Setting up a National Community of Practice for Internationally Educated Professional Nurse Advocates

In this blog, Emma and Kevin, both qualified Professional Nurse Advocates, discuss why they set up a National Community of Practice for Internationally Educated Nurses, the impact to date for its members, and their hopes for the future. Emma Perry (@EmmaPerry2007) is a Mental Health Nursing Advisor for International Recruitment at NHS England and the Divisional Director of Nursing Adult Mental Health at Black Country Healthcare NHS Foundation Trust while Kevin Fernandez (@k9fernandez) is a Lecturer for Adult Nursing and the International Lead for the Three Counties School of Nursing and Midwifery at the University of Worcester.

Prior to and especially during the COVID-19 pandemic, there was growing evidence emphasising the need to support the wellbeing of healthcare staff and ensure a culture of supervision, kindness, and compassion (OneVoice, 2021; NHS Reset and NHS Confederation, 2020; West et al, 2020). Research has highlighted that regular restorative clinical supervision (RCS) offers significant health benefits to healthcare professionals and supports retention (Davenport, 2013; Wallbank, 2010).  A principle of the Professional Nurse Advocate (PNA) model (adapted from the Professional Midwife Advocate) was to strategically respond to national initiatives, particularly in supporting the mental health and wellbeing aspect of the NHS People Plan 2020/21 (NHS England, 2020b) and the NHS Long Term Plan (NHS England, 2019).  The Advocating for Education, Quality and Improvement (A-EQUIP) Model (NHS England, 2021a; 2021b) has been shown to have several benefits including advocacy for healthcare staff and service users and promoting the education and development of nurses.

As part of the National NHS England PNA programme, places were allocated specifically for internationally educated nurses (IEN).  The National Community of Practice (CoP) for IEN PNAs was set up in August 2022 to recognise and support this cohort of nursing colleagues.  As stipulated in the original terms of reference, which were reviewed and approved in January 2023 by the chairs, the objectives of the CoP are:

  • to provide a reflective, restorative, and brave space for qualified and trainee IEN PNAs,
  • to facilitate a network of clinical support, and
  • to amplify the IEN PNA voice.

This aligns with two of the four #StayAndThrive bundles of ‘belonging’ and ‘maximise personal and professional growth’ identified from research into global migration and retention of international nurses (Pressley et al, 2022). Furthermore, evidence from the Workforce Race Equality Standard reports (NHS England, 2023) has shown that black and minority ethnic staff members have measurably worse day-to-day experiences of life in NHS organisations and have more obstacles to progressing in their careers.  When we first met in the summer of 2022, we discussed how we could ‘amplify the whispers’ of our IEN colleagues who do not speak up in the same way and volume as their white UK healthcare colleagues.  This can be potentially attributed to the known cultural and linguistic barriers but also aligns with the third NHS People Promise (NHS England, 2020a) statement; ‘we each have a voice that counts’.

Group members collectively agreed the definition of IEN to be culturally and linguistically diverse nurses who trained overseas or in the UK.  The CoP meet via MS Teams on the third Thursday of each month, with member presentations and guest speakers who are working as or supporting PNAs reflecting the four key elements of the A-EQUIP model (NHS England, 2021a; 2021b).  We have, to date, successfully engendered a community of nurses sharing best practices in supporting the health and wellbeing of the IEN workforce celebrating each other’s PNA journey and successes (see image 1). From January to June 2023, 100% (n=37) of members who completed a member feedback survey said they would attend again and recommend it to other International Nurse PNAs.  Moreover, 100% (n=37) have an action or idea that they will take away to support their professional development and/or wellbeing. We continue to maintain and promote the community whilst also considering how we further evaluate the impact that it has on members.

Image 1: Example of CoP IEN PNA members’ feedback

We are energised and inspired after each community of practice meeting.  We hope all nurses, especially international nursing colleagues, take up the opportunity to train as a PNA and join a community of practice that promotes and maintains their personal wellbeing and professional development.

Further information on the community of practice, case studies and resources for IEN PNAs can be found here Internationally Educated Nurse PNAs – Professional Nurse Advocate (PNA) – FutureNHS Collaboration Platform



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