Legacy Nurse: An Insiders Perspective

"From my experience, it’s a role I’d recommend to practitioners who want to contribute from experience as a positive role model and educator for future generations of Health Care workers."

Judy, heading for retirement but still passionate after a 35 year career in nursing became a Legacy Nurse and found the role so rewarding that she would like to recommend to others.

My Nursing Story

In 2021 approaching my 60th birthday I was preparing to retire, feeling like I’d done my bit for the NHS. Afterall, I began my nurse training in July 1979 at Great Ormond Street Hospital undertaking a combined course at Hammersmith hospital to qualify in 1984 as Staff Nurse qualified in both adult and paediatric fields.

Returning to nursing in 1993, following a 7-year break to have my children, the professional landscape was profoundly changed by the project 2000 revolution in nurse education. I recall being very ‘miffed’ when informed that my qualifications were now only ‘equivalent to a certificate’ in what was becoming a diploma/degree level profession.

Yet over time, I accumulated further competencies matched by educational and professional qualifications up to MSc (ANP- Advanced Nurse Practitioner) to meet the requirements of posts such as Health Visitor and Community Matron, as I pursued my interests and opportunities.

A lifelong learner and peer educator, there was no end to gaining skills and learning from experience; both necessary to maintain competency and develop knowledge as an autonomous practitioner when fulfilling the responsibilities of different roles whether in community, general practice, and secondary care settings.

In 2006, my role in a GP surgery included developing a wellbeing project called ‘Quality Zone’ for patients with long-term conditions, funded as a Developing Practice Award by the Queens Nursing Institute (QNI); in 2014 I became a Queens Nurse (QN) in recognition of my commitment to patient care and nursing practice in the community setting.

When I Decided To 'Leave My Legacy'

So, back to 2021 and the end of the initial Covid restrictions and challenges; I was ready to finish but didn’t feel finished as the embers of my vocation still smouldered; then came the job advert entitled ‘Legacy Nurse’ (LN), that set it alight again but what was one?

The answer for our Clinical Commissioning Group (CCG) became four part-time, late-career, differently experienced nurses who were still passionate about the profession and had valuable insights, experience, and wisdom to pass on to learners and NQN’s in any/all settings across the large geographical area that made up the patch.

How Our Legacy Team Was Formed

Following interview, candidate selection, and induction we gelled as a group and road-tested our way of working supportively within LN team, in preparation for working with our target audiences.

We identified contacts and links to establish opportunities to work with learners employed across the CCG (as it still was in 2021). This included acute, community and general practice NHS providers, social care providers including third sector ones, and no fewer than five higher education providers: all while playing to our various strengths, on 2 days a week!

It felt very ‘Jenga’-like as we began to balance who might want us to provide what to whom, when negotiating with individuals, services, and training pathways, even before the additional and prolonged complications of Covid restrictions which meant far less face-to-face delivery than anticipated.

From my experience, it’s a role I’d recommend to practitioners who want to contribute from experience as a positive role model and educator for future generations of Health Care workers.

We spread our working days Tuesday to Thursday, all working Wednesdays in common to facilitate communication, planning and to jointly deliver educational sessions and arrange meetings that might involve us all. Meetings with Health Educational England (HEE) retention/workforce representatives, to hear our career stories and how our experience influenced our plans to establish the role, were part of this.

These led to establishment of ‘Legacy: Community of Practice’ (LCoP) sessions, an online forum bringing together teams within other NHS organisations implementing or considering a similar approach, initially in the Eastern region, later nationwide. These continue monthly, a reflection that the LN role continues to be adopted and adapted whilst assimilating shared learning from different implementation models.

What Does A Legacy Nurse Do?

Our day-to-day work of delivering the role included:

• One to one sessions

- with students and NQNs,

- supporting newly promoted staff, 

- preceptorship/coaching style conversations,

- supporting GPN assessors, following changes to the syllabus/programme.

• Group sessions

- teaching cadet nurses (those gaining foundation qualifications to enable them to apply for a nurse training place),

- preceptorship sessions with newly qualified and international nurses and

- facilitated sessions with 3rd year MH nursing students to help relate the importance of monitoring & managing physical health conditions to promote stable mental health.

• Online education and facilitation sessions

- Participation in online school programme sessions to use career insights to encourage attendees to consider a career in the NHS,

- Exploring ‘spoke learning’ topics based on our areas of experience and opportunities students were missing due to reduced placement experience due to covid. These were initially designed for Trainee Nurse Associates (TNAs);

- child development,

- renal function and disease,

- cardiac function and heart disease,

- dementia,

- skin care and wound management.

- Redesigning sessions for wider audiences including MH students and social care settings (a mixed audience of registered and non-registered staff).

Topics were expanded for the setting, including: 

Managing breathlessness,

Falls prevention and management,

Constipation,

End of Life care and ReSPect forms.

A structured qualitative and quantitative evaluation ran alongside the role implementation, gathering feedback regarding our activities and effectiveness, identifying evidence of activity in all areas, except increasing placements (aimed at the GP network and notoriously difficult):

• Preceptorship,

• Transferring skills and knowledge of Legacy Nurses,

• Improving learner experience

• Support for assessors and supervisors

• Increasing placements and

• Working with Higher Education Institutions (HEIs).

So how did other’s view what we did?

Evaluation Of The Legacy Nurse

Here are two examples of feedback on Legacy Nurse input from learners and educators.

The feedback… from students so far has been amazing… 'your personal experiences had a profound impact upon them'.

In the words of one student, sharing real-life experiences made this ‘more real’ and she felt she could ‘better remember and relate’ to actual experiences rather than learning from a ‘textbook.

Many commented on the importance of knowing the patient as a person, not just someone with a mental health diagnosis.

'It was clear your contribution heightened the students’ awareness of being ‘clinically curious.’

Nurse cadets reported seeing the Legacy Nurse as a trustworthy nurse, with experience, and as someone who cared about their learning.

The Rewards Of Giving Back

Looking back, it seems astonishing how brave we were and how hard we worked on those 2-days a week! It helped that we became a well-knit team, were all still passionate about nursing and delivering excellent, person-centred care and believed that contributing to a positive student experience can fuel a life-long, rewarding career.

From my experience, it’s a role I’d recommend to practitioners who want to contribute from experience as a positive role model and educator for future generations of Health Care workers.