Nursing associates 6 years on: A review of the literature

Aim
This paper reviews the empirical research evidence relating to the nursing associate (NA) role since its implementation in England in 2017.

Background
The NA role arose from the findings of the Raising the Bar: Shape of Caring Review (Willis, 2015). The roles' aim is to bridge the gap between healthcare assistant and registered nurse as part of the nursing team, working with people of all ages in a variety of health and social care settings. NAs must successfully complete a trainee programme (usually a Foundation Degree) which, for many, has been completed as an apprentice while remaining in their place of work.

Methods
A literature search was performed using the British Nursing Index and CINAHL Plus, along with Google Scholar. Exact key words were ‘Nursing Associates’ and papers were refined to primary research only. Data restrictions were applied from 2017 to the end of September 2022. Each paper was critically appraised to assess the robustness and validity of the search processes and then thematic analysis was undertaken using Braun and Clarke's (Qualitative Research in Psychology, 3, 2006 and 77) six stages of analysis.

Results
Nineteen papers were identified; six key themes emerged: lack of support from others; career development; organisational readiness; resilience in the face of adversity; cost; and worker and learner identity.

Conclusion
The NA role is allowing career progression for those who would have historically been prevented from accessing the nursing workforce because of entry qualifications and financial limitations. There is a need for organisational readiness to ensure trainee nursing associates (TNA) are supported during their training, that they have equal opportunities to learn, and they are given the status and recognition as a learner. Organisations need to raise awareness among staff to allow the nursing team to understand the NA role.

Relevance to clinical practice
This literature review has relevance for those who employ Nursing Associates or who are considering introducing the role.

No patient or public consultation
Due to being a literature review no patient or public consultation took place; however, local employers identified the need for a review of the literature pertaining to the Nursing Associate role.