Exploring apprentice nursing associates' experiences of their home placements in primary care or social care.

BACKGROUND: An increasing number of apprentice nursing associates undertake their home placement in primary care or social care, but there is limited understanding of apprentice nursing associates' experiences in these settings. AIM: To explore apprentice nursing associates' experiences of a home placement in primary care or social care and provide initial insight into what may support or hinder their professional development in these settings. METHOD: A mixed-methods study design was used with qualitative interviews complemented by a quantitative survey. Participants were recruited among 27 current or former apprentice nursing associates studying at one London university. Eleven current or former apprentices were interviewed and 15 completed the survey. FINDINGS: Participants' motivations for applying to become nursing associates were to develop professionally and advance their careers. They experienced supportive learning environments where they felt part of the team, but also unsupportive learning environments where they were denied protected learning time and supervised practice. Several participants experienced unfair treatment and abuses of power, including non-payment for university days and external placements, sexual harassment and marginalisation. CONCLUSION: Apprentice nursing associates can have suboptimal experiences of home placements in primary care or social care and be subjected to unfair treatment and abuse. Urgent action is required from higher education institutions and employers to ensure apprentice nursing associates are adequately supported.

Student nurses' experiences of discrimination and racism on work placements: What can higher education institutions do?

BACKGROUND: There is persistent interpersonal, institutional and structural racism within the health sector and higher education. Such anti-Black and anti-Brown racisms are experienced by nursing students, nursing apprentices and fully qualified nurses. This discrimination intersects with other characteristics, namely gender and student status, which can make the nursing profession an unsafe environment for many. OBJECTIVES: To understand student nurses' experiences of racism and intersecting oppressions, at university and on work placement. DESIGN: A qualitative descriptive study with individual interviews and focus groups. SETTINGS: A widening participation higher education institution in London, UK. PARTICIPANTS: Twenty-four student nurses and nurse apprentices studying on an adult nursing programme. METHODS: Students were recruited through purposive sampling. In-depth data relating to student nurses' perspectives and experiences were gathered through two focus groups and three individual interviews conducted by student nurse peers. Interviews were transcribed verbatim and open coding was used to analyse transcripts using comparison and thematic analysis. RESULTS: Three key themes arose: safety and support in the university space; hierarchical treatment in work placements due to intersecting race and 'student' identities, and; direct racism by patients and staff in work placements. CONCLUSIONS: Student nurses expressed their vulnerability to discrimination and racism whilst on placement in the National Health Service. More opportunities within university curricula are needed for student nurses to learn about, reflect on, and gain support for managing experiences of discrimination in the health system.

Community learning disability teams: the need for objective methods of prioritization and discharge planning.

As part of caseload management for community learning disability teams (CLDTs), it would appear reasonable that services would have a mechanism for prioritizing referrals and discharge planning. However, any formal mechanism in relation to these two aspects apparently is lacking within the literature. This theoretical article attempts to illustrate this evidence-base need, and demonstrate how a prioritization and/or discharge planning system would aid CLDTs. In light of the scarcity of material for the learning disability sector, information has been examined from other health domains such as mental health. The paper also presents a discussion on whether rationing of services is best done via explicit or implicit means. Issues related to setting referral criteria and the allocation of referrals are also considered. Although suggestions have been made for CLDTs, it is difficult to do so whilst the evidence base for this sector is so lacking.

Caseload management in learning disabilities.

Like most health and social services, community learning disability teams are under increasing pressure to manage burgeoning caseloads without extra resources, both in terms of finances and staffing. This paper describes how one team set out to help practitioners manage their caseloads by developing tools to standardise workloads and prioritize referrals according to client need.