A significant number of nurses are eligible to retire within the next five years in England.

Couple that with the fact that 20% of newly qualified nurses leave the profession within 12 months of registration, and it creates a challenge with potentially disastrous implications.

To mitigate this, the Gateshead Health NHS Foundation Trust has created the Gateshead Guardian Scheme. This case study examines the need for schemes such as this one, and the successes they’ve had in Gateshead.

Added Pandemic Pressure

Gateshead is no exception from the nationwide nurse shortage, both struggling to recruit nurses and having high turnover rates.

Staffing numbers for nurses and midwives in Gateshead.[1]

The Covid-19 pandemic has exacerbated this problem. The transition from Student Nurse to Qualified Nurse has proven incredibly challenging.

Those who have qualified are experiencing a whole host of pandemic-related issues, with 25% of newly Qualified Nurses having post-traumatic stress disorder (PTSD).

This is in part due to the higher death rate amongst frontline nurses during the pandemic. Between 9th March and 28th December 2021, 47 male nurses and 110 female nurses lost their lives to Covid-19.[2]

For male nurses, the mortality rate was 79.1 deaths per 100,000 males, and for female nurses it was 24.5 deaths per 100,000 females.

In the general working population, the death rate for men was 31.4 deaths per 100,000 men, and for women, it was 16.8 deaths per 100,000 women.[2]

“The loss of life of healthcare workers is heart-breaking and is felt profoundly by every member of the nursing community”

Donna Kinnair, Chief Executive and General Secretary, Royal College of Nursing.

Kinnair has called for an inquiry into the death rate of nurses during the pandemic.

HR and management leads are searching for solutions to these issues, and are finding better ways to support new nurses to stay and contribute to patient care in the NHS.

Gateshead Guardian Scheme

The Pathways to Excellence team at Gateshead Health NHS Foundation Trust have created the Gateshead Guardian scheme to help settle new nurses into hospital life.

The trust put a lot of time and effort into getting a better understanding of the new cohort of nurses.

Generation Y, more commonly referred to as millennials, have different needs and expectations than their predecessors.

The team at Gateshead collated responses from millennials to put together a persona they could refer to when dealing with newly qualified nurses.

Education

  • Most respondents expect support in order to achieve, and have high levels of ambition.
  • Frequent recognition and feedback works well for most, as this is the system they have been educated within.

Employment and the NHS

  • Millennials are career motivated, but far less company-loyal than previous generations.
  • A flexible work-life balance is key to their happiness, and they will change jobs if their needs aren’t met.
  • This generation are still value-orientated, and do seek a sense of purpose and a desire to contribute to the greater good.

Communication

  • This generation grew up with rapidly developing technology, and are more adept with new technology than more senior colleagues.

Being part of a team

  • Millennials want to work ‘with you’ rather than ‘for you’. A sense of community in the workplace is a huge motivating factor.
  • They will need mentorship, coaching, and reassurance whilst also wanting to feel heard and valued.

Work, home, and finances

  • Productivity is high amongst millennials when they feel they have been given the tools and adequate training.
  • A sizeable amount will rely on parents for additional financial support.
  • They earn to spend, and want to spend a large portion of their time with friends and family.

Taking the time to understand these traits in the incoming batch of nurses allowed the Path to Excellence team at Gateshead to tailor their guardian’s programme to meet their needs.

How the Scheme Works

The Gateshead Guardians scheme is a buddy system whereby experienced, fully qualified nurses are partnered with new nurses to provide them with advice and support in their first 12 months.

The guardians spend one-to-one time with the newly qualified member of staff, helping to build their confidence and make them feel welcome in the role.

Before starting the role, the mentee has contact with the trust to help them prepare for their first few days.

Upon starting, all newly qualified nurses have a ‘meet and greet’ event with food donated by Sainsbury’s. This gives them a chance to meet their mentors as well as the wider faculty of staff.[1]

The guardians follow the acronym: ICORE.

Innovation

  • Looking for better ways to do things
  • Embracing new ways of working
  • Upholding a service ethos
  • Continually developing

Care

  • Putting themselves in other’s shoes
  • Being approachable
  • Being sensitive and considerate
  • Listening, responding, and supporting

Openness

  • Being honest and courageous
  • Admitting mistakes
  • Sharing information
  • Doing the right thing

Respect

  • Valuing the skills and contributions of others
  • Treating others fairly and reasonably
  • Appreciating and embracing differences
  • Being polite, helpful, and maintaining the dignity of others

Engagement

  • Involving others
  • Actively listening
  • Working together
  • Sharing information and resources

Successes of the Scheme

The reviews of the scheme from mentees have been overwhelmingly positive.

Starting as a newly qualified nurse is not an easy transition and it can be really difficult because it is such a huge change of role and responsibility from being a nursing assistant or student nurse.

But with the great support of the hospital, my amazing colleagues and a dedicated preceptor, I have settled in extremely well. I have gained so much more confidence since those early days as a new Staff Nurse.

Kayleigh Atkinson, A&E Nurse.[3]

Not only are those receiving the support benefiting, but the guardians themselves feel more valued and are getting great job satisfaction from the programme.

As an experienced nurse to still feel appreciated by your organisation is very important. Although I have been in the profession for a number of years, I can still recollect my first experiences in the role. In those days, there was no one to go to and discuss my fears, worries or concerns, or just someone to run something past.

I made a promise to myself all those years ago that whenever there was a newly qualified nurse, I would try my best to ensure they knew who they could turn to when feeling a little vulnerable. This is something that has always been important to me.

Chris Fawcett, Dementia Nurse Specialist and Guardian.[4]

Due to the successes of Gateshead’s Guardians, the trust is launching more initiatives to further support newly qualified nurses.

Nursing ambassadors now share the success stories across trusts, to promote the good work and approach implemented by the Pathways to Excellence team.

There are now more training and secondment opportunities available to nurses earlier on in the process, to give them a breadth of knowledge from the beginning.

Achievements are celebrated through the annual Star Awards, highlighting the best of a trust and giving staff the recognition they deserve.[1]

The trust is aiming to expand the Gateshead Guardian scheme to other staff groups that could benefit from it.

[1]Jobson, Victoria. 2021. Pathways to Excellence Nurse Lead. Gateshead Guardian Scheme.

[2]NursingTimes.net. 2021. Covid-19 New Nurse Death Figures.

[3]qegateshead.nhs.uk. 2020. Meet a newly qualified A&E Nurse.

[4]fabnhsstuff.net. 2020. Gateshead Guardians.

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With nurse retention rates at an all time low, Gateshead NHS Trust has developed a strategy to make new starters feel welcome and prepared, whilst giving more experienced staff a new lease of life and job satisfaction.

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