Seconding healthcare assistants to a pre-registration nursing course: Role transition to qualified practitioner

Attrition from traditional pre-registration nursing programmes in the United Kingdom continues to be substantial and, once qualified, new staff nurses experience a number of challenges in adapting to their new role. A possible solution, strongly favoured by the current government, is to second existing healthcare assistants onto pre-registration programmes. The premise is that, because of their previous caring experience and exposure to work in the National Health Service, secondees will be more committed to complete training and will undergo role transition more effectively. This paper presents an in-depth, qualitative study concerning the role transition of newly qualified staff nurses who had previously been employed as healthcare assistants. Uptake of the scheme had been substantially lower than anticipated, with only a small number of secondees eventually returning to their original wards. Secondees, their ward managers, percerptors and clinical practice facilitators were interviewed and the data were analysed employing the sequence for qualitative data analysis described by Miles and Huberman (1994). Findings suggest that healthcare-assistant secondment may not offer a ready solution to increasing the qualified nursing workforce. Contributory factors include: the length of time required for each newly qualified practitioner to qualify via the secondment route; the degree of commitment required on the part of secondees and university staff; the apparently limited benefits of previous healthcare-assistant experience; and personal costs to the secondees. Secondees described how they had been afraid of not completing the course successfully because of the public nature of failure if they were obliged to return to their original workplaces in the same role as before. This additional pressure has not been anticipated by proponents of secondment schemes and may help to explain why so few eligible candidates applied for secondment