Professional advocates creating recovery space for nurses and midwives

Professional Nurse and Midwife Advocates support the personal and professional wellbeing of nurses and midwives through a range of innovative listening and engagement tools, including restorative clinical supervision.

The Q Professional Advocacy group has been set up in response to a programme developed by NHS England for nurses and midwives.

Having recently graduated as a QI Coach from NHS Elect, I am excited and passionate as a Q member to connect this community to further support and develop ideas I have. 

Following the COVID-19 pandemic, the Nursing and Midwifery Council noted a worrying trend of nurses and midwives leaving the profession earlier than might be expected. 

A 2022 survey provided some insight about the underlying reasons for why nurses and midwives were choosing to leave. These included workplace pressures such as burn out, concern about the quality of people’s care, workload and staffing levels.

To address nurses’ and midwives’ concerns, and encourage recovery of the workforce, NHS England introduced the Professional Nurse Advocate (PNA) programme.

A similar version of the programme, known as the Professional Midwife Advocate (PMA) programme, was already in place. 

PNA/PMA programmes are MSc-level modules providing learners with skills to deliver restorative clinical supervision, career development and to initiate quality improvement projects. 

The overall aim of this programme is to help improve wellbeing, retention and betterment of the nursing and midwifery workforce. 

Trained PNAs/​​PMAs provide psychologically safe spaces in nursing and midwifery workplaces for staff to reflect and take a breath.

According to an evaluation done by Coventry University in 2023, 8,000 nurses have completed PNA training to date and we hope to see more in the coming years.

This is a new change for organisations and levels of engagement vary, but it would be fair to say that this programme is here to stay. 

The type of skills that PNAs/​​PMAs are introducing to the workforce signal a shift toward sustainable and continuous improvement for our profession. 

I am a lead Professional Nurse Advocate and run the UK-wide Parliament of Professional Advocates, which has over 750 members and growing. 

I hear first-hand the struggles and needs of the community. 

It takes a village to support and nurture each member of our profession, and I firmly believe that there is fantastic opportunity to make lasting change for the betterment of our workforce.

A major focus of my work has involved using a QI approach to develop models of practice that PNAs/​​PMAs can use to listen and support their colleagues in the workplace. 

Some examples of these are: 

Itchy Feet clinics: This is a psychologically safe space for nurses to talk about how they really are. An Itchy Feet clinic is offered virtually and at a time that suits the staff member. Of those surveyed, 97.5% feel this space improves retention in their current role. 

The Walkie-Talkie model of practice: This model uses a simple two-pronged approach, as outlined here: 

1. Walkie – I meet staff outside their base and walk them to their next visit or around a park and deliver restorative clinical supervision, career conversations or support QI. 
2. Talkie – I call people via MS teams or on the phone and deliver restorative clinical supervision, career development or support QI. 

Data from this approach shows that this type of support has the potential to reduce sickness absence by 67.5% and result in improved mental health. 

This is why to me Professional Advocacy is so critical to addressing the wellbeing needs of our nurses and midwives, and allowing this workforce to recover. 

If Professional Advocacy is truly embedded and engaged with at board level the outcomes can be monumental.