Clinical Nurse Specialists (CNSs) and Nurse Practitioners (NPs) are registered nurses with relevant experience and post-registration education for working within a specific area of practice. They assess, manage, deliver care, advise on, and support the care for people within a specialist area (Chief Nursing Officer Directorate, Transforming Roles Paper 8, 2021)
Across NHSGGC there are over 200 Clinical Nurse Specialists and Nurse Practitioners practising in a wide variety of different areas including:
Oncology, Cardiology, Dermatology, Diabetes, Minor Injuries, Gastroenterology, Nutrition, Gerontology, Orthopaedics, General Surgery, Pain, Palliative Care, Respiratory, Rheumatology, Sexual Health, Vascular, Urology, HIV, Diabetes, Osteoporosis, Parkinson’s disease, and Stoma Care The recently published CNO’s Transforming Roles Paper 8 provides an updated definition.
Definition
“A registered nurse with relevant experience and post-registration education for working within a specific area of practice. Educated in an appropriate subject to the level of graduate certificate (honours degree) at a minimum, although a postgraduate certificate is recommended, they are assessed as clinically competent in their defined area of practice. They assess, manage, deliver care, advise on, and support the care for people within a specialist area.
As a Level 6 Senior Practitioner they work under guidance in a peer relationship with other members of the multidisciplinary team. They have the autonomy to act and accept responsibility and accountability for their actions, acting as a skilled advisor or resource for others. This includes specialist assessment, informed decision making, and treatment using a personalised approach to care for patients’ multidimensional presentations. This may require supporting specialist care over a prolonged period of time. They have the authority to refer patients, and may admit or discharge within appropriate clinical areas of practice. This is characterised by a level of decision making based on detailed knowledge and understanding of their area of practice.
As part of the multidisciplinary team they can work in or across many settings, including non-clinical, depending on their area of expertise and scope of practice.” (CNOD 2021)
Training
CNSs and NPs train in post for the role. Increasingly, CNSs and NPs are being formally employed in training posts (using Annex 21 from Agenda for Change) while they learn. Trainee CNSs and NPs are supervised whilst they learn and will also undertake appropriate post-registration education at university to support their learning. Trainees will build a portfolio of evidence to demonstrate they are competent to practice which is formally assessed at the end of their training.
Competency Framework
Transforming Roles Paper 8 sets out the core competencies for any CNS or NP. To these additional specialist competencies are added. The competency framework needs to be completed before a new CNS or NP can be regarded as appropriately prepared.
Agenda for Change
CNSs/NPs are paid at a minimum of Band 6
A warm welcome from the Advanced Practice Team at NHS Greater Glasgow & Clyde. We are here to support the Nurse Practitioners, Advanced Nurse Practitioners, Clinical Nurse Specialists & Advanced Clinical Nurse Specialists of NHSGGC. We have a variety of resources including important information about these roles, links to key documents, information on education and CPD, and support with the ANP / ACNS sign off procedure.
Staff can access all of these resources by visiting the NHSGGC Staffnet site, selecting ‘Nursing & Midwifery’ from the top menu, and selecting ‘Advanced Practice’.
Contact details
The key Advanced Practice contacts for NHSGGC are:
Dr Mark Cooper – Consultant Nurse, Advanced Practice
Victoria Campbell – Lecturer Practitioner, Advanced Practice
Edward Pool – Lecturer Practitioner, Specialist Practice
But when these pressures or demands become excessive, and you can’t cope with them, then you can become stressed. For many people, stress is a significant problem that seriously affects their daily lives and the lives of those around them.
Stress is the most common mental health problem faced by people throughout the world. Two in five of us will experience stress at some stage in our lives and seven out of 10 of us know someone who has it.
So what is stress?
For most people, it involves anxiety or depression, or a combination of both. It becomes a problem when you can’t get rid of it, even though you try. You feel you are losing control of your life. You feel that you can’t cope with things that others can deal with.
The range of signs and symptoms of stress include:
The good news is that there’s a lot that can be done to support people struggling with stress.
