Case studies

Ruth Fortune is a registered nursing associate in an older adult’s community mental health team at Oxleas NHS Foundation Trust. Ruth shares her experiences both as a nursing associate and as an ambassador.

How it started

“I had no burning ambition and fell into nursing. I started at Oxleas at aged 19 and I was here for 10 years, maybe more. I then moved into the private health sector and around seven years ago decided to come back and worked in the crisis team. When the nursing associate role came about, it was discussed with me and to be honest - I was not convinced.

“My life was good, and I worried about failure and what it could mean. Did I want to take the risk? Did I really want this role?

“One of the consultants said something to me that gave me the injection I needed. They said, ‘It’s about the recognition for what you already do’ and that is what it took for me to take the step and start my nursing associate journey.

“After I qualified, I was very fortunate to get a scholarship on the Florence nightingale leadership course and now I’ve been accepted onto a nursing apprenticeship to eventually become a registered nurse in mental health. In this journey of lifelong learning, I do not stop evolving.  

The benefits to the Trust, organisation, and patients

“At Oxleas, we have set up quality improvement programme related to antipsychotic medication. With this I make appointments to visit people in their homes and carry out cardiometabolic assessments and as part of this I take blood samples and check for lipids, HBA1c and try to really promote the parity between physical health and mental health.

“In my role, I am reaching people who would not ordinarily access mental health services at GP’s. As a result of the quality improvement programme in my team, we have identified a number of people who are diabetic to pre diabetic and those with cholesterol levels which the GP has then followed up with.

“As a nursing associate I now have evidence-based information, I have more flexibility and knowledge and can be dynamic as things progress for any given patient. Any interventions I put in place for patients is more of a collaborative approach and much more person centred.

The challenges  

“When I first started out there were some difficulties. I was in the first cohort of trainee nursing associates - the role was brand new and people around me did not really know much about the role or the skills a nursing associate or trainee nursing associate have. This brought some level of anxiety and hesitance.  

“Initially colleagues did not realise we had a PIN number or would be accountable so there was some confusion to begin with. What was lovely is that people were genuinely interested in the role and wanted to know more, and I personally encountered lots of positivity and curiosity.  People felt assured once I explained and feel very positive about the role.

“The one thing that surprises me given my experience is that there are not more nursing associates. Nursing associates can only improve care for service users, patients and families, and years from now we will not even be questioning this role. The role can be whatever an employer wants it to be to support its services.

As an ambassador

“The HEE ambassador role is a new role for me. I started a couple of months ago and I mostly utilise twitter and social media to promote the role and link in with other nursing associates who are currently undergoing training. Really the main thing I do as an ambassador is promote the role and provide support.

“For instance, I have had a couple of people who have approached me directly with specific questions either related to job interviews or preparing for work. I have also provided advise around bank work and because of my bank work background in a crisis team, I could really relate to this query. Being part of the first cohort, I also speak at various events speaking to potential students and employers, demonstrating to them the value of a nursing associate.

My advice

“If you are thinking of becoming a nursing associate just go for it, take a risk, it’s a fantastic role and there are so many opportunities. Throughout this, I have not met anyone who regrets their decision. Say yes and push yourself outside of the comfort zone, be open to opportunities. Really, just make the very best of every opportunity that comes your way by saying yes.” 

Kerslie Luktung is a trainee nursing associate in Cumbria, working in general practice. He shares his experiences of supporting patients with learning disabilities.

How it started

“Before starting the course, I worked as a healthcare support worker. I am now a trainee nursing associate following a learning disabilities route. I started in March 2020 and initially I struggled to manage my time and the jump from healthcare support worker to nursing associate felt like 10 levels. As my confidence grew, I felt much better.

“My journey initially started in a care home where I looked after patients with dementia, and it was here that I decided that I wanted to become a nurse. For me, the best route to do this is via a nursing associate route.

“Before I started as a trainee nursing associate, I was already working in the surgery and we identified that we did not have any learning disabilities leaders in the surgery for nursing. Knowing it could improve the quality of patients’ lives, my manager and I sat down with my mentor and discussed how I could support. I chose to go down a learning disabilities specialist area as I had an interest, and it also fit the needs of a surgery.

The support I provide and the impact I have on patients

“In my role, I contact patients for an annual health check. There are 178 patients on our learning disabilities register, and we have a robust system of calling them in. I get to know them and measure things like BMI and then follow the health check template. They then go to see a nurse practitioner and get a medication health check. The more skilled I become; the more time the practice nurses have to do what they are qualified to do.

“A typical day for me includes being a health care assistant in the morning and in the afternoon I’m a trainee nursing associate. This works for me and the practice. I have been trained to do learning disabilities checks and I also did an annual health check course so on Thursdays this is the bulk of my role.

Moving forward

“Right now, it is still early days but I’m doing a lot more dressings, health checks and support lots of injections like those for the flu and vitamin B12 and everyday I’m becoming more competent in other areas.

“My practice is part of four different surgeries and we’re a big team. We work collaboratively to give patient centred care.

“I saw a patient recently who had a bad wound, I took a swab and could see signs of infection. I took my concerns to the GP who prescribed antibiotics. Without my trainee nursing associate course, I wouldn’t have known what to look for, nor would I have had the confidence to talk to the GP and share my concerns. Because of the training and education, I’ve received on this nursing associate journey, I can see changes in the way I think about treating patients.

My advice

“If you are considering becoming a nursing associate, just go for it. It will improve every aspect of your life, your skills your knowledge, your experiences, and your confidence. For me, working in primary care is incredibly exciting - it works for me, my interests and my career aspirations.”

Tracy Eves is a registered nursing associate in a nursing home for adults with physical disabilities. Tracy shares her experiences as nursing associate with us.

“Meadow house is a nursing home for people with disabilities in Norfolk, we care for people aged 18 and above. I qualified in December 2020, and in my role as a nursing associate I am part of a team that delivers person centred care, it is not just about medications but about making our residents as comfortable as possible.

“I initially started as a care assistant then went on to become a senior care assistant before becoming a trainee nursing associate. The nursing associate course gave me clinical skills and a deeper understanding of the laws, legislation, and policies as well as a better insight into the human body. Being on the NMC register, it has also given me accountability. As a care assistant I used my instincts and now as a nursing associate I have clinical judgement to support patient care on my side as well.

The benefits to the Trust, organisation, and patients

“As a nursing associate, I step in and support the nursing staff. I support with catheter care, medication, escalate things where needed, calling in the doctors or paramedics. When we were in the height of the pandemic, we had nurses who had to isolate or who were not able to come in – as an organisation we were not using any agency staff but as a nursing associate I had the skills to be able to support and fill gaps.

“During this time, I was still studying, juggling assignments as well as the fear of what we were facing. On one of the night shifts, it felt as though everything was falling apart, but we got through it, and we got through it by working as a team to support our residents.

The challenges 

“After leaving school with not much education to my name, on my first day of university I didn’t think I had a chance, and I had my doubts. It was my 20-year-old son who encouraged me to get through that bit. The training has been intense but now I am on the other side, I have the confidence to make decisions that benefit colleagues and our residents. The knowledge I have gained about medication has had the biggest impact on the care I give.

“Between the other nursing associate and I we have bridged the gap between carers and nurses, and we have been adaptable to the needs of our residents and employer. We can be a senior carer and also adopt nursing skills as necessary.

“I love care and I love looking after people and having gone through this journey I have made myself proud – I have a foundation degree to my name and there is a career path for progression. If you are thinking about becoming a nursing associate, the biggest thing is to believe in yourself.”

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