3. Compulsory rotational posts

Suffolk Branch

(R) That this meeting of RCN Congress urges Council to call for rotational posts to be compulsory for the first year after qualification

Result

The resolution was rejected.

For: 16.51% (69)
Against: 83.49% (349)
Abstain: (15)

Debate report

Andrea Williams, of the Suffolk branch, addressed Congress to call for rotational posts to be compulsory for nurses for their first year after graduation. By making rotational posts compulsory, newly registered nurses (NRNs) would gain a wide variety of skills, have a structured career path, and therefore become better nurses, she said.
Simon Clark from the Eastern region backed the argument and stated that there is an increasingly diverse group of patients that need to be cared for, and nurses need varied skills in order to do this.

Roisin Devlin from Northern Ireland argued that an NRN’s career progression would be delayed if they must go through an additional year of not being able to focus on their chosen field.

A point of order was raised to change the term ‘compulsory’ to ‘available’ but it was decided that this would change the resolution too drastically and it was agreed that the debate would continue.

There was an overwhelming feeling that while rotational posts are valuable, making them compulsory would not benefit all NRNs. Iain McGregor, Vice Chair of the People’s Forum, questioned if this was to be unique to the NHS or all areas.

The proposer clarified that it was not necessary to decide on the finer details of the system now, and that rotational posts need to be part of a robust system along with preceptorship.

Background

Rotational programmes are well established in medicine and are gaining popularity in nursing. They have been defined as “the purposeful and organised movement and education of staff within and across organisations to enhance both the success of the organisation and the employability of staff ” (Coyne, 2011). By moving around an organisation, it is argued that newly registered nurses (NRNs) will gain a broader skill set and experience of nursing practice, easing the transition from higher education to employment.

On starting work, NRNs can feel that they have been thrown in at the deep end, with the reality of practice demanding a catch-up for practical skills; development of clinical judgement; a new dynamic for professional relationships; improved time management; ward or caseload management; being accountable and responsible; prioritisation; and delegation.

A compulsory rotational programme in the first year post-qualification, with preceptorship and study days to update mandatory training skills and learn new ones (such as IV administration, venepuncture and cannulation), could ensure maximum learning and development opportunities and equip staff nurses to care for a range of patients in different clinical settings. For example the Scottish Government currently has a policy initiative to support NRNs, who have studied in Scotland but cannot get a job through the 1 Year Job Guarantee scheme, into work. This currently operates as a one year part-time internship scheme where NRNs are placed in NHS boards and go through a rotational programme, while also completing the Flying Start preceptorship programme.

It can also be difficult for NRNs to be sure which area of nursing they want to develop a career in. Rotational programmes can help them to make up their mind, ultimately leading to improved retention for organisations.

There are logistical impacts to rotational posts, not least the detailed co-ordination needed, but also for issues such as funding if nurses aren’t being recruited into static vacancies. Additionally, the feasibility of such posts in community settings where NRNs are attached to a community team and in the independent sector, needs consideration.

The wider skill set would have advantages in Northern Ireland, where recruitment and selection processes for band 5 nurses mean trusts no longer recruit to specific posts or areas of clinical practice, and instead simply engage general band 5 nurses on a part-time, full-time, temporary, permanent or temporary waiting list basis.

References and further reading

Coyne P (2011) An evidence based model of job rotation, Doctor of Professional Studies thesis, School of Health and Social Sciences, Middlesex University [online]. Available at: www.nurserotation.com/index.php/thestudies/thesis (accessed 12/03/13) (Web).