Professional Nurse Advocate – Evidence-Based Nursing Blog

In this week’s blog, Kate Wales (@Katewales20) and Emma Dillon (@EmmaDillonMH) share their thoughts on their experiences of the Professional Nurse Advisor (PNA) journey as a PNA graduate and PNA module leader. Kate works as a national PNA and Governance Manager for The Practice Plus Group, and Emma is a Senior Lecturer on the University of Northampton and a member of the national PNA Expert Reference Group.

The Professional nursing attorney (PNA) was launched by NHS England in 2021 Chief Nurse Ruth May highlighted the necessity to equip nurses with the abilities to grasp the demands of their role and the way colleagues may feel, develop leadership skills, improve quality, and embed robust Restorative Clinical Surveillance (RCS) into healthcare. Based on the Professional Midwifery Advocate (PMA) document and supported by the AEQUIP framework (1), providing the much-needed structure to actually concentrate on and support nurses, a compassionate work culture and enable high-quality care, purposeful education and mental safety through ( RCS) emphasizing the role of PNA.

The impact on nurses’ physical and emotional well-being has been discussed for a few years as a part of ad hoc sets of fine practice to make sure authentic and lasting interventions that support and enable nurses’ true ability to acknowledge and take care of themselves with the intention to provide effective take care of others. Evidence shows that nurses’ poor well-being may impact the standard of care provided and increase the chance of nurses suffering moral harm (2). The have to feel a way of belonging, care and concern for our colleagues increases the sensation of being valued, respected and supported, which promotes positive well-being (3).

To enable those completing a PNA course to attain maximum personal and skilled development, it is vital that they feel supported and have a secure space by which they’ll reflect, restore and develop their very own self-care technique to then have the option to facilitate authentic leadership, education and RCS for others , all based on compassion and curiosity. Nurses have to feel supported to do the fitting thing, have a voice, and have a supportive culture to take care of well-being (4).

Kate’s journey to PNA

When I began my PNA course on the University of Northampton, I knew I desired to be a part of a culture that recognizes and respects the mental and physical needs of our staff, understanding that during the last yr our healthcare teams have needed to adapt to a changing environment and recent ways of working . Our teams’ resilience has been tested to the limit because of the coronavirus pandemic. I desired to create a culture where employees say that “my right to supervision”!

In June 2021 I studied on the University of Northampton where I had a really positive experience taking the PNA course. The course covered leadership, quality improvement, self-care, mindfulness, personal and skilled resilience and supporting staff wellbeing.

The course allowed me to concentrate on the wellbeing of our staff and emphasized the importance of reflective practice and supporting staff inside Restorative Clinical Governance. For example, I arrange wellbeing forums for our Health in Justice (HiJ) PNAs to make sure they stay secure, handle their mental health and have the chance to learn from one another.

Taking the course equipped me with the abilities and knowledge obligatory to support the implementation of RCS and allowed me to appreciate that the historically largely hierarchical and prescriptive way of conducting clinical governance needed to be revitalized and refreshed in my very own organization to enable a culture of continuous improvement.

From my very own experience, I understand the importance of compassion, self-care and kindness, and the way necessary it’s to value the well-being of our staff to have interaction and empower them in order that we are able to take care of our patients more safely.

Staff working with HiJ are exposed to such emotionally difficult situations and there are sometimes high levels of emotional labor and compassion fatigue. Therefore, there’s a necessity for effective clinical leadership to support staff through the trauma and challenges they face each day. Restorative clinical supervision is the one trauma-informed supervision model that allows and enhances personal growth through personal reflection and renewal (5).

Within HIJ there is commonly a high level of illness amongst staff and the day-to-day demands of the clinical environment mean that healthcare teams are likely to prioritize service demands over the necessity for ongoing reflection and support for wellbeing, often leading to high levels of illness. burnout (6). We often see within the nursing industry that clinical supervision is commonly one in every of the primary things to be discarded when staffing levels are low or service demands require it. In my role as PNA and thru my experience, I felt that the best value I could offer could be to supply employees in any respect levels with a secure and reflective space where they may recharge and reflect on the challenges employees face each day.

