An examination of a nursing assistant role in an acute hospital setting

Pressures on the Australian health system and forecasted healthcare workforce shortages have required a re-evaluation of the framework of healthcare delivery and the composition of the healthcare workforce in the Australian public health sector. Proposed health workforce reforms aim for healthcare professionals to be enabled to work to the upper end of their scope of practice, utilising their skills and knowledge, while lower trained workers attend to work that does not require high levels of training. In 2009, a new workforce initiative, an unregulated nursing assistant (NA) position, was introduced as a supernumerary addition to the nursing team in the acute ward setting at a tertiary-level hospital in Victoria, Australia. The intention of this position was to supplement the existing nursing team, to enhance patient care and assist with the nurses' workload. This study aimed to examine the unregulated NA role in the acute ward setting using a single case, embedded, descriptive case study research design. Nurse leaders (policy makers, mangers, supervisors and educators), nurses (Registered Nurse/ Enrolled Nurse) and NAs participated in individual interviews or focus groups to inform this research. Documentary evidence was collected to augment and triangulate the information learnt during the interview process. The results demonstrated that five key areas need to be considered for the implementation of the role to be effective clarity, consistency, communication, collegiality and commitment. As the NA role becomes more prevalent in the Australian context, Australian nurses need to take responsibility for enacting their profession and ensuring the quality of care provided to their patients by a wider team. They need to work as a team with the NA, sharing expectations and respect for each-others' roles within the nursing team. Australian nurses have the opportunity to learn from the experiences of their international counterparts and ensure the NA role enhances both patient care and the nursing experience through leadership, support and direction