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Who are nursing associates?

Firstly, and most importantly, nursing associates (NAs) should not be viewed as a ‘cheap nurse’ – they bring essential knowledge and skills to a healthcare team. When valued and deployed effectively, they facilitate high quality patient care. 

The nursing associate (NA) role was proposed in England in 2015 following the Shape of Caring review (Health Education England, HEE, 2017) and is regulated by the Nursing and Midwifery Council (NMC). Professional regulators ensure that their registrants are fit to practise in their profession. Unlike non-registrants, such as healthcare support workers, registrants are accountable to the NMC which means they need to be able to account for their actions or omissions and abide by a professional code of conduct (NMC, 2018) to ensure the quality and safety of patient care.

The nursing associate role sought to ‘bridge the gap’ between the registered nurse and healthcare assistant in the healthcare team (HEE, 2017; NMC, 2022). Nursing associates contribute to most of the care for patients under the supervision of a registered nurse, but they do not complete all tasks that a registered nurse would. It is known that the nursing associate role is being utilised in many different healthcare environments (e.g., GP practices, inpatient settings, intensive care, prisons, private nursing homes, social care and in the community) and that employers have differing policies about what the nursing associate is able to do in practice. However, NAs are usually involved in the essential patient facing care, taking a more generic psychological, social and biological approach rather than a specialist, field specific approach to patient care that registered nurses would in their role. The difference between a nursing associate and registered nurse is summarised in the table. Essentially, the registered nurse will lead/co-ordinate and the NA delivers/implements. 

Table 1 The similarities and differences between the nursing associate and registered nurse (West, 2019) 

Why do we need nursing associates?

We know that there are a range of challenges for trainee nursing associates (TNAs) and NAs working in practice and the role is relatively new. Research shows that NAs have a significant and important part to play in healthcare teams but rarely is this widely noted (Thurgate & Griggs, 2023). It is our ethos at the Open University that everyone should be encouraging, empowering, enabling and ennobling the NA role to all stakeholders, including the public. 

We believe it’s important for our NAs to recognise the strengths of their role, not solely for the purposes of professional identity but so that everyone can ennoble the role and be confident in their worth as a professional in their own right.

The research report from Ryan-Blackwell & Genders (2023) (536.5 KB) , explored the strengths, opportunities, weaknesses and threats (SWOT) to NA role using semi-structured interviews and focus groups. Pages 10-12 outline the challenges and opportunities of the role and provides some information about what The Open University can do to help improve their curriculum and also what different people (e.g., learners, employers) can do to promote the role positively on p15-19. Table 1 below outlines the NA role and the positive impact they have on healthcare teams.

Table 2 What is the nursing associate role?

Conclusion

This article has provided you with information about the very important NA role in health and social care. You should be able to explain the strengths and opportunities of the NA role and if you read the full research report from Ryan-Blackwell & Genders (2023) you will also note the very significant challenges they face in practice and how people and organisations could help to promote the importance and positive nature of the role for patient care. 

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