Nursing Lecturer University of Bradford
Recent changes to healthcare policy such as the Five Year Forward View (NHS, 2014) the Five Year Forward View for Mental Health (Mental Health Taskforce, 2016) and the GP Forward View (RCGP & HEE, 2016) has indicated a commitment by the government to improve patient care through ensuring the provision of both experienced nurses and experienced leaders able to drive forward effective change in order to meet future need.
Furthermore with a greater emphasis on pre-registration nurses being able to demonstrate their ability to carry out research, engage in critical enquiry, develop greater decision making skills and instil these findings into everyday practice (Willis, 2015), Clinical Nurse Educators (CNEs) will be required to develop additional skills in research, leadership and management with a considerable emphasis on improving the quality of patient care. The primary role of the CNE being to support the educational needs of nursing staff (Coates and Frazer, 2014) while having a pivotal role in ensuring the integration of theory into practice (Conway and Elwin, 2007). CNEs are part of the educational workforce and as such are required to demonstrate high level skills of reflection (Bulman et al., 2016) and in so doing support the development of student portfolios.
Disappointingly there is limited research about the process of preparing clinicians specifically for the CNE role. Research is therefore needed to enhance understanding of clinicians’ perspectives as they develop the skills necessary to be a CNE (Cangelosi et al., 2009) with the role needing to be more fully defined (McAllister and Flynn 2016). For a nurse who is proficient in clinical practice is not necessarily adept at teaching clinical skills. Teaching is not a natural consequence of clinical expertise, but requires a skill set of its own (Cangelosi, 2009).
Excellence in nurse education not only involves competent teaching but also requires vision, curiosity, and commitment to research for continual improvement. With the challenges faced within nursing and nurse education including nurse shortages (RCN, 2018), nursing skill mix (Aiken et al., 2016) and a lack of resources (Scott et al., 2018) CNEs have a unique contribution to make to the educating of nurses (McAllister and Flynn, 2016).
The changing landscape of pre-registration nurse education within the UK (NMC, 2018) requires now more than ever, experienced and educated CNEs who have a clear understanding of how these challenges can be met. Significant emphasis is also placed on the importance of nurses teaching others both formerly and informally (Council of Deans of Health, 2016). This has the potential to encourage the development of both the novice and experienced nurse enabling the advancement of future nurse leaders. Such prominence on professional development puts experienced CNEs who have additional skills of mentorship, at the heart of both clinical practice and nurse education and aligns personal strengths with passion and improved performance. For quality mentors support the transition of values, skills and knowledge (Banister and Gennaro, 2012). They encourage a collaborative learning partnership, nurture strong networks within the broader multi-disciplinary team and inspire innovation (Norman and Roche, 2015).
CNEs are required to support the development of nurse practitioners who are adequately skilled and knowledgeable to critically reflect and act appropriately; the outcome of which constitutes critical knowledge as argued by Taylor (2010). The significance of reflection and the importance of embracing theories and literature to inform the reflective process is essential if nurses are to develop the skills required to support global nursing. No more is this evident than through revalidation (NMC, 2019). A process through which nurses are encouraged to celebrate their success, recognise their own imitations and act accordingly to improve outcomes, through the development of a portfolio. As Liz Allibone (cited in Spinks, 2016, p.11) argues a greater recognition therefore is needed of the role that CNEs play in promoting quality nurse education and effective patient care; it being needed now more than ever.
The importance of nurses becoming involved in high quality research, in order to improve the provision of safe and effective care is perceived as the gold standard and requires a significant commitment from the nursing profession (Brown et al., 2009). The ability to encourage the application of research into clinical practice is therefore integral to the role of the CNE (Sayers et al., 2011).
CNEs combine both expert knowledge and experience and are fundamental to the developing of a skilled and proficient workforce (Sayers, et al., 2011). They encourage ethical behaviours (Lewenson, et al., 2005), reciprocal sharing, learning and acquisition of knowledge and inﬂuence individual growth and transition (Thompson, et al., 2012). They have significant potential to become educational leaders (Adelman-MuIlally, et al., 2012).
The role of the CNE is expanding, and with it the need for CNEs to recognise the unique contribution they make to the mentoring of nurses, including themselves. For as Weidman (2013) purports research has indicated that those who fail to receive effective mentorship have a more challenging time developing their role as CNEs than those who do.
CNEs must also be encouraged to become self-determined life-long learners a process known as heutagogy (Bhoyrub, 2010), for CNEs must be able to work in environments that are dynamic and require the utilisation of a plethora of skills, including teaching, assessment, effective communication and audit. Further commitment is needed to ensure that CNEs have a defined skill set that enables them to transition to this role with the least possible anxieties. In so doing, as with any nursing role, ultimately, we are assigning the theory practice gap, extensively researched within the nursing literature, to the annals of nursing history.
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