Healthcare professionals' perspectives on enrolled nurses, practical nurses and other second-level nursing roles: A systematic review and thematic synthesis

Healthcare professionals' views of a new second‐level nursing associate role: A qualitative study exploring early implementation in an acute setting

“…Whilst several studies have been conducted on views of secondlevel nursing in different countries (Lucas et al, 2021), given the recency of this role development in England, research into how this role is being operationalised and how healthcare organisations have reacted and responded to its implementation is relatively limited. Initial research into nursing associate trainees' experiences largely focused on the training model.…”

A tale of two bridges: Factors influencing career choices of trainee nursing associates in England: A longitudinal qualitative study

“…This is consistent with findings from the national TNA evaluation (Vanson & Bidey, 2019) which identified the negative impact on well-being resulting from role ambiguity and lack of acceptance by colleagues. Similarly, Lucas et al, (2021a) found that second level nurses have been plagued by both role ambiguity, and intra-and inter-professional conflict over the years. NA stakeholders in particular report a lack of a clear NA job descriptions and a requirement to jump between roles (Lucas et al, 2021b).…”

“…Many high‐income countries deploy second‐level nurses, such as enrolled nurses in Australia and New Zealand, and licenced vocational nurses or licenced practical nurses in North America, who provide fundamental care, undertake patient observations and support rehabilitation (Lucas et al, 2021a ; The Health Foundation et al, 2018 ). The scope of practice of second level nurses varies globally, but generally they work under the supervision of Registered Nurses and are prepared at diploma level, compared with degree level nursing programmes (Lucas et al, 2021a ). The NA role is a new second‐level nursing role in England and follows on from the second level “state enrolled nurse” (SEN) in the UK which was discontinued in the 1990s in a move towards an all‐graduate nursing profession (Glasper, 2016 ).…”

“…Barriers to the success of second‐level nursing roles include role ambiguity, intra and inter‐professional conflict and restrictions on practice (Lucas et al 2021a ). Furthermore, the importance of clarifying role identity and opportunities for career development have been raised by key stakeholders (Kessler et al, 2021 ), with some areas found to be less suitable for NAs such as intensive care, due to limitations in their scope of practice (Lucas et al, 2021b ).…”

Job satisfaction among primary health care nurses

“…The number of nurses dominates until (55-65%). Nursing services are carried out constantly and continuously for 24 hours to patients every day [3], [5]. This reality shows the large contribution of the nursing profession in determining the quality of health services.…”