In May 2022, I used to be delegated to the position of national supervision manager and PNA leader at HIJ, and the aim of the project was to instill a culture of positive supervision throughout the organization and the role of the PNA. My vision was to create a multi-professional environment based on a restorative approach that will provide flexibility and ad hoc opportunities to access supervision, recognizing that point to attend sessions is all the time very difficult to secure and noisy environments are sometimes difficult to supply a secure space for reflection. This just isn’t to say that prescriptive, structured supervision sessions are sometimes needed across the HiJ, but to acknowledge that the model can reveal flexibility in its approach. It is essential to emphasise that the proposed model involved multiple professionals (including registered staff, non-registered staff and allied health professionals) so there was a possibility for a shared understanding of one another’s roles.

As a part of the project, I conducted a baseline survey and focus groups to find out what the barriers and enablers to effective clinical supervision were. Not surprisingly, the important thing topics highlighted were time, resources, access to a professional supervisor and confidentiality, although most employees said they valued supervision. I quickly realized that restorative clinical governance could be a cultural shift for some people within the organization and the necessity for positive psychology and compassionate leadership to enable implementation. Resources, including posters and leaflets, were developed and made available to all parties to boost awareness and profile of existing PNAs and the RCS model I used to be attempting to implement. I conducted awareness sessions throughout July and August, encouraging staff to take part in conversations about clinical governance and the aim of PNA. A niche evaluation was conducted to find out current service delivery and implementation support needs.

Personally, to have the option to effectively implement the PNA role, it needed to be operational and strategic in nature.outbid’ from my organization. Meeting with key people in my organization, including the Director of Nursing and Quality, to have a look at how the PNA role could possibly be implemented across the organization and the way we could support colleagues to develop the role and construct support forums to enable staff engaging in the method was essential.

What was exciting was that we formed a monthly PNA network of 20 of our trained PNAs and held our first “Community of Practice” meeting which enabled us to plan for the long run at HiJ. We have 37 aspiring PNAs in the subsequent cohort of the PNA program, which is admittedly exciting!

I’m currently working with the Foundation for Nursing Studies to develop a resiliency-based/restorative clinical supervision trainer/master training model that shall be implemented across the Health in Justice system.

summary

Kate’s journey is an ideal example of how powerful the PNA role may be for nurses, nursing students and other members of the healthcare team. We must truly put money into ourselves, one another, and the people around us to actually embed a real culture of well-being that allows QI/leadership, education, and patient care to flourish.

Check PNA website.

Bibliography

1. Capito C et al(2022) Advocates for skilled midwifery: providing restorative clinical supervision. Nursing times [online]; 118:2,26-28.
2. Society of Occupational Medicine (2020) Mental health and wellbeing of nurses and midwives within the UK: https://www.som.org.uk/sites/som.org.uk/files/The_Mental_Health_and_Wellbeing_of_Nurses_and_Midwives_in_the_United_Kingdom.pdf
3. The Kings Fund (2020) The Courage of Compassion: https://hsruk.org/hsruk/publication/kings-fund-courage-compassion-supporting-nurses-and-midwives-deliver-high-quality
4. Royal College of Nursing (2020) Well-being. Psychological safety: https://protect-eu.mimecast.com/s/pKdMC5l9YIMDKJwszmOYO?domain=rcn.org.uk
5. Wallbank (S) (2016) A restorative model of resilience in supervisionvolume 1. 1^street ed. Hove: Pavilion.
6. Rouse S (2019) The role of PMA and barriers within the effective implementation of restorative clinical supervision. British Journal of Obstetrics. volume 27 (6)

(Visited 5267 times, 2 visits today)