Nurse Rotation Scheme at CNWL/WLMHT
Research Report

Appendices
Table of Contents
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Appendices

A. Table of results

B. Research Tools

Pre scheme focus groups discussion guide

Stakeholder discussion guide

Leaver form

First questionnaire

Second questionnaire

Third questionnaire

C: Project Management

Appendix A: Satisfaction at the start, middle and end of the scheme for 3 cohorts

  Percentage satisfied with aspects of the scheme
(ie. score is 7 or above)
    Cohort 1   Cohort 2 Cohort 3
  1st Survey 2nd Survey 3rd Survey 1st Survey Final survey 1st Survey 2nd Survey 3rd Survey
  N=23 N=14 N=8 N=13 N=5 N=11 N=12 N=8
Placement                
Welcome received at placement 59 73 50 77 100 36 44 33
Specialty you are working in 50 80 71 62 100 64 60 67
Physical environment 50 50 50 31 40 27 56 50
The degree of choice you had regarding the placement 28 27 57 31 100 46 25 33
(Process of moving to next placement) — 36 38 — 60 — 25 17
Social contact                
Friendliness of colleagues 65 73 75 84 100 82 70 50
Level of contact with other scheme participants 45 55 63 31 80 36 30 50
Attitude of other staff to the rotation scheme 35 70 63 54 40 46 50 33
Supervision/support                
Level of contact with your supervisor 50 46 38 46 80 36 40 17
Quality of support offered by your supervisor 50 50 38 69 60 46 40 17
Support of line manager 40 64 75 77 80 73 78 33
Support from colleagues within the placement 35 44 50 46 60 55 56 50
Information                
Access to information 40 50 71 46 60 55 60 33
Awareness of other staff of the scheme and its objectives 30 50 50 54 30 18 30 17
Information given before/(since) applying to/(joining) the scheme 26 67 13 69 25 55 25 13
Ability to get queries about the scheme answered 25 37 25 61 17 46 17 0
Information about the education component prior to starting work 20 — — 54 — 55 — —
Education                
Content of the educational component 75 83 50 77 83 82 83 75
Standard of teaching on study days 70 83 50 100 92 91 92 75
Organisation and co-ordination of the educational component 60 73 63 85 83 82 83 75
Learning opportunities (on placements) 50 75 63 46 40 73 40 50
Organisation                
Commitment of the Trust to the rotation scheme 65 46 25 77 36 55 36 13
Terms and conditions of employment for your post 45 30 25 58 18 50 18 25
Access to study leave 45 60 88 77 78 55 78 50
The recruitment process for the scheme 42 — — 69 — 60 — —
Service provided by personnel/ HR department 40 8 14 77 9 46 9 0
The overall organisation of the scheme 25 25 25 46 8 64 8 25
(Communication with rotation scheme co-ordinators) — 42 38 — 25 — 25 13
(Co-ordination of the scheme) — 33 25 — 25 — 25 0

Not applicable ( ) Represents change in wording between surveys.


Appendix B1: Discussion Guide for Managers & Clinical Supervisors

A. The scheme in general

  1. What did you think of the scheme when you first heard about it?
  2. Have your views changed since then?
  3. In what way, & why?
  4. Breaking it down into 3 main parts, views specifically of each:
    • Rotation for 8 month slots (views re timing etc.)
    • Educational component (knowledge of it, applicability)
    • Promotional opp to E grade
  5. Overall, what would you say are the main good points of the scheme?
  6. What aspects are most appealing to nurses?
  7. What do you see as the problems or possible problems with it?
  8. Can you think of any ways in which the scheme could be improved?

B. Views of the recruitment process

  1. Recruitment to scheme — were you involved?
  2. What did you think of recruitment/selection process?
  3. Could it have been improved in any way?
  4. How well do you think the scheme hits the mark, in terms of attracting new staff?
  5. Why do you think nurses are applying/not applying? (why god response to advert but few applications?)

