Newly registered nurses are struggling to see primary care as a ‘viable place’ to start their careers, with limited placements opportunities and many vacancies seeking experienced nurses only.
Despite the UK facing growing nurse shortages, vacancies are being described as hard to come by across primary and secondary care, with many roles requiring a level of experience that prevents new nurses from applying.
Limited opportunities
Laine Cooper is a final year nursing student at the University of Cumbria and is set to graduate in a few weeks’ time.
She has undertaken six nursing placements as part of her studies and is soon to complete her final placement in general practice nursing.
Five out of six of Ms Cooper’s placements took place in hospital settings, such as surgical and ward environments.
Speaking to Nursing in Practice, she explained how she was initially assigned her final placement in an outpatient ward – which was presented to her as a primary care opportunity – but she pushed to complete her studies in general practice instead.
‘I’ve fallen in love with primary care and it’s only when I came to this placement that I realised that primary care is definitely where I want to work,’ Ms Cooper said.
‘When it comes to having primary care placements, I think you’re very lucky if you get a placement in a GP or out with a district nursing team, I think that it’s very much pushed on us [nursing students] that we’ll be working in a ward or working in A&E or ICU and I think primary care is really overlooked.’
Ahead of graduating, Ms Cooper has been looking for general practice nursing roles to enter once she has completed her studies and received her pin.
Despite looking for over a month, she has so far only found two suitable general practice roles, with one only offering a 16-hour contract.
‘There are no jobs and it’s just a battlefield to try and get a job whether that’s in primary or secondary care,’ she explained.
The need to invest
Sara Baldwin is a general practice nurse and advanced clinical practitioner champion at Lancashire and South Cumbria Training Hub.
She believes more investment is needed to protect primary care nursing and enable practices to recruit general practice nursing.
‘I really feel that unless there’s more money and more investment coming into primary care and into nursing in primary care, I think it’s going to be a dreadful loss to the community,’ Ms Baldwin told Nursing in Practice.
‘There’s a lot that goes on in primary care that relies on nurses, and I think we are an integral part of primary care.
‘We are the supper connectors of primary care. We’re ones who signpost to everybody else. We really are the gatekeepers of the gatekeepers.’
Ms Baldwin described the lack of funding as ‘appalling’, and made clear that her practice makes a real effort to recruit newly registered nurses into primary care, while committing to train and support the new nurses who enter the role.
‘We spend far more time than we can afford effectively,’ she added.
However, she warned that poor funding for practices to house nursing students on a clinical placement meant there was not always an ‘incentive’ to do so.
While clinical placement tariffs vary across the country, medical placements typically have a much higher tariff than those for nursing students.
For example, at the Lincolnshire training hub the tariff for nursing students is paid at £3.49 an hour per student, or £130.88 a week based on a 37.5-hour week, according to Ms Baldwin.
This contrasts with the tariff for medical students which is approximately £450 per week per student, with the placement actively seeking to ‘encourage’ and ‘attract’ students to seek employment as GPs in Lincolnshire after their placement.
Ms Baldwin recently expressed her concerns in a GPN roundtable hosted by Nursing in Practice, reiterating the difficulty that surgeries are facing in trying to ‘justify the costs’ of hiring newly registered nurses into primary care.
The need for training
Senior lecturer in adult nursing at Keele University, Dr Andrew Finney, has a background in general practice and has been working to help the university better prepare nursing students for a career in primary care.
Since last year, Keele’s School of Nursing and Midwifery, has been working closely with the Staffordshire Training Hub as part of its GPN training school which aims to help standardise training and support for nurses new to general practice.
While there had been strong interest in the GPN school, Dr Finney said more widely that for many nursing students primary care still does not seem ‘a viable place to start your career’.
‘I think the main reason why newly registered nurses have not opted for primary care is that they feel it is not somewhere where you can start with no post registration experience,’ he added.
Dr Finney believes there is a sense among students and newly registered nurses that secondary care experience is needed before making the transition into primary and community care.
Though he said the GPN school – which provides training pathway for nurses new to general practice – has helped reassure new nurses that primary care is an option, and provided a ‘safer passage’ into the sector.
Dr Finney believes more practices need to recognise that ‘primary care nursing is not something you can just drop into,’ but that specialist training is required to best prepare and entice newly registered nursing staff.
He warned that the expertise of general practice nurses is increasingly overlooked and under-appreciated, citing the early exclusion of general practice nurses from the additional roles reimbursement scheme (ARRS) as clear evidence of this.
‘I think in primary care more so than anywhere else, there’s a fear that Band 5 nurses might no longer be the chosen model,’ added Dr Finney.
