Recruit and Retain:The nursing perspective in the

Western Isles of Scotland Strategies for recruiting and retaining

health care workers in remote and rural areas 2011

Dr Annetta Smith 11 October 2011

Overview

Pre-registration nurse educationThe start: recruitingThe experience: retainingThe finish: measures of success

Post-registration nursingRecruit, retain, enhance, develop Future perspectives

The Start: Recruitment

Background The funding for nursing and midwifery students comes from the

Scottish Government's Health budget The NHS commissions the number of nursing and midwifery

students using mechanisms calculated to meet the healthcare sector's workforce requirements for the future

The NHS and the HEIs collaborate to achieve the best outcomes. A critical measure is that an optimum number of students successfully complete the programmes they embark upon, and subsequently enter the Nursing & Midwifery Council (NMC) Register and enter employment in the healthcare sector

At present non means tested bursary is £6578 P.A.

The Start: Recruitment

Average recruitment 17-20 undergraduate students p.a. Recruitment mainly from local area

Approximately 93% of applicants from 2007- 2011 had a local contact address on application

The Start: Recruitment

Applications received from:School leaversFE / HEI graduates Mature students

Access courses

Revision of career aspirations From other employmentRe-joining the workforce

“Some might say that leaving a good job with prospects and a regular income is risky or even foolish, but I can honestly say that I have never once looked back.  I took the plunge to retrain as a nurse and have grown every day since, on both a personal level and a professional level. ..

The campus location was of vital importance to my decision to study nursing.  My life is here, my family, my children, my home – it wasn’t an option for me to leave the island for 3 years of study.

I hadn’t studied in over a decade...I wasn’t a particularly high achiever.  However, I discovered that with a bit of determination and commitment, it’s amazing what can be achieved.  I enjoyed it so much that I completed my degree with Hons, and am now studying at Masters level.  If someone had told me a few years ago I would be doing this now, I wouldn’t have believed them.”

Some unknown impacts

Change in number of school leaversDestination of school leavers – local vs.

mainland Job security Availability of social/ family supportGrowing impact of finance on study and

careers decisions

The student’s academic experience

Education experience needs to be equitable with students on similar programmes

Access to wider network Good grade trajectory

“I would feel bad if I didn’t do well – I see the investment that is made for me and that makes you invest in yourself” (3rd year student)

The student’s clinical experience The practice placement experience needs to meet NMC

requirements NMC review 2011(QA monitoring), e.g.

‘Evidence of effective partnerships between education and service providers, including other education institutions’

“Good rotation of placements and breadth of experience”(3rd year student nurse)

“They [mentors] want you to succeed” (3rd year student nurse)

“The learning environment is good. The clinical network is used to give students the best experience” (3rd year student nurse)

The student’s social experience ...

Measures of success: UoS Bomont Prize winners for excellence in clinical practice

Rachel Macleod 2006/7 Norma Macleod 2008/9

Measures of success: Completion

Employability and destinations

Local / National / UK employers:– NHS– Social care– Private sector – Oil industry

International

Post-registration: recruitment

• Healthy recruitment of Band 5 – 7

• Recruitment of specialist nurses can be more challenging

• Increasing remoteness can impact on recruitment

Post-registration: retain, enhance, develop • One year job guarantee / Flying Start • Education – pathways

– http://www.youtube.com/watch?v=qD9VtFMGA4Y

• Development opportunities - clinical career structure e.g. – Clinical academic careers (Clinical Academic Fellowships)– Clinical doctorates

• Access to wider clinical networks • Maintaining competence and confidence • Job fulfillment• Value base

Developing perspectives: Enhancements

NES

NHSWIHead of clinical governance and practice development team

UoS WI campus staff

Policies and ProceduresMPT reviews NMAHP Education forumHonorary contractsDesignated teachersClinical Strategy Support & advice

KNOWLEDGE & SERVICE EXCHANGE NETWORK BETWEEN NHS WESTERN ISLES & UNIVERSITY OF STIRLING

University of Stirling and NHSWI has developed a Knowledge and Service exchange network in which mutual and complementary goals are developed and supported between the University of Stirling and NHS Western Isles

Future perspectives

ChallengesFinancial NHS re-design Age profile of workforce Integration agendasReview of nurse education in Scotland

OpportunitiesNHS re-design Integration agendasReview of nurse education in ScotlandBetter use of simulation / VLE Integrated project with Education / NHS / HEI for hard to

recruit areasResearch –development of robust evidence base

challengesopportunities