Summary
Clinical mental health nursing leadership is essential in enabling and empowering registered mental health nurses to continuously improve their learning on quality and safety and the care they provide to patients and families.
This document describes the implementation of the professional nurse educator (PNE) role within mental health services and offers advice on how providers of mental health services can effectively implement the role within their mental health services.
The PNE role has three key functions which support both the quality of patient care and the effectiveness of the mental health nursing workforce:
- Improve – quality and patient experience of care.
- Increase – the supply and retention of registered mental health nurses into the workforce.
- Support – the mental health and wellbeing of all mental health staff.
The PNE role has been developed following a review of the research literature, and from empirical evidence and expert advice guidance. Additionally, a national pilot of the role across 12 provider organisations was commissioned has provided valuable insights regarding best practice and implementation.
Introduction
This document describes the Professional Nurse Educator (PNE) role and provides guidance on its implementation in practice. It is of relevance to:
- Registered mental health nurses.
- Wider mental health workforce
- Chief nurses
- Providers of mental health services
- Integrated care boards (ICBs)
The professional nurse educator (PNE) is an innovative clinical mental health nursing role which supports the facilitation of a learning environment, embedding a learning culture and works as an addition to and not instead of other roles.
The PNE role offers the opportunity for registered mental health nurses to work in a clinical leadership role to support and educate the nursing workforce, illustrated in various case studies. The role works to develop competence and confidence of the mental health nursing workforce and improve the quality, safety and effectiveness of care provided to patients. The role of the Professional Nurse educator aligns to the ambitions of the Long term workforce plan to increase supply and retention of mental health nurses, the delivery of the mental health strategy and Chief nursing officer for England’s vision for nurses and midwifery.
What is the professional nurse educator role?
Professional nurse educators (PNE) are experienced registered mental health nurses who work in a supernumerary capacity to support the delivery of effective, high quality and safe care to patients and their families. PNEs support the mental health workforce by role modelling clinical leadership, demonstrating advanced nursing practice skills and, by embedding a culture of learning and development within mental health teams. They have three key functions:
- Improve – quality and patient experience of care.
- Increase – the supply and retention of registered mental health nurses into the workforce.
- Support – the mental health and wellbeing of all mental health staff.
PNEs work across a small number of unit areas/teams to ensure they can support individual staff in a personalised and responsive way by offering a range of interventions aligned to local need and NICE guidance While PNEs support the whole mental health workforce, they give particular focus on supporting mental health nursing staff who may be new to a clinical area (e.g., healthcare support workers, student mental health nurses, preceptee nurses and internationally educated nurses).
This professional leadership role is undertaken by experienced registered mental health nurses who are also expected to have qualified as professional nurse advocates (PNAs). For further information on becoming a PNE, please view the PNE role criteria checklist. More information about the PNA role can be found on our website.
With this skillset they are equipped to support and promote the wellbeing of the mental health nurse workforce by facilitating restorative clinical supervision, develop the nursing workforce by offering annual career conversations, and improve patient care and experience by supporting and leading nursing quality improvement initiatives.
The implementation of the PNE role gives registered mental health nurses an opportunity to develop and progress their careers within the clinical environment. Research draws attention to the importance of retaining experienced nurses in the clinical environment for patient safety and quality (Zaranko et al, 2022).
Research suggests that providing a career pathway within this environment helps retain experienced nurses in the clinical environment, the recognition of continued professional development (CPD) is essential for the workforce to expand their knowledge, develop their practice and grow as a profession (Health Education England, 2022). The PNE role also strengthens the visibility of clinical nursing leadership, a key objective of the Chief Nursing Officer for England’s strategy for nursing which is reflected in the NHS mental health implementation plan.
The mental health nurse’s handbook is a vital tool for PNEs and mental health nurses in critically welcoming and supporting new colleagues to the profession. PNEs should use evidence and resources to support them in their role, the national guideline of the mental health nurse’s handbook supports PNEs to implement best practice in their workforce.
The PNE role has been piloted across 12 provider organisations, and below we include case studies giving insight into best practice and implementation. Accessible checklists for the providers can be found here.
Functions of the professional nurse educator role
Improving quality and safety
The PNE has a key focus on improving quality, safety, and patient experience of care, and provides visible senior professional nursing leadership in practice areas.
They improve quality through role modelling evidence-based practice and professional leadership behaviours, as well as developing a culture of learning to improve the workforce’s competence.
The PNE role:
- provides a visible nursing leadership presence in clinical areas.
- role models best practice and evidence-based interventions, and effective professional attitudes and leadership behaviours
- leads the development of psychologically safe learning culture in the clinical environment, one underpinned by ‘just culture’ principles.
- promotes a culture of improvement through encouraging feedback from staff, patients, carers, and the community to improve the quality of clinical care, treatment, and environments.
- leads innovation by instigating quality improvement programmes, promoting a culture of change and quality improvement based on evidence/research.
- delivers restorative clinical supervision.
