'Doing the writing' and 'working in parallel': How 'distal nursing' affects delegation and supervision in the emerging role of the newly qualified nurse

Article

Johnson, M., Magnusson, C., Allan, H., Evans, K., Ball, E., Horton, K., Curtis, K. and Westwood, S. 2015. 'Doing the writing' and 'working in parallel': How 'distal nursing' affects delegation and supervision in the emerging role of the newly qualified nurse. Nurse Education Today. 35 (2), pp. e29-e33. https://doi.org/10.1016/j.nedt.2014.11.020
TypeArticle
Title'Doing the writing' and 'working in parallel': How 'distal nursing' affects delegation and supervision in the emerging role of the newly qualified nurse
AuthorsJohnson, M., Magnusson, C., Allan, H., Evans, K., Ball, E., Horton, K., Curtis, K. and Westwood, S.
Abstract

Background: The role of the acute hospital nurse has moved away from the direct delivery of patient care and more towards the management of the delivery of bedside care by healthcare assistants. How newly qualified nurses delegate to and supervise healthcare assistants is important as failures can lead to care being missed, duplicated and/or incorrectly performed.
Objectives: The data described here form part of a wider study which explored how newly qualified nurses recontextualise knowledge into practice, and develop and apply effective delegation and supervision skills. This article analyses team working between newly qualified nurses and healthcare assistants, and nurses' balancing of administrative tasks with bedside care.
Methods and Analysis: Ethnographic case studies were undertaken in three hospital sites in England, using a mixed methods approach involving: participant observations; interviews with 33 newly qualified nurses, 10 healthcare assistants and 12 ward managers. Data were analysed using thematic analysis, aided by the qualitative software NVivo. Findings:Multiple demands upon the newly qualified nurses' time, particularly the pressures tomaintain records, can influence how effectively they delegate to, and supervise, healthcare assistants. While some nurses and healthcare assistants work successfully together, others work ‘in parallel’ rather than as an efficient team.
Conclusions: While some ward cultures and individual working styles promote effective team working, others lead to less efficient collaboration between newly qualified nurses and healthcare assistants. In particular the need for qualified nurses to maintain records can create a gap between them, and between nurses and patients. Newly qualified nurses require more assistance in managing their own time and developing successful working relationships with healthcare assistants.

PublisherElsevier
Churchill Livingstone
JournalNurse Education Today
ISSN0260-6917
Electronic1532-2793
Publication dates
Online02 Dec 2014
PrintFeb 2015
Publication process dates
Accepted21 Nov 2014
Deposited22 Apr 2015
Output statusPublished
Accepted author manuscript
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Open
Copyright Statement

