Radical changes to school nurse role in Scotland leads to resignations

Recommendations to further develop the skills of nurses following a review of new models of care in schools have been welcomed by the RCN.

Recommendations to further develop the skills of nurses following a review of new models of care in schools have been welcomed by the RCN.

School_nurse resign
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A number of nurses in Scotland chose to leave their posts, however, rather than alter their ways of working after the school nursing role was revamped, a report has revealed.

The Scottish government investigation found a total of seven staff – including three only recently hired – have opted to resign or retire before the reforms were rolled out.

In 2015, health boards NHS Dumfries, and Galloway and NHS Tayside, became early adopters of the new school nurse role, aimed at freeing up nurses to focus on nine priority areas, including mental health, domestic abuse and homelessness.

The changes allow traditional jobs, such as treating injuries and administering inoculations, to be handled by schools’ wider health teams. 

In a report evaluating the reforms highlights nurses’ concerns about lack of training, problems with pupil access and choice of priority areas.

Staff retention

The problems with retention of staff before and during the trial is identified as a key issue, with the government admitting the refocused role is ‘very different from much of the work undertaken by school nurses’ and that ‘not all staff would necessarily wish to work in this manner’.

One member of senior nursing staff is quoted as saying: ‘Many of the newly hired staff were only on fixed-term contracts and so could not afford to wait for the specialist school nurse training to be available.

‘We’ve had two retirals and two resignations. The school nurse model wasn’t something that some of our staff wanted to take on. So that has caused quite a significant challenge in capacity.’

The report also reveals that 68% of children’s issues referred by nurses at both sites involve mental health and that some nurses have concerns about their levels of expertise in this area.

The authors said: ‘Nurses recognised that mental health and wellbeing is an important pathway, however a number of nurses, including those with SPQ, felt they are inadequately trained to deal with low to moderate mental health issues.’

Areas for improvement

Following the review the Scottish government identified eight areas for improvement, including:​

  • Additional training on the mental health and wellbeing pathway.
  • Focus training on practical skills so nurses can both identify risk and deliver interventions.
  • A need to backfill the posts of staff as they undertake full time training for the new roles.

RCN Scotland associate nurse director Ellen Hudson said: ‘Implementing a new model takes time, and ensuring nurses have the right knowledge and skills to meet the needs of children and young people will be key.

‘We welcome the recommendations around the need to develop further skills-based training, particularly in relation to mental health and wellbeing, and to ensure that current staffing levels are maintained while training takes place.’

A Scottish government spokesperson added: ‘These pioneering pilots showed that a targeted school nursing role has added value to the service through maximising their contribution and effectiveness.

‘We will work with NHS Boards ‎to support them rolling out this refocused role.’

Further information

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