- could support facilitation of incident debriefs.
- provides student nurse placement assessment and supervision.
- supports nurse preceptorship and those nurses who are new to the clinical area.
Case study: Essex Partnership University NHS Trust
Emily is an experienced mental health nurse who has worked in both clinical and educational roles. In her PNE role at Essex Partnership University NHS Trust, Emily focuses on being physically present on the two acute wards she works with. This visibility to team members has allowed Emily to become part of the team, and with this she has been able to normalise education in the team and encourage a culture of continuous learning. Emily supports the busy acute wards with responsive learning opportunities after incidents on the ward through innovative ‘learning huddles’. These support and debrief staff, identify good practice and role model evidence-based practice. Learning and support are accessible and timely for staff, without the need to organise a formal structured intervention.
Case study: Central and North West London NHS Foundation Trust
Timi, the PNE working in Central and North West London NHS Foundation Trust, works with the lead nurse on the unit to respond to risks raised in safety huddles. Together they facilitate sessions for new nurses on conducting searches. These sessions review policy, and discuss person-centred care, dignity, and capacity, as well as risk assessing and establishing ward boundaries in line with ‘see think act’. This focused work is helping to reduce the contraband found on the ward and improve staff engagement and rapport with visitors. The sessions enabled the fostering of clear communication, boundaries and expectations of the ward and visitors to allow for a positive experience for patients and staff.
Increasing supply
The PNE supports mental health nurse supply, and delivery of the NHS Long Term Workforce Plan, by offering personalised support so those entering or returning to this workforce or new to the practice area, including student mental health nurses, internationally educated nurses and healthcare support workers.
Personalised interventions support both development of clinical competency and wellbeing. The PNE may provide support through:
- increasing student nurse placement capacity in clinical areas
- providing student support, e.g., drop-ins/bespoke training sessions
- being the practice assessor for student nurses
- offering the opportunity for shift shadowing/role modelling of professional/clinical practice
- offering career development conversations
- offering pastoral support and restorative clinical supervision to all clinical staff
- supporting healthcare support workers to complete care certificates
- supporting internationally educated nurses with objective structured clinical examination (OSCE) preparation and transition.
- offering ‘on the unit’ training and support for internationally educated nurses.
- developing individualised actions plans to support nursing staff with areas they are under-confident in or need to increase their knowledge or skill in
- supporting staff to access to nursing apprenticeships.
- supporting registered nurses to return to practice.
Case study: Humber Teaching NHS Foundation Trust
Dani is the PNE working in Humber Teaching NHS Foundation Trust. One way she supports mental health nurse supply is by supporting student mental health nurses to complete their placements. Dani has been a long arm practice assessor for several nursing students placed on the unit area she covers. She also supports student nurses with bespoke teaching sessions and offers restorative supervision spaces to those on placement. Dani also offers career conversations to the student nurses she supports and can them to consider and apply for employment in the trust.
Another way is by supporting nurses returning to practice after periods of illness, career break or retirement and who may need to develop competence in clinical areas. Dani offers shift shadowing, 1:1 meetings, restorative support and bespoke learning opportunities based on individual staff need.
Case study: Surrey and Borders Partnership NHS Foundation Trust
Alberta, a PNE at Surrey and Borders Partnership NHS Foundation Trust, identified that the internationally educated nurses (IENs) in the clinical areas she worked in needed support. As an IEN herself, Alberta felt she could bring her experience of trying to integrate and build confidence and competence to support new IENs. She does this in clinical practice with interventions including shadow shift opportunities,1:1 support with specific competencies and OSCE preparation. Alberta also offers career conversations and interview preparation, including for IENs looking for different job opportunities. Restorative clinical supervision sessions are particularly important for IENs and, as Alberta is a qualified PNA, she can offer them restorative spaces both formally and informally to support them with the challenges of nursing in a different country.
Supporting retention
As identified in NHS Employers (2022) Improving staff retention, offering support at key transition points in a nursing career is important for retention. This includes tailored career support for student nurses, early career nurses and IENs.
The PNE supports the retention of the mental health nursing workforce in their unit area. They work with the unit teams and therefore understand them and can offer bespoke interventions based on localised need that encourage mental health nurses to stay. Interventions may include:
- providing a new clinical career option (Health Education England, 2022)
- providing a practice based clinical education role (NHS England, 2023)
- undertaking a training needs analysis (TNA) of the ward/unit team, and designing, offering, or facilitating access to training and continued professional development (CPD) in partnership with the ward/team manager.
- developing bespoke practice-based training programmes for groups of nurses, e.g., preceptees, Band 5/6 nurses
- supporting IENs with transition to practice in their identified clinical environments
- facilitating of career and ‘stay’ conversations.
- supporting staff support with confidence and competency development following periods of absence.
- influencing wider organisation clinical nurse education and training based on insights from role.
- working with others involved in education, clinical practice, and academia, to adapt/change and inform programme development.