© 2014. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/

Digital Object Identifier (DOI)https://doi.org/10.1016/j.nedt.2014.11.020
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Raleigh, M. and Allan, H. 2017. A qualitative study of advanced nurse practitioners’ use of physical assessment skills in the community: shifting skills across professional boundaries. Journal of Clinical Nursing. 26 (13-14), pp. 2025-2035. https://doi.org/10.1111/jocn.13613
Editorial: Ethnocentrism and racism in nursing: reflections on the Brexit vote
Allan, H. 2017. Editorial: Ethnocentrism and racism in nursing: reflections on the Brexit vote. Journal of Clinical Nursing. 26 (9-10), pp. 1149-1151. https://doi.org/10.1111/jocn.13627
From transformative learning to social change? Using action research to explore and improve informal complaints management in an NHS trust
Odelius, A., Allan, H., Hunter, B., Bryan, K., Knibb, W. and Shawe, J. 2015. From transformative learning to social change? Using action research to explore and improve informal complaints management in an NHS trust. International Practice Development Journal. 5 (1).
Editorial: the anxiety of caring and the devaluing of nursing
Allan, H. 2017. Editorial: the anxiety of caring and the devaluing of nursing. Journal of Clinical Nursing. 26 (3-4), pp. 299-301. https://doi.org/10.1111/jocn.13380
Adherence to ‘pressure-relief’ regimen for pressure ulcer (PrU) prevention in spinal cord injury (SCI)
Liu, L., Chapman, S., Deegan, R., Allan, H., Traynor, M. and Gall, A. 2016. Adherence to ‘pressure-relief’ regimen for pressure ulcer (PrU) prevention in spinal cord injury (SCI). The 55th ISCoS Annual Scientific Meeting. Vienna, Austria 14 - 16 Sep 2016
Nurses’ experiences of clinical commissioning group boards
Allan, H., O'Driscoll, M., Savage, J., Lee, G. and Dixon, R. 2016. Nurses’ experiences of clinical commissioning group boards. Nursing Standard. 30 (42), pp. 46-55. https://doi.org/10.7748/ns.2016.e9633
Executive summary of the RESPONSE project (responding effectively to services users (patients and cares) and practitioners' (nurses and midwives) perspectives on care concerns: developing sustainable responses through educational action research
Allan, H., Shawe, J., Odelius, A., Knibb, W., Gallagher, A., Hunter, B. and Bryan, K. 2014. Executive summary of the RESPONSE project (responding effectively to services users (patients and cares) and practitioners' (nurses and midwives) perspectives on care concerns: developing sustainable responses through educational action research. University of Surrey.
An investigation into newly qualified nurse' ability to recontextualise knowledge to allow them to delegate and supervise care(AaRK)
Magnusson, C., Westwood, S., Ball, E., Curtis, K., Evans, K., Horton, K., Johnson, M. and Allan, H. 2014. An investigation into newly qualified nurse' ability to recontextualise knowledge to allow them to delegate and supervise care(AaRK). University of Surrey.
Understanding sociology in nursing
Allan, H., Traynor, M., Kelly, D. and Smith, P. 2016. Understanding sociology in nursing. London SAGE Publications.
New role raises questions
Traynor, M., Allan, H., Allan, H., Dyson, S., Corbett, K. and Centre for Criitcal Research in Nursing and Midwifery 2016. New role raises questions. Nursing Standard. 30 (29), pp. 26-27. https://doi.org/10.7748/ns.30.29.26.s25
Delegation and supervision of health care assistants’ work in the daily management of uncertainty and the unexpected in clinical practice: invisible learning among newly qualified nurses
Allan, H., Magnusson, C., Evans, K., Ball, E., Westwood, S., Curtis, K., Horton, K. and Johnson, M. 2016. Delegation and supervision of health care assistants’ work in the daily management of uncertainty and the unexpected in clinical practice: invisible learning among newly qualified nurses. Nursing Inquiry. 23 (4), pp. 377-385. https://doi.org/10.1111/nin.12155
Survey of the Commissioning Nurse Leaders’ Network membership 2015: summary of results
Allan, H. and O'Driscoll, M. 2016. Survey of the Commissioning Nurse Leaders’ Network membership 2015: summary of results. Middlesex University.
Are senior nurses on Clinical Commissioning Groups in England inadvertently supporting the devaluation of their profession?: A critical integrative review of the literature
Allan, H., Dixon, R., Lee, G., O'Driscoll, M., Savage, J. and Tapson, C. 2016. Are senior nurses on Clinical Commissioning Groups in England inadvertently supporting the devaluation of their profession?: A critical integrative review of the literature. Nursing Inquiry. 23 (2), pp. 178-187. https://doi.org/10.1111/nin.12129
An evaluation of the impact of ‘Compassion in practice: nursing, midwifery and care staff - our vision and strategy’ on staff experience in NHS Trusts in England.
Allan, H., O'Driscoll, M., Liu, L., Corbett, K. and Department of Adult, Child and Midwifery, School of Health and Education, Middlesex University 2015. An evaluation of the impact of ‘Compassion in practice: nursing, midwifery and care staff - our vision and strategy’ on staff experience in NHS Trusts in England. School of Health and Education, Middlesex University.
Non-European nurses’ perceived barriers to UK nurse registration
