The role of the assistant practitioner in the clinical setting: a focus group study

Abstract

BackgroundAssistant practitioners have knowledge and skills beyond the level of traditional support workers, and work in many clinical settings. However, some assistant practitioners lack a clearly defined role and may be under-used due to issues around accountability and uncertainty about their purpose. This paper explores the assistant practitioner role from the perspectives of assistant practitioners and registered nurses.MethodsThis study aimed to explore the role of the assistant practitioner from the perspectives of assistant practitioners and registered nurses in two NHS hospital trusts in Oxfordshire, United Kingdom. Six qualitative focus groups were undertaken between February–March 2017. Ethical approval was obtained (FREC 2016/05) and written consent was provided by participants. Data was analysed thematically analysed using the Framework method.ResultsNineteen participants (assistant practitioners, n = 12; registered nurses, n = 7) were recruited using convenience sampling. Emerging themes related to ‘fluctuating roles and responsibilities of assistant practitioners’, ‘role differences between registered nurses and assistant practitioners’, ‘working relationships’, ‘supervision’ and ‘redefining nursing pathways’.The Results and Discussion sections highlight a lack of role clarity and blurring of boundaries between the roles of assistant practitioners and registered nurses, with many tasks undertaken by both. This lack of ownership of ‘nurse-specific’ roles by registered nurses was evident and clear differences were only encountered with regard to accountability. The development of the Nursing Associate role provides managers with the opportunity to redefine staff banding hierarchies to ensure that clinical staff are aware of their role capabilities and limitations and are practicing safely, whilst promoting career development and progression pathways.ConclusionAddressing issues around role clarity can benefit professional development, satisfaction, role identity and ownership for registered nurses and assistant practitioners, by recognising the individual and collective value they bring to the clinical team. The findings can help inform the development of the Nursing Associate role.

Motivations, experiences and aspirations of trainee nursing associates in England: a qualitative study

“…The SEN role was phased out in the 1990s after the restructuring of nurse education following criticism of its lack of career progression and the limitations imposed by employers in narrow interpretations of role competencies [19,20]. More recently the assistant practitioner (AP) role was introduced [6], however it has experienced wide variation in titles, scope of practice and pay due to a lack of national regulation [21,22].…”

Motivations, experiences and aspirations of Trainee Nursing Associates in England. A qualitative study

“…The SEN role was phased out in the 1990s after the restructuring of nurse education following criticism of its lack of career progression and the limitations imposed by employers in narrow interpretations of role competencies (19,20). More recently the assistant practitioner (AP) role was introduced (6), however it has experienced wide variation in titles, scope of practice and pay due to a lack of national regulation (21,22).…”

The organisation of nurse staffing in intensive care units: A qualitative study

“…Coupled with the development of new roles, such as critical care nursing associates (Bates, 2019), and physician assistant/ assistant practitioner roles in ICU, the workforce operates in an increasingly diverse way across the United Kingdom. The evidence around these changes is, as yet, lacking but a need to better understand what influences how this new workforce is deployed has been articulated (Henshall et al, 2018), not least as there are several implications around role boundaries that have a direct impact on staffing decisions.…”