychological problems; yellow flags are associated with beliefs values, emotions, fears and cultural consideration; blue flags highlight relationship issues; green flags are linked to the Code and legal issues; and violet flags have been used to represent issues that are concerned with housing or social issues, acknowledging, for example, that nursing associates care for people in places of detention and in secure environments, as well as for those who are homeless.

Using a range of full‐colour illustrations, photographs, line drawings, tables, and graphs, the book engages readers, providing them with the skills to be able to demonstrate proficiency and to make the important link with theory and practice.

The terms that are used to describe people and communities are important. The importance of these terms is that they have the potential to create a particular perception of an individual or community that may be positive and enriching or harmful and stigmatising. Addressing people and communities how they wish to be addressed can enhance the therapeutic relationship.

There is and has been much debate about the best words to describe those people who use the services of healthcare professionals (including nursing associates). ‘Patient’ has been the traditional term; for some, the word ‘patient’ conjures up an image of passivity and the implied inequality in the relationship between the parties. It should also be pointed out that many people using the services of the nursing associate are not ill, but may be attending with lifestyle concerns, for example, fertility issues or for vaccination against illness.

There is a multiplicity of terms used in practice and in the literature, for example, ‘person’, ‘survivor’, ‘service user’, ‘users’, ‘patient’, ‘expert’, ‘consumer’, ‘recipient’ and ‘client’. In this text, we have employed a number of terms to describe those who use the services of the nursing associate.

We have taken on writing this book for you with delight as we respond to the needs of the growing numbers of nursing associates. This book provides you with information that will empower you to develop and master your skills, and grow in confidence and competence, enabling you to offer care to people that is safe, effective and responsive to their needs.

Our aim was to produce a helpful, informative resource that provides you with the principles of care that can be adapted to meet the needs of people in dynamic healthcare and social care environments. Our aim was also to help you understand and perfect the care and support you offer as you realise that your contribution to the health and well‐being of communities and nations is essential and is a combination of both art and science.

Ian Peate Gibraltar

References

1 Health Education England (2015) “Raising the Bar. Shape of Caring: A Review of the Future Education and Training of Registered Nurses and Care Assistants” https://www.hee.nhs.uk/sites/default/files/documents/2348‐Shape‐of‐caring‐review‐FINAL.pdf last accessed November 2019

2 Nursing and Midwifery Council (2018a) “Standards for Proficiency for Nursing Associates” https://www.nmc.org.uk/globalassets/sitedocuments/education‐standards/nursing‐assciates‐proficiency‐standards.pdf last accessed November 2019

3 Nursing and Midwifery Council (2018b) “The Code Professional standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates” https://www.nmc.org.uk/globalassets/sitedocuments/nmc‐publications/nmc‐code.pdf last accessed November 2019