When the Trainee Nursing Associate (TNA) role was first introduced there was a huge buzz about a new addition to the nursing family. In the initial months we were reminded we were a pilot but also called trail blazers, paving the way for future cohorts. I’m a little fire phobic so like to stick with my comparison to the hobnob biscuit - in part due to the uniform colour.

Clare Barnes

I should begin by explaining what a TNA is. The Nursing Associate will work under the direction of a fully qualified Registered Nurse (RN). The Nursing Associate is not a Registered Nurse but will undertake some of the duties that a RN currently undertakes, enabling the Registered Nurse to spend more time on the assessment and care associated with both complex needs and advances in treatments.

We will be regulated by the NMC and our standards are currently being finalized. We come with a variety of clinical skills and experience however all have the same fundamental training and as such these skills are transferrable to any area within the hospital. We’re flexible biscuits, soaked in knowledge and ready to be dunked in any area that needs us.

Being a biscuit is a lot less crumbly that you would think. I’ve previously compared our role to Hobnobs taking the outlook of Peter Kay who refers to them as the hard-core dunking biscuits - persistent and refuse to crumble under pressure. That likeness has proved more than appropriate over the last 15 months as we met every update to our course with a smile and a resilience that refuses to be broken.

My introduction to The Christie came at a personal level when I lost my mother to ovarian cancer however the care we received as a family at that time was second to none. Our hospital has created a unique environment where despite the somewhat scary circumstances, patients can feel at ease. The people who work at The Christie are wonderful, caring souls and I am genuinely proud to be part of something special.

When I was younger (a LONG time ago) I had wanted to be a nurse. My mum had also worked in a hospital and I can still remember the nurses letting me wear one of their hats when we picked her up at the end of a shift. Life happened, and I got lost in a career in the banking industry eventually working from home.

After my introduction to The Christie I was drawn to the possibility of working there. I joined The Christie in 2015 as a clerical officer working as a small cog in a big machine that continues to turn, providing exceptional care to our patients when they need it the most. I began on the endocrine department and found the role rewarding working within a friendly team however I quickly came to realize that I had a desire to play a more hands on role in patient care. When a health care assistant (HCA) role was advertised in the same department with the same shift pattern I jumped at the opportunity to support the nursing team on the unit.

It didn’t take me long to complete my skill set for the role and I began looking for opportunities to progress and become more involved in-patient care. Ultimately, I knew one day I wanted to become a nurse, I just wasn’t sure how I was going to make that happen - bills have a habit of still needing to be paid and as much as my son likes to think he is self-sufficient - he’s not quite there yet!

Staring at the computer screen and taking in all the information I did the maths in my head, “what if?” “how can I?” were all questions floating about. One of the nurses had pulled me to one side to show me the advertisement for a brand-new role starting in January - a pilot scheme but something she assured me I would be great at. As for all my questions the reply came in the form of another question “What if one opportunity could change your life?” So, I filled out the application, made myself sound more awesome than sauce in less than 200 words (It’s possible!), secured my interview and pinched myself when I got the call to tell me I had been successful.

There were 1,700 applicants to the pilot scheme in Greater Manchester, 240 were successfully appointed to post. 8 of those are based at the Christie. The original pilot wave saw 2,000 Trainee Nursing Associates recruited across England. A further 5000 are planned to be recruited this year and we have an additional 6 biscuits starting their apprenticeship at the end of April taking the trust total to 14.

We’re now in our third placement block and time flies when you’re having fun. Our course combines a mix of clinical placements and academic study. We work 30 hours a week in clinical practice with one day a week at university. My allocated university is Manchester Metropolitan University.

My clinical experience has been amazing providing me a wealth of information, experience and has also helped me put together the jigsaw puzzle that forms the patient journey from initial referral to eventual discharge. Throughout our clinical placements we are allocated a mentor to ensure we meet out learning objectives for the placement and our overall experience is looked after by our clinical educator who is always on hand to support our progress. Our placements are divided into four blocks covering Specialist, Community, Surgical and Medical. Within each block, we rotate through various areas to provide an overall view of the services available within the hospital and community setting.

I initially began with my specialist placement in January 2017. We stayed in our original home to enable us to find our feet. In July 2017, I moved to the community placement working with The Christie at Home Team, Outreach and the Mobile Chemo Unit. January 2018 saw me move to my surgical placement based at the IPU with rotations in theatres and the surgical wards. All our placements provide the opportunity for us to spoke out and I have taken advantage of placements with CCU Outreach, Enhanced recovery and the Stoma Nurses to name a few.

I have found through experience that the nursing team around us are our greatest teachers. Every person across the multi-disciplinary team offers support and different perspectives on how we can make each contact count with our patients. The knowledge that we have gained from university is helping to change the way we view things turning a clinical task into one that is supported with the knowledge of why we are doing it and the confidence to explain this to our patients and their carers.

Looking to the future, I can see a biscuit army on the horizon. The NHS is faced with many challenges, an aging population, patients with complex needs and the recruitment of nurses into the workforce. The TNAs are not intended as a replacement for any role, we are a new role created as an addition to the nursing family. We aim to compliment the workforce, adding value to the nursing team, providing support nurses and to bridge the gap between the HCAs and RNs. The role provides a career pathway for HCAs should they wish like myself to progress to nursing. The biscuits are here to help, we want our skills and knowledge to be utilised and hope to be seen as a positive addition to strengthen an ever-changing workforce.

June 2018