NHSGGC’s stress in the workplace policy has been developed to support staff to deal with issues that contribute to stress at work and in the outside world. It encourages staff wellbeing by giving information on techniques and services which help individuals to cope with pressure and stress and equipping all staff, including managers, with tools to identify the risk of stress and intervene at an early stage.
Staff should be aware of the signs and symptoms of stress as outlined in this article, and know how to receive support if required. The organisation has put in place a range of measures to reduce the risk of staff being affected by stress in the workplace, but staff should be aware that stress can often originate from life outside of work. The organisation will do all it can to support you if you are suffering from stress.
A guide to the policy and the responsibilities it sets for the organisation, managers and individuals in supporting employees at risk of stress.
The organisation
NHS Greater Glasgow and Clyde is committed to:
action to support employees to address issues contributing to stress at work and in their wider lives
action to support staff who have experienced mental or physical health symptoms associated with stress to return to work and ensure their skills are not lost
action to tackle stress and provide support to help staff manage stress.
Directors and senior managers
developing an organisational culture where stress is not seen as a sign of weakness or incompetence and where seeking help in managing stress is seen as a sign of strength and good practice
reducing and managing, as far as possible, factors which lead to stress in the workplace
providing advice and information to managers on their duty of care to staff
encouraging a working environment where staff who feel at risk of experiencing the effects of stress can raise an issue in confidence.
Line managers
encouraging a team culture where mental wellbeing is as important as physical health
carrying out stress risk assessments every two years or before if stress related issues are raised
resolving work-related issues at individual level and team level as appropriate, involving people outside the team if necessary
regularly reviewing excess hours worked by staff
when change is being introduced, provide the necessary support and training to staff
when issues arise, involve staff in seeking solutions.
Individuals
ll staff are responsible for:
talking to your line manager if you have a problem. If this is not possible, then you should talk to our occupational health service or human resources
supporting colleagues experiencing work-related stress and encouraging them to talk to their line manager, occupational health service, human resources or trade union
seeking support, which may include in-house counselling from the Occupational Health Service
speaking to your GP if worried about health issues
recognising that stress is not a weakness
attending stress management course if identified that this would help
discussing with your manager whether it is possible to alter your job if necessary to make it less stressful.
Human resources department
The department is responsible for:
promoting a positive culture within the workforce
assisting the process of return to work for staff
facilitating discussions within areas of conflict
making sure that polices and codes of conduct are adhered to.
Trade unions
Trades unions are responsible for:
encouraging members to speak up
investigating potential hazards and complaints from their members
liaising with managers to carry out risk assessments.
Occupational health service
The service is responsible for:
providing support for staff who may be experiencing stress
advising managers and staff on stress triggers and risk assessment process
delivering training and education programmes on stress risk assessment with the Health and Safety Service
monitoring and reviewing patterns of stress-related sickness absence.
In-house counselling service
The service is available to anyone experiencing problems which affect their ability to function.
Part of Occupational Health, the service is responsible for:
offering help to establish a tailor-made programme of stress management which extends beyond work into home life
offering help to individuals is assessing whether their coping strategies are working
offering an opportunity to talk in confidence about any problem or difficulty, whether work-related or not. The service offers face-to-face and telephone appointments. Please call 0141 201 0600 to make an appointment with one of our counselling team.
Health and safety service
The service is responsible for:
ensuring training is provided to managers to carry out stress risk assessments
advising managers on effective measures for work-related stress
helping monitor work-related stress by assisting with analysis of Datix incident data related to stress.
The mental health and wellbeing of our staff is important to us. Growing research demonstrates the importance of mental health and wellbeing in relation to satisfaction and effectiveness at work.
Stress, depression and anxiety are reported as the most common reasons for staff absence. Poor mental health is associated with an increased risk of diseases such as cardiovascular disease, cancer and diabetes, while good mental health is a known protective factor. Poor physical health also increases the risk of people developing mental health problems.
NHSGGC have in place a range of support for staff and managers in order to prevent and assist with mental health issues in the workplace.
Newly Qualified Practitioners (NQPs) should attend a Day 1 and a Day 2 study day in their first year of practice, these contribute to your 24 hours protected study time. NQPs may book on to a session at any of the sites, please ensure you discuss booking with SCN/SCM/Line Manager to ensure date is suitable for you to attend. Information will be sent in advance of the session to print and bring with you. Please click the relevant box for available dates.
