This weeks’ blog is by Emma Dillon – Senior Lecturer Mental Health Nursing University Northampton, Emma Swain – Aspire and Level 4 Certificate Programme Lead at St Andrew’s Healthcare, Nicky Peasnell – Senior Lecturer Nursing University Northampton, Rachel Garner -Preceptorship and Clinical Placement Lead (and APEL module Lead) at St Andrew’s Healthcare and Tim Alexander – Senior Lecturer Mental Health Nursing University Northampton

The need to widen participation to BSc Nursing Mental Health and Learning Disabilities is nothing new, over ten years ago it was viewed as a necessity¹ With nursing shortages reaching all time high levels within the United Kingdom (UK) and the recognition of increasing complex health care needs² suggestions have been made on how to grow the nursing population, minimise the number leaving the profession, and enable organisations to “grow their own” registered nurses.  The level 4 Care Certificate³ aided the “grow your own” concept by providing a mandatory qualification that standardised practice of healthcare support staff. There was limited evidence of research within the area of fast-track routes into year two of nursing in the UK⁴, future research into the experiences of students who had undergone accelerated nursing programmes was needed to provide a deeper understanding of the factors impacting their experiences⁵.

In view of this, the ASPIRE project (2016) was developed as a partnership pilot initiative between the University of Northampton and St Andrews Health Care.to support local healthcare trusts to develop their Health Care Assistants (HCA) and provide a fast-track education programme that enabled Accreditation of Prior Learning (APEL) into year 2 of the BSc Mental Health (MH) and Learning Disabilities Nursing (LD). The study aimed to explore how well students’ have been prepared in the transition from year one nursing and the ASPIRE process to year two in meeting the requirements of the BSc Mental Health and Learning Disability programmes.

Compared to a traditional route into nursing is the ASPIRE process effective in providing the confidence, knowledge and skills that will enable a HCA to safely progress to an undergraduate student nurse?

The objectives:

• To identify areas of good practice and ways to support the students transition into year two of the LD and MH BSc nursing programmes.
• To further develop the students’ confidence, knowledge and skills to initiate safe patient care.

Ethical approval to Interviews took place with a mixture of traditional students and fast track ASPIRE students at the end of year 2.

Of the 30 participants, 23 were ASPIRE and 7 were traditional students. All interviews were recorded, transcribed and thematic analysis undertaken by an independent (external) researcher.

Key Findings:

1. Traditional students felt more prepared for year 2 in terms of course expectations and academic preparation.
2. Both groups of students indicated the same things that would help with the transition: help with online activities, prioritizing and managing workload.
3.  Both groups of students had felt nervous about the Practice Learning Opportunity (PLO) in year 2 and what to expect. The ASPIRE students reported that sometimes the PLO didn’t feel challenging enough.
4. A sense of belonging as a cohort and student nurse had mixed responses with the ASPIRE students finding it took longer to feel they belonged.
5. Both groups of students felt they already had and most definitely developed their organizational levels over year 2.
6. Both groups of students felt that their communication skills developed over year 2.
7. Students in both groups reported that they felt confident to navigate and access support for the electronic practice document. They were all vocal in key academic and practice staff who were very helpful.
8. Both groups welcomed robust academic feedback and asked for more detail.

Discussion

Both groups’ experiences of year 2 BSc MH/LD nursing were very similar, the ASPIRE students felt less prepared and had found it took longer to feel a sense of belonging to the cohort.  This provided rich learning for the partnership. Based on these findings, an ongoing review of the ASPIRE programme and positive evaluation and feedback, some key improvements have been made. For example,

During the ASPIRE transition year, students receive five education sessions at the university enabling them to gain familiarity with the environment and university processes. They have regular “meet and greet” sessions with university staff and students to build a sense of belonging and meet university support teams such as the library. Prior to year two, students have a final session with the university and the organisation to answer any last-minute questions and explore hopes and any worries. The learning in the ASPIRE transition year is mapped to that of the year 1 BSc nursing programme due to feedback from the interviews.

Student Feedback

“‘I made it my ambition to be accepted onto the programme and fortunately my manager supported me wholeheartedly. The tutors on the course are lovely and the combination of their backing and the work experience I have gained on the wards meant I felt confident joining the nurses at the university in the second year of their degree programme” (Alice)

“For those, such as me, with dyslexia or who perhaps didn’t do so well at school, it offers an alternative route into becoming a qualified mental health nurse. I’ve gained such a lot of knowledge and been able to use my previous experience too” (Stephen)

“Aspire is a great way for St Andrew’s to develop home-grown nurses and for us to retain them. When I was younger, university wasn’t an option, but Aspire has enabled me to reach my potential” (Susan)

“Fantastic programme without which it is very unlikely I would have been able to return to study and qualify as a registered mental health nurse. Long may it continue” (Simon)

Conclusion 

133 student nurses have progressed via the ASPIRE programme (2016-2023) with an accelerated access to year 2. Of these, 122 have graduated with a BSc Mental Health nursing and 11 with a BSc Learning Disability nursing.  At eighteen months post-graduation 95% of the nurses are in senior roles demonstrating the success of a programme that facilitates a “grow your own” approach to workforce.

References

• Royal College of Nursing (2013) https://www.rcn.org.uk/news-and-events/news/uk-mental-health-parity-it-feels-like-a-losing-battle-101023
• NHSE (2023) Long Term Work Force Plan https://www.england.nhs.uk/publication/nhs-long-term-workforce-plan/
• Skills for Care (2013) Support for leaders and managers/ Managing people/Code of conduct https://www.skillsforcare.org.uk/resources/documents/Support-for-leaders-and-managers/Managing-people/Code-of-conduct/Code-of-Conduct.pdf
• G. Pollock.K and Crawford.P (2015) A case study exploring the experience of graduate nursing students when learning in practice. Journal of Advanced Nursing 71 (9)
• M. (2011) Graduate- entry nursing students’ experience of an accelerated nursing degree: a literature review. Nurse Education in Practice 11, 81-85