Picture credit: Tim George

What does a PNA do?

PNAs provide clinical and well-being support for colleagues. This may take the form of:

Why was the role created and how does it work?

The professional nurse advocate programme was established in 2021 by NHS England and was the first of its kind for nurses anywhere in the world. ‘It came in at a time when the nursing workforce was burnt out,’ says RCN professional lead for mental health Stephen Jones.

‘Staff had been challenged with the pandemic and there were clear issues with mental well-being. Initially, it was a response to all of that.’

What makes the role unique is that it is more than clinical supervision training with an extra quality improvement aspect, says Mr Jones.

‘It’s a complex role and people have implemented it differently,’ he says. ‘Some have created dedicated PNA roles with senior leads in that position. Others are released for a set amount of time on top of their job, while some are just expected to do it as part of their day-to-day work.’

What difference are PNAs making?

‘PNAs are establishing that a component of nurses’ work is to include reflective practice. Before this role, it was an add-on and may not have been done,’ says Foundation of Nursing Studies chief executive Joanne Bosanquet.

For PNA lead Martin Hogan, the role is pivotal in recruitment and retention, reducing sickness absence, and improving clinical practice and safety.

‘It feeds into everything strategically that every organisation is trying to do,’ he says.

It is also reassuring for nursing students. ‘I tell them, when you qualify, every organisation will have a PNA. Something I didn’t have when I was at my most vulnerable. It’s a real selling point, especially in the current climate.’

Is PNA training accredited?

There is a level 7 postgraduate-accredited programme, which usually runs for ten days, although there is variation among the institutions providing the training, says NHS England. The programme features academic assessment, poster presentations and competency portfolios.

While there has been extensive uptake by education institutions and employers to support the PNA role, there are discrepancies in what is provided by universities, with RCN members reporting different learning experiences, says Mr Jones.

‘The challenge for education is to ensure quality assurance, particularly when something has been rolled out quite quickly,’ he says.

To address these challenges, NHS England commissioned the RCN to work with a variety of stakeholders in NHS trusts, universities and charities on standards for education and training programmes and modules. These were published in April 2023. This means education institutions and academies can now seek RCN accreditation.

‘The framework will help ensure the quality of education can be assessed and measured,’ says Mr Jones. ‘We want nurses to have the best possible learning experience.’

Can any nurse become a PNA?

Ideally, learners should have experience of receiving restorative clinical supervision from a trained PNA, says the framework.

‘It’s beneficial for anyone who delivers clinical supervision to access PNA training,’ says Mr Jones. ‘It improves a nurse’s skill set, both for their own learning and the learning of others.’

How can I become a PNA?

Contact your local PNA regional team, advises Mr Jones. ‘They will be able to identify a provider, although this may not be local to you and it could involve learning remotely.’

For many people, it may be the next step after preceptorship, but you do not need to have done any specialist training or leadership courses before joining a programme.

‘Don’t do it just because it’s available,’ says Mr Jones. ‘Especially if you don’t feel as if you’re standing on your own two feet as yet. The role can be demanding.’

Can PNA training enhance your career and qualifications?

As it is a level 7 programme, it gives credits towards a master’s degree or may help the learner top-up to achieve their master’s, says Mr Jones.

The role may strengthen the individual’s personal and professional boundaries, providing a tool kit that supports their and others’ development.

But in practice, how much you can actually achieve as a PNA depends on your employer, says Mr Jones.

‘Just because you’ve done a course, your trust may not be receptive to doing anything with the role – we know that’s sometimes the case,’ he says.

In contrast, others have the prospect of various development opportunities. ‘Organisations need to think about how they support those who are doing the course, so they can better use their skills,’ says Mr Jones.

Becoming a PNA can open up other doors, says Ms Bosanquet. ‘It can take a nurse down a different career path to the one they might have thought possible,’ she says.

‘There are lots of potential opportunities in education and academia. It also helps leadership and the way nurses can build their own professional identity, improving confidence. The programme enables nurses to look outwards a lot more, seeing the system as a whole and not just their immediate surroundings.’

This is an abridged version of an article at rcni.com/nurse-advocate