Introduction
The Professional Nurse Advocate (PNA) role was established within the NHS in 2020 to support nursing staff to reflect, re-set and recover post Covid. Reflective supervision enables staff protected and confidential time to discuss reflectively any professional, emotional and personal issues, recent incidents, personal development or innovation ideas. The role of the PNA is to facilitate these conversations and coach the participant through a process of reflection, planning and supporting the actions of their next steps.
The Professional Nurse Advocate role was introduced to Pioneer WHLC on 1st August 2024 as a 6 month, 7.5 hours/ week fixed term role to establish if this role would be accepted and utilised by staff and have an impact on staff wellbeing and development.
Carole Young, an already well established and experienced Nurse Consultant in Tissue Viability, took up this brand new PNA role at Pioneer in August 2024.
Carole has been a Tissue Viability Specialist Nurse for 25 years in a large NHS Teaching Trust, and an Associate Lecturer for pre-registration nursing for 10 years. Carole left the NHS in 2022 to start as an independent TVN consultant and educator before joining the Pioneer Bank to support clinical care in 2023. She works this around her regular hobby of sailing in the Mediterranean!
Carole became interested in the role of a PNA whilst undertaking a Florence Nightingale Foundation Academy Leadership Scholarship and took this interest further by obtaining the formal PNA qualification in 2022.
At Pioneer, Reflective Supervision is recognised to support the organisations core values of, Patients First, Communication, Staff Development, Research, Excellence.
Whilst the original objective of the PNA role was designed to support nurses, Pioneer has a diverse and multi-skilled workforce and recognises that all staff regardless of whether they are clinicians, or non-clinicians could benefit from supervision and support that incorporates reflective, restorative and resilience-based elements from a PNA. At Pioneer, the PNA role is open to all staff to access reflective supervision, this includes medical staff, allied health professionals, administrative, support staff and nursing staff.
Since Carole has been in the PNA role she has supported Pioneer to formalise a job description and associated polices related to the role, provided teaching sessions for raising staff awareness and set up a booking process for staff to access the service.
From October 2024 to January 2025, 12 individual staff members have utilised the PNA service with 50% returning for follow up sessions. 4 large group sessions and 3 small group sessions have been delivered also to specifically reflect as a group on building resilience and adapting to changes taking place within the organisation.
Of those staff who have engaged with the PNA service, we found that whilst 22% of staff booked a session on the recommendation of their manager or colleague, 78% booked independently to take up the opportunity of a reflective discussion, career planning or learning development conversations.
Staff have provided the below anonymous feedback on utilising the PNA service:
“I feel these sessions are key to a healthy working relationship, it provides a safe place to reflect on issues, in a non-judgemental environment. I felt listened to and heard, I felt my concerns where valued and support provided to be honest with how I was feeling”
“It felt safe to discuss my experiences and concerns, feeling better and helped me reflect”
“I believe this session was invaluable to be able to be open, honest and not be anxious about stating how we feel was a relief. Someone to listen to us, without judging, someone we can trust. Great session. Hope we have more in the future”
“A really really useful addition to the armoury of supporting staff”
“Session was far more beneficial than I had imagined, especially the follow up summary with reading recommendations and further thoughts for reflection before a further session”
Beyond this, Pioneer recognise the staff feedback of needing more time for the PNA sessions and for the group sessions specifically to be longer in duration.
Professor Jenni MacDonald, Executive Nurse Director who championed this new role said the “introduction of Carole and the PNA service into Pioneer has been a resounding success. Changing landscapes and evolving strategic priorities are a constant source of change at Pioneer so having a dedicated PNA, for all staff, not just nurses is not only important for our staffs development but also their wellbeing”.
Carole Young, Pioneers PNA said “This has been a fabulous opportunity to develop a role through my passion for staff wellbeing and development. It’s rare in the NHS for the PNA role to be a stand-alone post, the role is often combined with another post within education or seen as an “add on” or “as well as”. It is really forward thinking and innovative for Pioneer to recognise the importance of giving staff a safe place to reflect, re-set and plan for their future practice and learning with a dedicated PNA to facilitate and coach.”