A registered nurse (NA) has raised awareness of her profession through a regular podcast and addressed the stigma and misinformation that can be associated with the role.
Martyn Davey graduated in 2017 as part of the first class of nursing assistants and almost seven years later he says he will “never do anything else”.
Mr Davey set up an NA Facebook group during his training and today the group has nearly 5,000 members, bringing NAs from across the UK together to share their experiences in this role.
Shortly after founding the group, Mr Davey launched Just a Sharp Scratch – a regular podcast that now has 19 episodes and features guests such as Professor of Health and Labour Market Modelling Alison Leary, general practice nursing assistants and nursing teachers.
“There was a need for some kind of platform where nurses could share their experiences, insights and the important contributions they have made to healthcare,” he said Care in practice.
“So my goal was to create a community where nurses feel heard, valued and inspired, while educating the public and healthcare professionals about the importance of our role.”
Nurses in primary care
For the past four years, Mr Davey has worked at East Quay Medical Practice, an experience he says has shown him how NAs can play “a hugely important role” in primary care.
“By providing patients with consistent and personalized care, they (NAs) can help manage chronic conditions, conduct routine health checks, and support health promotion and disease prevention initiatives,” he said.
Mr Davey sees the extra time NAs can spend with patients as beneficial because it allows registered nurses and doctors to “focus on those complex cases,” which also allows NAs to spend more time educating patients.
Mr Davey’s responsibilities include supporting men of a similar age to better manage their diabetes.
“I want to use my role as a nursing assistant in an educational way. I am diabetic and this makes me feel like I can engage with them on an equal level and educate them about their care,” he said.
“So I can talk to them, monitor them and if I feel there are concerns, I can bring those straight back to the doctor so the patient can be reassessed. It’s kind of a holistic approach.”
Controversies about the role
Since its introduction in 2019, the NA role has been the subject of some controversy, with concerns about potential role substitution and the risk of exploitation of jobholders by employers.
In a previous interview with Nursing in Practice last year, Heather Randle, professional lead for primary care at the Royal College of Nursing (RCN), warned that there had been “significant role changes” at the college since the introduction of ARRS, with NAs and care coordinators being used in place of general practice nurses in particular.
In March statistics from the latest Quarterly update on primary care workforce found that the number of NAs working in general practice and primary care networks (PCNs) increased by 55.5% in 2023, while the number of nurses increased by only 4.5% over the same period.
NAs can be employed in general practice under the Additional Roles Reimbursement Scheme (ARRS), which can be used by primary care networks to reimburse salaries for specific roles.
GPNs are currently excluded from the scheme, however the senior level practice nurse role was added this year.
A recent report by the Queen’s Nursing Institute (QNI) has raised concerns that GPNs are expected to take over the training and supervision of ARRS staff – namely NAs – and in many cases for less money.
Change perception
Mr Davey says “it could always be better” but believes “the perception of the role has definitely evolved” since he started the podcast.
“Initially there was a certain amount of skepticism and a certain lack of understanding towards nursing assistants and their work,” he said.
“Over time, more and more people have recognized the positive influence that nursing assistants have on patients.”
“Recognition and respect for this role is on the rise and NAs are increasingly viewed as an integral member of the healthcare team.”
“Many nurses have reached out and said that the podcast resonates with their own experiences and makes them feel less alone with their problems.”
Room for improvement
Outside of the podcast, Mr Davey believes the role of the NA needs to be examined “with fresh eyes” to “reassess” it and ensure better policies are developed to protect professionals.
“It’s about making sure the role of nursing assistant is not abused. Therefore, more safeguards are needed to ensure NAs are not exploited.”
For Mr Davey, this means more clarity regarding training, professional development and fair pay.
“It must be possible to develop this role further. Clearer guidelines on the scope of work and responsibilities would prevent national representations from being overloaded with tasks that go beyond their role,” said Davey.
And he suggested that NA salaries should be considered “on an individual basis and not as a blanket measure.”
Calls for clarification of the role of the nursing assistant have also been taken up by the QNI, which issued a statement earlier this year asking for “clear guidance on the scope and boundaries of the nursing assistant’s role”.
“We are here to stay and we are here to support”
Although Mr Davey has been in this position for several years, he does not believe he will ever give it up.
“They can take patients away from nurses who do not need their care at that time,” he said.
“It’s not about taking over the work and becoming a cheap caregiver. It’s about supporting and taking the pressure off so that caregivers can focus on the critical patient who really needs their help.”
In the future, Mr. Davey plans to increase the awareness of the NAs even further.
“We are here to stay (and) we are here to support – not to be seen as cheap caregivers, because that is not what we are,” he said.
“I really want to take this role into positions that make a difference for nurses. I am in close contact with people in good, senior positions to hopefully be able to make this happen in the future.”
He added: “In order to take care of the nurses, nurses have to be in the room.”
