Case study - the registered nurse

Ryan

Ryan recently completed his pre-registration nurse education and has taken up a staff nurse post on an emergency admissions unit in Warwickshire, but for the least five years he worked as a health care assistant in a cardiology unit and hospital bank, in every ward and department as needed.

Working on different wards, Ryan was very aware that his role as an HCA varied according to where he was working. He had taken many courses and been signed off as competent in tasks such as venepuncture, conducting ECGs and many others. However, he found that while some registered nurses would be confident to delegate appropriate clinical tasks to him, others would only let him perform the more fundamental (yet still important) tasks. This would depend upon the registered nurse’s confidence in delegation.

Ryan decided to make the journey from HCA to staff nurse, but it was not an easy three years. During his time at university he got married, had two children and moved house twice, all while studying full time and continuing his HCA role!

If you too are thinking about moving into the registered nurse role, Ryan provides the following advice:

Spend some time watching and talking to different nurses to get a good understanding of the role. During your training, remember what it was that brought you into the profession, and try to provide the best care possible. Ensure that you work within your role boundaries if you continue to work as an HCA at the same time.

Ryan believes HCAs are an integral part of the nursing team, and thinks communication is the key to effective working between registered nurses and HCAs. HCAs’ skill sets can sometimes be ‘overlooked’ if others are not aware of all the tasks they are competent to perform. He is keen to promote the use of the terms ‘registered’ and ‘unregistered’ staff as opposed to ‘trained’ and ‘untrained’ or  ‘qualified’ and ‘unqualified’ staff, as it can undermine all the hard work HCAs put in to being signed off as trained and competent to perform a wide range of important nursing tasks.

Key points:

HCAs are in a great position to go on to become registered nurses, as they already have a wealth of knowledge and experience behind them.

It is important to be able to demonstrate competence through competence based training and assessment. This enable registered nurses to delegate effectively and appropriately.

All members of the healthcare team must be aware of the limitations of their role and work within their competence levels at all times.The RCN  has produced the briefing paper The Nursing Team: common goals, different roles (PDF 79KB)  [how to access PDF files] which explains how the members of the nursing team work together.