C. Impact

  1. How do you think it will impact on the wards/clinical work areas?
  2. How do you think other staff feel/will feel about scheme?
  3. What if any will be impact on staffing levels and retention?
  4. Do you think it will have any knock on effects? What? On Who?

D. The supervisor role

  1. How do you view your role as supervisor? (what is the role, what do you feel about this role)
  2. Involvement in setting up the scheme
  3. Information you have had about the scheme and its participants -
  4. Do you know what to expect in terms of how scheme will run, and what is expected of you?
  5. Preparation to act as supervisors

E. Any other comments, about scheme or your involvement in it?


Appendix B2: Stakeholder Discussion Guide

Origins

  1. History of scheme
  2. What was driver/rationale for scheme?

Aims

  1. What are aims/objectives?
  2. What are expected outcomes?
  3. How will you judge if it has been a success or not?
  4. What do you see as bottom line, that you want scheme to achieve?
  5. What is the most important indicator of whether it has been a success or not?

Setting up the scheme

  1. How/Who
  2. Resource implications (is it viable without consortia money?)

Current format

  1. Why educational component and rotation? Why 3 lots of 8 months?
  2. Reaction/communication
  3. Do staff at CNWL know about scheme?
  4. Reaction of other staff/managers?
  5. Other Trusts/health service managers
  6. What has been reaction of other professionals (any of them want to try it also?)
  7. Links to HR, training?

Problems

  1. What problems have there been?
  2. Leavers/Attrition

Future

  1. If another unit was thinking of introducing some form rotation scheme, what would your advice be?
  2. Is there anything you would do differently?
  3. Views of experienced staff scheme

Appendix B3: Scheme leavers questionnaire

As you know, the rotation scheme at CNWL/WLMHT is a new idea, and it is being evaluated to see how well the scheme works and how it could be improved. A key part of the research is to find out why people leave the scheme. Could you help by answering the 4 questions below? Your answers will not be used individually. The responses from all leavers will be compiled to give an overall picture of reasons why people leave, and help identify problems with the scheme. Many thanks, Jane Ball (Employment Research, 01273 299 719).

1. Why did you leave the scheme? (Please circle one letter)

  1. Dissatisfaction with the scheme
  2. Dissatisfaction with the Trust
  3. Personal reasons (family/domestic situation)
  4. Not dissatisfied with the scheme, but wished to pursue other opportunity

2. If you answered a) or b), which of the following best describes your dissatisfaction: (Please circle one letter)

  1. Rotation process — choice of placements, process for arranging next placement
  2. Staff management in clinical placement
  3. Level of support in clinical placement
  4. Location of the clinical placements
  5. Attitude of colleagues in clinical placement
  6. Working environment
  7. Academic part of scheme too difficult
  8. Dissatisfied with content of educational component
  9. Problems combining the coursework with clinical working
  10. Insufficient academic support
  11. Other (please describe below)

3. Is there anything the Trust could have done that might have encouraged you to stay?



4. How do you think the rotation scheme could be improved? (continue overleaf if necessary)




Appendix C. Management Structure for the Project

Provided by Patrick Coyne:

Joint trust advisory group — lead by Directors of Nursing, HR Directors; Rotation Scheme co-ordinator

Partnership group: university, consortium, rotation scheme co-ordinator; external researchers; nurses who take up the posts; senior managers

Local development groups: operational manager, lead nurses, HR manager; ward managers and supervisors, rotation scheme co-ordinator.

University liaison group.

Annual large group meeting — review group.

Management process:

Proposal from local service to develop rotation schemes

Conceptualisation and board agreement for a post

Detailed development of a model for job rotation for d/e grade nurses by the co-ordinator in negotiation with universities, managers, nurses, directorate of nursing, education consortium

Application for funding for education and research from the education consortium

Establishment of various management structures and processes

Annual review

Expansion of the project in response to local demand, and the availability of both consortium and operational funds to continue both the education, management and research components of the model/scheme.

Collection of research data and writing of reports/papers

Dissemination of results/learning

Stakeholder review meeting (approx mid 2004).