Section Five — Conclusions

5.1 Introduction — including Strengths and Limitations

This section is normally entitled ‘Conclusions and Recommendations’ but, in the spirit of Action Research, recommendations have been made on an on-going basis and already have been, or are being, put into place. Similarly, since this is an on-going evaluation, conclusions are tentative. Only further research will indicate whether or not the hopes and concerns of the participants were valid and how they have been reconciled.

One strength of this research is that all the stakeholders have accepted the risk involved with continuous evaluation.

Another strength is that it provides us with the views of the participants in the Experienced Nurse Rotation Scheme thus helping us to understand how they experienced the early stages of the programme and how we, the other stakeholders, can best help them and consider helping any future cohorts.

There are a number of other strengths. It provides not only a decision trail but also an audit trail to prove the worth of the research whilst, at the same time, allowing people to understand how Action Research applies to organisational development. It will also, hopefully, highlight the reality of ongoing evaluation and its contribution to change and help stakeholders to see where we are now and how we can move to the next phase.

There are also a number of limitations, not the least of which is that the reading of this report will involve at least five sets of stakeholder viewpoints. It is clearly difficult for any author to write to the expectations of any one viewpoint. The task becomes more difficult when it is remembered that individual stakeholders have become involved in the scheme at different times and may have slightly different views as to what it was meant to achieve.

Because the evaluation concerns an Experienced Nurse Rotation Scheme that involves work-based learning, it would be easy to assume that it is about adult education and adult learning or even what it is like to experience the beginning of a course. It is important to remember that none of these topics were the focus of the study.

Although the participants in the study discussed their thoughts and experiences as they had taken place over a period of time, this report still represents a snapshot in time. This is highlighted by the comments of the participants themselves when they were asked to read and comment on the work. They found it interesting to recall how they felt at the time but now they have moved on. The next stage of the evaluation will, hopefully, demonstrate this.

Finally, in research terms, the report is politically and interpretively vulnerable. Even though the methodology and it philosophical underpinnings have been clearly explained, if competitors, or those from a different philosophical perspective, look at the work with a ‘different eye’ they might consider it to be poor research. Others might attempt to draw conclusions from the findings even though those conclusions are not generalisable.

5.2 Stakeholders and the future

Since this pilot scheme is up and running, one thing we can be certain of is that it was, at least initially, attractive to Experienced Nurses. The next part of the evaluation will demonstrate whether or not it continued to be so after the end of the first year.

There are many possible outcomes for the scheme. As discussed throughout this report, but mainly in Section Three, the potential is great if all stakeholders, especially the Trusts, take full advantage of the possibilities. As was implied, how it is managed will determine it’s nature and if it is managed in such a way that it becomes bureaucratised then many things can go wrong. Perhaps the most that could be hoped for, if that happened, is that the practitioners taking part in the pilot scheme stay with their Trusts.

Strangely, even that would be a form of success since, whilst it costs almost £2,000 per person for the educational modules it costs £5,000 at the very least to replace an Experienced Nurse ( Buchan 1999). There would also be the added advantage that the practitioners have, at best, achieved their degrees or, at worst, achieved a considerable amount through their studies and Work-Based Learning. The Trusts could only benefit from this and the practitioners would be in a better position to move on in their careers. It may be assumed that such an outcome would lead the practitioners to be much happier and even better participants in the NHS.

Hopefully the pilot scheme will become a model for others to adopt but as yet, there is no money for further Experienced Nurse Rotation Schemes. Consequently, much depends on the success of this pilot scheme and at present the situation is encouraging. Although the project leader has now left the scheme for a new position, whilst remaining its ‘Principle Investigator’, the scheme remains on course. All the organisations involved continue to support it, as do the managers involved in the rotation placements. Justine Trippier and James Dalrymple continue in their operational roles.

As important as the success of this pilot scheme is the power and influence of those practitioners who are taking part in it. They are influential within both their organisations and their professional groups and have great potential to influence the funding for and running of schemes for further cohorts of Experienced Nurses. It is to be hoped that they will grasp that nettle.

Finally, there does seem to be two potential, or even real, problems that now needs to be dealt with. The first, relating to Professional Nursing Supervision was discussed in 4.9.

This is an issue for both of the Trusts. There is a need to ensure reference to Professional Conceptual Frameworks as well as the regular provision of Professional Nursing Supervision. It should not be left to either the willingness or the ability of the Principal Investigator/ Rotation Scheme Co-ordinator to provide Professional Nursing Supervision. This is something that might be considered by National Policy Bodies and Consumer Bodies be they for Nursing or any other profession.

The second potential or real problem exists among managers in the Trusts, in particular those who signed up to support the Experienced Nurse Rotation Scheme. At the time when practitioners were signing up to join the scheme there was a considerable amount of conversation with the managers; they knew a lot about the scheme and looked on themselves as it’s stakeholders. Now, nearly eighteen months on, those managers may or may not still be in post, and some current managers may not know anything about the scheme.

If the present pilot scheme is to lead to future cohorts of practitioners on Experienced Nurse Rotation Schemes, then there must be a mechanism put into place whereby when people move into a role that relates in any way to the scheme, they are facilitated into the role of stakeholder so that they may both understand the scheme and become committed to it’s success. The same, of course, applies to any other aspect of the Action Research Project.