University leads training to help NHS respond to stress and burnout

With the additional pressures of COVID-19, it has been a year like no other for the NHS.

Now the University of Plymouth has been working with and training nurse professionals to help colleagues in need of support.

The Professional Nurse Advocates (PNA) programme was launched this year by Chief Nursing Officer for England, Ruth May and funded by NHS England.

With 400 teaching places in the first wave, funded nationwide, the University was allocated 120 – and has just completed training its first cohort.

PNA training provides those on the programme with skills to improve the quality of patient care, and to facilitate restorative supervision to their colleagues and teams in nursing and beyond.

Delivered by experienced academics, the programme equips professionals to listen and understand challenges and demands of fellow colleagues, and to lead, support and deliver quality improvement initiatives in response.

Due to the exceptional pressure that many nurses are experiencing through the pandemic, the development of this role started with those working in critical care.

The course builds on the established use of the A-EQUIP model (Advocating for Education and QUality ImProvement) in maternity settings.

Andrea Stebbings, lead for the Plymouth delivery of the PNA programme, said:

“It is widely recognised that all sectors of the healthcare workforce were already experiencing widespread stress, mental health problems and burnout. Rather than see these valued skilled people leave the profession, this initiative looks to help value them, enhance the care they can give and combat the problems from within, and this will help to retain staff.

“Being the largest provider and well established leader of healthcare training in the South West, we’re very proud to have been awarded this contract at the University of Plymouth, and hope it’ll help more people feel valued and supported and therefore stay in nursing.”


On announcing the programme, Chief Nursing Officer for England, Ruth May, said: 

“We’ve all been affected professionally and personally during the pandemic and it is my absolute priority to ensure staff get the rest, respite and recovery they need. With this in mind, I am very pleased to announce the roll-out of a brand new professional nurse advocate (PNA) programme, to deliver training and restorative supervision for colleagues right across the country. This programme is the first of its kind for our profession in England. 

“I am hugely proud of what our professions have delivered during the pandemic but now we must take care of them.”

What the nurses say

Melanie Gager, Nurse Consultant in Critical Care at Royal Berkshire Hospital, Reading, has just started on the second cohort of the programme at the University of Plymouth. She said:

“Almost overnight in March 2020 Intensive Care Units up and down the country were preparing for the unknown. We were immersed into a world where every patient had the same condition and treatment. Every member of staff unrecognisable because of PPE. A world where families were initially not allowed to visit. Everyone lost their identity.

“Intensive Care is all about being reactive and responsive in super quick time, but the impact on humanity was massive. Not knowing your patients because the families were not visiting and able to share something of who they were. Not knowing how to support those families. Not knowing how best to support staff. Not knowing how long this would go on for. Not knowing whether we were putting our families at risk.

“And yet…somehow together we faced the challenge, knowing that we would most likely have to face it all again. The second wave saw higher numbers, younger patients and a different disease process. You cannot measure the impact.

“As we reflect on the last 15 months we recognise the importance of looking after staff – this most valuable resource. We emerged battle weary and ready to rest, recover, restore. The offer to enrol on a postgraduate course at such a time as this seemed crazy and yet there was a sense that this was something innovative and the beginnings of a national movement.

“I am proud to have a place on this course. I am proud that I am part of the University of Plymouth. I am proud to be a critical care nurse. But most of all I am proud of what the community of critical care has achieved and has the potential to achieve through this course.”

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Eugene McCarthy, Senior Charge Nurse at University Hospital Birmingham, New Queen Elizabeth Hospital Critical Care Services, has also just started the programme. He said:

“Since being involved directly with the arrival of the first suspected Covid patient into critical care in early March 2020 I have been immersed, almost literally, in COVID-19.

“COVID ‘part two’ this year was worse, in my experience, as we knew by then exactly what we were facing, and the nebulous and vague dread of March 20 solidified into the daily fear and savage reality of January 21.

“Beginning this course has given me the opportunity to step outside of the bubble of the lived experience and daily routines in my own workplace, which naturally dominate my own working life and thought processes. Getting to know nurses and midwives from all over the country has also been most enjoyable and inspiring. I look forward with renewed optimism and confidence to using my newly learned skills as a PNA to help the recovery essential rehab and forward development of the profession I love.

“I am most grateful to my employer University Hospital Birmingham, the encouragement of Susan Price, Head of Inclusion and Diversity, Louisa Murphy, restorative care nurse, Chief Nurse Lisa Stalley Green, and my matron, friends and colleagues for the opportunity this represents.

“I’ve been a proud critical care nurse for 21 years, love my job deeply and look forward to being a small cog in the ‘wheel of healing’ post pandemic; using my PNA skillset to improve and enhance the working lives of those who bear the scars of our recent experiences.”