DAY 1: Please click on preferred date to book Flying Start Day 1 (choose only one date to attend Day 1)
Throughout your first year and your career, as a healthcare professional, you are likely to experience a range of emotions, which could affect your health and wellbeing. The link below will take you to the NHSGGC organisational page for health and wellbeing, where you can explore these emotions and become aware of the supports available to you, to ensure you can address your emotions in a positive way.
NHSGGC has also produced a brief booklet with a number of resources which can support staff to take care of their own mental health and support colleagues to do so too. Access this booklet here.
As NQPs, commencing your career in healthcare, it is imperative that you are aware of, and look after your own wellbeing. Access this link Newly Qualified Staff – Looking after your wellbeing for guidance which could support you to do this.
It is recognised that exceptional demands are currently being placed on people working in health and social care. The National Wellbeing Hub contains information, resources and supports which you may find helpful at work and at home.
(Please note: the Hub is not specifically for NQPs, but you may find the contents are beneficial to you).
Within this section you will find Flying Start portfolio examples, which have been kindly submitted by NQPs who have completed the programme. This is to allow publication of examples for your information.
Please note: The portfolios have been published in the formats provided by the NQPs and are intended to be published in full. For anonymity reasons there may be portfolios where a piece of evidence has been replaced with a blank template. Furthermore, these portfolios may not reflect discussions which have taken place between NQP and Facilitator to meet learning outcomes.
Below you will find the Flying Start Facilitators Information Guide, which provides information on the programme, protected study time and the role of the Facilitator, as well as guidance around the resources that NQPs can use to evidence their learning. Information regarding the LearnPro module: GGC Flying Start Facilitator Guide can also be found below. (Please note: For nurses and midwives, it is likely that your preceptor and facilitator will be the same person).
There is also a LearnPro module GGC: Flying Start Facilitator Guide that your facilitator can complete to refresh their knowledge or to familiarise themselves with the role of facilitator. Please find this information thin LearnPro, under CPD.
Facilitators Information Sessions
The NHSGGC Practice Education Team host Flying Start Facilitator information sessions on MS Teams for nurses, midwives and allied health professionals who are currently supporting, or will support, newly qualified practitioners (NQPs) in their first year of practice. These 90-minute group sessions (dates and times below), will offer guidance on supporting NQPs with the requirements of the Flying Start NHS programme, the NHSGGC Flying Start Portal and address any related questions or queries. Please click links below to book.
Read and view some of the experiences of registered professionals who have completed the Flying Start programme. For newly qualified practitioners these highlight what they feel have been the benefits of the programme and some of their experiences throughout their first year in practice. This is further reflected in the video messages from NQPs, which you will find helpful.
Facilitator testimonials are also included below and highlight the benefits of this role for both the NQP and the facilitator themselves.
“Flying Start resources have given me the opportunity to become more self-aware by way of the reflective accounts I have to do. It enables me to see what point I ‘m at as a Newly Qualified Practitioner and how far I need to go to become a better practitioner.”
“Flying Start modules should also give me a headstart when revalidating as a nurse and will populate my portfolio ready for that.”
AHPs
“I still use the 4 pillars structure to help me navigate my way around my learning.”
“Being able to manage yourself, as well as leading your patients is important, this has made me more confident in my role.”
“Through Flying Start Leadership pillar, I took most learning in self leadership and strategies to help manage myself and the impact I have on other people.”
“Through Flying Start Evidence, Research and Development pillar, I became involved in developing a formal pathway for patient feedback, making feedback accessible for all, patients felt listened to.”
“By working through Flying Start, my portfolio evidence has helped me with my TURAS Appraisal and has enough in it to get me through the HCPC process.”
Midwives
“Flying Start has helped me bridge the gap from student to newly qualified midwife, and has allowed me to become more independent.”
“Meeting learning outcomes for Flying Start has supported my transition to being a capable confident midwife.”
Mental Health Nurse
“I realised the importance of the programme early on and this was reinforced by my colleagues supporting me.”
