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Promoting autonomous practice in pre-registration student nurses

02 February 2025
Volume 36 · Issue 2

Abstract

General Practice Nurses are autonomous or semi-autonomous practitioners, functioning and working behind closed doors. Shaun Heath looks at how pre-registration students can be helped to experience semi-autonomous practice.

Pre-registration student nurse placements have been increasing over the last few years; there is an expectation that by the time a student reaches their final year that they should be practising (semi) autonomously. This article explores how the General Practice Nurse (GPN) can help students experience semi-autonomous practice; patient safety is paramount, however structured assessments developed reflecting educational theory can provide reassurance in autonomy.

This article explores how GPN educators can facilitate safe practice to allow student nurses to flourish in primary care as safe, and increasingly semi-autonomous practitioners. To promote students in semi-autonomous practice, this article explores educational theories and conceptual frameworks. The theories are linked to worked examples that have successfully been used in clinical practice.

There is a continued lack of clinical placements within primary care; successive policies have made some headway, for example, the GP Forward View and the GPN Ten Point Action Plan, both of which set priorities to increase placement capacity (NHSE 2016; NHSE 2017). The lack of placements may be caused by common misconceptions, such as perceptions that students will get in the way and hinder service delivery, the practice's knowledge on what they can, or cannot do, time pressures for assessment, and low tariffs in comparison to medical students. Corneck et al (2023) and Hawkes (2019) point out that students really value placements and the unique perspectives of healthcare on offer in primary care. There are other rationales as to why there is a lack of enthusiasm for student nurse placements; but one question GPNs should consider is, how can the GPN workforce develop placements to ensure they are positive for the learner and allow them to practise semi-autonomously. Increasing the numbers of registered nurses through the development of quality educational (placements) is a key demand within the National Health Service's (NHS) long-term plan (NHS 2019, V3.0) and within the NHS's workforce development plan (2023); this plan suggests that nursing positions in primary care should be increased by an additional 5400, by 2036/37.

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