Allan, H. and Westwood, S. 2016. Non-European nurses’ perceived barriers to UK nurse registration. Nursing Standard. 30 (37), pp. 45-51. https://doi.org/10.7748/ns.30.37.45.s41
Managing infertility in primary care
Allan, H. and Mounce, G. 2015. Managing infertility in primary care. Practice Nursing. 26 (9), pp. 440-443. https://doi.org/10.12968/pnur.2015.26.9.440
Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study
Husebø, A., Karlsen, B., Allan, H., Søreide, J. and Bru, E. 2015. Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study. Journal of Clinical Nursing. 24 (3-4), pp. 500-510. https://doi.org/10.1111/jocn.12633
Exercise: a path to wellness during adjuvant chemotherapy for breast cancer?
Husebø, A., Allan, H., Karlsen, B., Soreide, J. and Bru, E. 2015. Exercise: a path to wellness during adjuvant chemotherapy for breast cancer? Cancer Nursing. 38 (5), pp. E13-E20. https://doi.org/10.1097/NCC.0000000000000205
Supporting staff to respond effectively to informal complaints: findings from an action research study
Allan, H., Odelius, A., Hunter, B., Bryan, K., Knibb, W., Shawe, J. and Gallagher, A. 2015. Supporting staff to respond effectively to informal complaints: findings from an action research study. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.12770
Gatekeeping access to the midwifery unit: managing complaints by bending the rules
Allan, H., Odelius, A., Hunter, B., Bryan, K., Knibb, W. and Shawe, J. 2015. Gatekeeping access to the midwifery unit: managing complaints by bending the rules. Health. 19 (6), pp. 652-669. https://doi.org/10.1177/1363459314567791
English language skills requirements for internationally educated nurses working in the care industry: barriers to UK registration or institutionalised discrimination?
Allan, H. and Westwood, S. 2016. English language skills requirements for internationally educated nurses working in the care industry: barriers to UK registration or institutionalised discrimination? International Journal of Nursing Studies. 54, pp. 1-4. https://doi.org/10.1016/j.ijnurstu.2014.12.006
White British researchers and internationally educated research participants: insights from reflective practices on issues of language and culture in nursing contexts
Allan, H. and Westwood, S. 2015. White British researchers and internationally educated research participants: insights from reflective practices on issues of language and culture in nursing contexts. Journal of Research in Nursing. 20 (8), pp. 640-652. https://doi.org/10.1177/1744987115618236
Early intervention screening involves more than “simple” screening
Lee, H., Lu, Z., Allan, H., Yeh, M. and Chang, S. 2015. Early intervention screening involves more than “simple” screening. International Journal of Healthcare, Insurance and Equity. 2 (1).
Developing a robust tool: Advancing the multiple mini interview in pre-registration student midwife selection in a UK setting
Callwood, A., Cooke, D. and Allan, H. 2014. Developing a robust tool: Advancing the multiple mini interview in pre-registration student midwife selection in a UK setting. Nurse Education Today. 34 (12), pp. 1450-1454. https://doi.org/10.1016/j.nedt.2014.04.023
People, liminal spaces and experience: Understanding recontextualisation of knowledge for newly qualified nurses
Allan, H., Magnusson, C., Horton, K., Evans, K., Ball, E., Curtis, K. and Johnson, M. 2015. People, liminal spaces and experience: Understanding recontextualisation of knowledge for newly qualified nurses. Nurse Education Today. 35 (2), pp. e78-e83. https://doi.org/10.1016/j.nedt.2014.10.018
Learning from people with long-term conditions: new insights for governance in primary health care
Ross, F., Smith, P., Byng, R., Christian, S., Allan, H., Price, L. and Brearley, S. 2014. Learning from people with long-term conditions: new insights for governance in primary health care. Health and Social Care in the Community. 22 (4), pp. 405-416. https://doi.org/10.1111/hsc.12097
Cervical screening and the aftermath of childhood sexual abuse: are clinical staff trained to recognise and manage the effect this has on their patients?
Walker, J. and Allan, H. 2014. Cervical screening and the aftermath of childhood sexual abuse: are clinical staff trained to recognise and manage the effect this has on their patients? Journal of Clinical Nursing. 23 (13-14), pp. 1857-1865. https://doi.org/10.1111/jocn.12390
Teachers' views of using e-learning for non-traditional students in higher education across three disciplines [nursing, chemistry and management] at a time of massification and increased diversity in higher education
Allan, H., O'Driscoll, M., Simpson, V. and Shawe, J. 2013. Teachers' views of using e-learning for non-traditional students in higher education across three disciplines [nursing, chemistry and management] at a time of massification and increased diversity in higher education. Nurse Education Today. 33 (9), pp. 1068-1073. https://doi.org/10.1016/j.nedt.2012.04.003
Experiences of supernumerary status and the hidden curriculum in nursing: a new twist in the theory-practice gap?
Allan, H., Smith, P. and O'Driscoll, M. 2011. Experiences of supernumerary status and the hidden curriculum in nursing: a new twist in the theory-practice gap? Journal of Clinical Nursing. 20 (5-6), pp. 847-855. https://doi.org/10.1111/j.1365-2702.2010.03570.x