Experienced Nurse Job Rotation Scheme
Phase two final evaluation
By
Lead Researcher
&
Principal Investigator — Rotation Scheme Research
July 2006
Published by Central and North West London Mental Health NHS Trust, London. (www.nurserotation.com)
Acknowledgements
In particular we want to thank Peter Walsh, Dir of Nursing and Luella Dixon, Deputy Dir. Of Human Resources in CNWL Mental Health NHS Trust, for their initial concept paper on Rotation Schemes, and their support for the development of the projects.
We are grateful to all of the participants in the Experienced Nurse Job Rotation Scheme — in particular Justine Trippier and James Dalrymple, and the whole action research community — in particular the two Trusts who have set up the pilot (CNWL and WL Mental Health NHS Trusts), the Workforce and Education Confederation; Middlesex University the education provider; and the local managers who are supporting the scheme. We want also to thank the other researchers involved with the overall rotation scheme and the action research — Professor James Buchan and Jane Ball.
Finally, in the light of the regular organisation changes for both West London Mental Health NHS Trust, and Central and North West London Mental Health NHS Trust, we want to thank all of the new stakeholders who provide us with support.
TABLE OF CONTENTS
SECTION ONE — EXPERIENCED NURSE JOB ROTATION SCHEME
1.3 The Problems That Have Led To The Action Research Study
1.3.2 Challenging institutionalisation through staff transfer
SECTION TWO — METHODOLOGY AND METHODS
SECTION 3 — FINDINGS AND DISCUSSION
3.2 Progress through the scheme
3.2.2 Achievements from completion and non-completion of the scheme
3.2.3 Work based learning/job rotation — an alternative to traditional education
3.3 Emerging modes of job rotation
3.4 The Experience of reflection
3.4.1 Appreciating one’s own capability and worth
3.4.2 Working with regret/ distress/ confusion
3.5 How reflective practice has been used
3.6 Work based learning and Action Learning
3.7 Value of the educators to the organisation and the rotatees and the clients
3.8 Value of the scheme for the participants
3.9 Value of the scheme for the colleagues of the experienced nurses taking part in the scheme
3.10 Value of the scheme for the clients of the experienced nurses taking part in the scheme
3.10.2 Partnerships with service users
3.10.4 Suitability of staff for the scheme
3.11 Value of the scheme for the organisation / Health Service
3.12 The nature of the modules
3.13 The group of participants on the Experienced Nurse Job Rotation Scheme
3.14 The type of person who would benefit from the course and who would benefit the Trust
3.15 Difficulties that emerged regarding the educational aspects of the scheme
SECTION 4 — CONCLUSIONS
4.2 Aspects of the scheme that were shown to be useful
4.3 Aspects of the scheme that were shown not to be useful
4.5 Evidence of unplanned added value to the scheme
4.6 Aspects of the scheme that need changing and what is needed to change them
SECTION 5 — RECOMMENDATIONS, STRENGTHS, AND LIMITATIONS
SECTION SEVEN — APPENDICES 1, 2 AND 3
EXECUTIVE SUMMARY
This is the second and final evaluation report of The Experienced Nurse Job Rotation Scheme, developed by The Central and North West London and The West London Mental Health NHS Trusts.
The Scheme was developed as a pilot scheme to explore ways of retaining experienced personnel within health care organisations, at a time when many are not only leaving those organisations, but health care per se.
The scheme sought to offer Experience Nurses an incentive to retain them, an opportunity to use their extensive motivation and experience and to develop their careers, and as such to support their continued motivation to work within health services, provide health care to communities, and to lead, develop and improve the health services.
It is a ‘spiral’ or ‘spin-off’ of another recruitment and retention scheme i.e. the D/E Nurse Job Rotation Scheme (Buchan and Ball 2004; Lucock & Coyne 2003, August 2006, and September 2006), which is an Action Research project, also originating and operating within the two organisations. As such, the scheme forms part of the Action Research project.
Conclusions
The study shows that the model of job rotation used here was effective with a small cohort, to retain them within the health and social care areas, and to a great extent within the Trusts concerned.
The model was shown to facilitate the extensive development of their reflective practice capabilities, and to enable these experienced nurses to gain the work based learning that they needed to make planned changes to their careers. It supported job changes — either within speciality areas or transfer across them. Indeed, for the few who did not complete the scheme, there were still benefits gained for their careers, the organisation, colleagues and patients/clients. Work based learning was successful in facilitating a successful partnership between academia and the work place and was, to a great extent, a retaining factor by providing supervision and support that was limited in hard to staff areas.
A variety of unexpected benefits accrued which added value to the use of the model. There were a few problems identified with leadership, education, and rotation negotiation.
Recommendations
It is recommended that this model be used widely for the retention of experienced personnel within the health and social care environment, especially for those parts which might be hard to staff; are seeking to improve the quality of care; are seeking to avoid institutionalisation and are looking to transfer good practice across a learning organisation. In particular it may be useful for those who might be facing the possibility of burn out, or who wish to make new contributions to the organisation. Further evaluation is needed to develop the evidence base.
