Amelia Greenwood-Blott

Agency nurses, protect yourselves, protect your patients

Background

The project evolved from the need to have a programme of mentorship and leadership for agency nurses, which was previously unheard of in this sector. Agency nurses are able to provide the highest level of care through years of experience in a variety of health care settings, and with the extra specialist support of a designated clinical lead nurse they are able to become advocates for the patients that they care for. 

 

Agency nurses are able to provide the highest level of care through years of experience in a variety of health care settings, and with the extra specialist support of a designated clinical lead nurse they are able to become advocates for the patients that they care for

 

Our aim is to protect agency nurses and in turn empower them to protect their patients providing the highest standard of care. In turn we are able to safeguard the patients our nurses are caring for, maintaining high standards of patient care utilising quality evidence-based practice.

We identified that agency nurses were often moved from a service or indeed prevented from working in a service after an untoward incident occurred rather than being given the opportunity to learn and develop from it. Agency nurses did not experience the same level of support and opportunity to learn and develop that permanent nurses were able to.

 

[...] agency nurses were often moved from a service or indeed prevented from working in a service after an untoward incident occurred rather than being given the opportunity to learn and develop from it

Aims and objectives 

The initial aim of the project was to develop support for agency nurses through a tangible resource, and then deliver it for the nurses that work with the Local Care Force nursing agency.

We also wanted to promote the idea to local nurses and services to move forward nationally.

It is the intended aim of the project to share our experience to enable others to follow our lead in providing specialist support and mentorship to agency nurses.

nurse sitting with patient talking about medication

Agency nurses do not experience the same level of support and opportunity to learn and develop that permanent nurses are able to

Activity to date

We have developed a ‘Protect yourself, protect your patients’ training package for our Local Care Force (LCF) nurses to support their induction. This includes training in mental health, professional issues and clinical skills. We also include clinical supervision and peer support, revalidation workshops, appraisals and bespoke support for individual nurses. In addition, new nurses are provided with an overview of expectations, managing challenging situations, and safeguarding.

We also developed a training package for non-clinical office staff to enable them to have an increased awareness of the day to day challenges faced by agency nurses.  

We have made plans for the future development of the project to incorporate the RCN’s toolkit for agency workforce. We have developed the LCF blog, Facebook page, Twitter feed and LinkedIn social media platforms.

We were finalists in the Nursing Times 2017 ‘Patient Safety Improvement’ category, the Talk of Manchester 2017 ‘Best Specialist Recruitment Agency’ award winner, and are 21st in the Times ‘Top 100 Best Small Companies to Work for’ in 2017.  We have also been named finalists in the Burdett Trust 2018 awards, in the ‘Who Dares, Wins’ category.

Outputs to date

We have produced an Agency Nurse Survival Guide, client feedback forms, a ‘Getting to Know Your Clinical Lead and Clinical Trainer’ handout, a revalidation support handbook and a comprehensive guide to the ‘Agency nurses protect yourself’ project as part of our nurses’ induction pack. 


Lessons learned

The first and foremost challenge we faced and still continue to face are the negative attitudes and prejudices often held toward agency nurses and nursing agencies.

Convincing “traditional” nursing services that we are different than the perceived “usual” nursing agencies took hard work and persistence. 


The first [...] challenge we [...] face are the negative attitudes and prejudices often held toward agency nurses and nursing agencies

 

Agency nurses voiced to us that they often feel disenfranchised from their contemporaries that have permanent roles. By enabling them to build their confidence from support provided by a clinical lead nurse they no longer felt distanced from their peers. Our nurses professionalism has spoken for the benefits of having a clinical lead nurse supporting them.  

It was unknown to have clinical leads hence the initiative evolved through trial and error, learning with our nurses as part of a team.

open book

Agency nurses voiced to us that they often feel disenfranchised from their contemporaries that have permanent roles

Reflections on impact

We surveyed 143 nurses registered with a nursing agency at the RCN Job Fair in 2014. Of those nurses, 79 had or did work for an agency.

38% said they did not feel fully supported by their agency and 60% felt isolated while working for an agency. 37% did not always feel safe and 40% did not feel that they got a complete explanation of their agency placement.

 

38% [of surveyed nurses] said they did not feel fully supported by their agency and 60% felt isolated while working for an agency. 37% did not always feel safe and 40% did not feel that they got a complete explanation of their agency placement

 

We also surveyed 64 nurses who did not work for an agency, and asked them why they might not work for one. 49% said they felt they would not be supported enough, 55% said they felt they would not be offered career development, and 47% felt they would not receive adequate training. 

Eighty-seven nurses working for Local Care Force were surveyed 6 months after the conception of the project. 99% felt supported, 79% felt part of a team and 89% felt safe when working. 

Going forward we intend to utilise the nurse feedback forms to monitor client satisfaction.We will continue to monitor and collate the number and type of incidents to identify any trends that may inform increased support and training for our nurses. We are in the process of developing a formal tool to utilise to monitor and improve staff satisfaction.

The way forward

The project is both scalable and applicable to all agency and non-agency services that employ nurses as pastoral care can often be lacking in both sectors. The project is not role, specialism or site specific.

It is anticipated that with increased coverage and promotion of the project, the framework and ideology will become the gold standard for support of nurses within the agency sector. 

We hope that others across the UK will take on board this approach to support their nurses and in turn provide safer, supported and empowered agency staff. 

The initiative is simple and straight forward to emulate and replicate.

Sustain momentum embed the project

We have developed an active presence on social media including Facebook, Twitter and LinkedIn, ensuring that we are open about how we provide unique support to the nurses that work with us. 

Links have been forged with the RCN, becoming members of the West Yorkshire branch Multicultural Nurses Network and our clinical lead undertaking training to become a RCN steward.

We attended congress 2017 as voting members and plan to facilitate a fringe event at congress and hold a stall promoting the project at congress in 2018. 

We have entered a number of 2018 awards to promote awareness of the project. 

With the 2017 publication of the RCNs ‘Healthy workplace toolkit for an agency workforce’, plans are in place to utilise the toolkit within our project to further solidify the support and mentorship we provide to agency nurses.