Do Newly Qualified Nurses Receive Enough Support?

A survey of more than 5000 Student and Registered Nurses found widespread concerns about the support that Newly Qualified Nurses receive.

Newly Registered Nurses (NRNs) feel they are being left with insufficient support in their first roles according to a Nursing Times survey.

84% of Nurses responding to the survey said they thought the transition into newly registered Nursing practice had become increasingly challenging over the past two years.

Similarly, 4 out of 5 Nursing students thought their progression into the workforce would be harder than it previously had been due to Covid-19.

Nurses recounted being left in charge of wards within weeks of qualifying. The absence of support caused some to leave either their posts or the profession entirely. For others, it proved detrimental to their mental health and confidence. The phrase “thrown in at the deep end” was used by respondents repeatedly.

One Nurse recalled: “Covid-19 made an already challenging environment and transition dire. We are thrown into the deep end and expected to swim. It is unbelievably stressful. I am considering quitting Nursing altogether after only two years. My physical and mental health have suffered tremendously.”

Do you think that Newly Registered Nurses were sufficiently supported prior to COVID, or have the difficulties and demands of the pandemic merely exacerbated an already unsatisfactory situation?

Also, opportunities for study and training had been moved online or cancelled due to Covid-19 Nurses testified. A number of NRNs had their preceptorship programmes cut completely.

The aim of preceptorship is to provide structured support to newly registered practitioners, to assist in their transition from student to professional, and help build their confidence and reinforce their learning.

Stuart Tuckwood, Unison’s chief Nursing officer stated that the union was receiving reports from people involved in Nursing education and practice that they were “increasingly concerned by the challenges of transitioning into registered practice.”

Some of those replying to the survey considered preceptorship to be of even greater value given the challenges they had faced while studying during the pandemic.

One student said: “I have only had experience of placement during Covid-19 and feel that I haven’t had the opportunities so far to…gain confidence or experience in clinical skills.”

Will this lack of clinical skill development during the early stages of a Nurse’s career prove a permanent inhibitor on their professional development and career trajectory?

Just over 60% of Nurse respondents said they were offered a preceptorship programme when they qualified. Worryingly, only 43% felt they were given sufficient time to benefit from it.

One respondent explained the situation, saying: “If services are understaffed, clinical care will always be prioritised over the experiences of Newly Qualified Nurses. Practically every service is understaffed.”

Will it turn out to have been short-sighted to allow preceptorship to be negatively impacted during the pandemic, given ongoing retention issues and seemingly structural staff shortages in the health sector?

Or do workplace pressures resulting from understaffing mean that other considerations inevitably become secondary?

62% of the more than 800 students who took part in the survey said they expected to receive a preceptorship programme when they joined the workforce.

One Nursing student said they would not consider a job offer that didn’t include preceptorship, stating: “I believe this transition period from Student Nurse to independent practitioner is a crucial time in which I will require support and guidance, as I build my confidence in becoming an autonomous and independent Nurse. I also think that preceptorship [programmes] are essential in promoting safe practice and patient safety.”

Although currently at the discretion of the employer, the benefits of preceptorship can include improved recruitment and retention.

“Preceptorship plays a key role in retention by setting in place a structure to support newly qualified professionals, allowing them to translate their knowledge into everyday practice, grow in confidence and have the best possible start in their careers,” said Desiree Cox, national preceptorship programme lead.

Over 90% of Student and Registered Nurses who took part in the survey indicated they wanted to see it to become compulsory for employers to provide a preceptorship programme to Newly Registered Nurses.

Do you agree? Should preceptorship be a mandatory requirement for employers of Newly Registered Nurses?

Some workplaces may also give supernumerary status to new Nurses during their first few weeks, meaning that they will not be counted as part of the essential staffing numbers.

One Community Nurse who qualified in October 2020 said that by their third day of work they were left as the sole Nurse available and in charge of a team of eight people. This despite being promised supernumerary status for a month. On top of which, their preceptorship was subsequently cancelled as a result of Covid-19.

When asked, most Nurses (88%) and students (90%) said in the survey that they thought Newly Registered Nurses should be offered supernumerary status for a fixed period of time in their first roles.

Should supernumerary status be automatic for new Nurses, so they can adjust to their professional roles in a measured fashion, and not be subject to the uncertainties and variations of contemporary staffing demands?

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