- mental health and wellbeing support
Case study: Greater Manchester Mental Health NHS Foundation Trust and West London NHS Trust
Jen and Laura, PNEs at Greater Manchester Mental Health Trust, and Polly and Courtney, PNEs at West London NHS Trust, have all worked with their trust colleagues to develop and facilitate bespoke training programmes for nursing groups, including preceptees and Band 5 and 6 nurses working in their unit areas. Jen and Laura support the delivery of the ‘preceptorship plus’ programme as well as offering a programme for new leaders in inpatient services. Polly and Courtney have developed their ‘floor’ programme that supports both nurses new to the clinical area and those who want to develop in the clinical area. Both teams of PNEs have worked hard to understand the local educational needs of their workforce and support the development of programmes to improve confidence and competency, and support retention.
Case study: Sussex Partnership NHS Foundation Trust
Dale, a PNE based in Sussex Partnership NHS Foundation Trust, has responded to the local learning needs of the unit areas he supports through organising staff development days, and through the review of serious incidents, staff requests and Care Quality Commission feedback. Dale also links with colleagues in his organisation to support responsive development of organisational CPD courses based on the review and insights he collects in his PNE role.
Supporting the mental health and wellbeing of mental health staff
The PNE supports the mental health and wellbeing of staff through the offer of a range of interventions that enable mental health staff to feel heard, be able to reflect on their clinical practice and engage with colleagues. The PNE is expected to have completed their PNA training. This enhances their skills in supporting the wellbeing of the workforce. Interventions may include:
- facilitation of either 1:1 or group restorative clinical supervision
- signposting to further wellbeing staff support
- offering and facilitating reflective staff debriefs after incidents.
- providing informal support through being a visible leadership presence in clinical areas
- influencing wider organisation wellbeing support offers based on insights from role.
- supporting a psychologically safe ‘just culture’ to be embedded in clinical areas.
- role leadership behaviours that demonstrate civility and kindness
Case study: Cambridge and Peterborough NHS Foundation Trust
Sam and Charlie work as PNEs in inpatient eating disorder units. They have supported staff with their own wellbeing in various ways. They offer staff regular restorative space either as a group or individually. Restorative spaces offer the opportunity for reflective practice for staff and enable them to debrief after incidents, reflect on their own wellbeing and take time to understand further support that they may need. Sam and Charlie are also able to offer more informal restorative support to staff due to their regular presence in the clinical area. Both Sam and Charlie have undertaken their PNA training which has developed both their supervision and leadership skills helping them to support their clinical workforce effectively.
National support
Professional Nurse Educators should be encouraged to attend the monthly national community of practice, a space to share good practice and learning. It offers PNEs the opportunity to innovate and be creative through learning from other PNEs in the group. The community of practice also offers a restorative space for attendees.
The PNE and Mental health nursing futures platforms offer an additional national support function to PNEs, and provider organisations giving opportunities to engage, network and share best practice.
Outcomes of the professional nurse educator role
The evaluation findings of the national PNE pilot of 13 trusts across England identified several benefits of implementing the role in clinical teams. Harrison (2023) highlights the following benefits:
- Job satisfaction
- Autonomy
- Hands-on role
More so, Wadey and Dzikiti (2022) article outlined further benefits of the PNE role for the workforce and these include:
- Protected additional clinical support and mentoring;
- Increased confidence for both experienced and new to role staff on wards.
- Enhanced staff capability in clinical areas.
- Improved staff experience.
- Attracting and retaining our valued nursing workforce.
Furthermore, PNEs indicated that the PNE role offered them the ability of clinical career progression and enabled them to remain in clinical practice at a more senior position.
The evaluation outcome highlighted that ‘86% of staff who experienced the support of a PNE believed there was a need for the role in their trust’ (Harrison, 2023). The outcome is a result of PNEs offering staff restorative and pastoral support, empowering them to make decisions and further encouraging their continued professional development.
Further resources
Harrison, J. (2023) The professional nurse educator role: a way of reducing pressure and improving retention?. Mental Health Nursing 43(3).
NHS England. (2024) 2024/25 NHS Standard Contract.
Zaranko, B., Sanford, N.J., Kelly, E., et al. (2022) Nurse staffing and inpatient mortality in the English National Health Service: a retrospective longitudinal study. BMJ Quality Safety 32(5).
Acknowledgements
The Professional Nurse Educator taskforce is grateful to the following for their support in developing this implementation guide:
- Dame Ruth May DBE, Chief Nursing Officer for England
- Professor Emma Wadey, Deputy Director of Mental Health Nursing, NHS England
- Victoria Charlesworth, CNO Clinical Nurse Fellow, NHS England
- Katie Taylor-Cross, Senior Project Manager for Professional and System Leadership, NHS England
- Sarah Legood, Project Manager for Mental Health Nursing and Professional Nurse Advocate, NHS England
- Alberta Bemah, PNE, Surrey and Borders Partnership NHS Foundation Trust
- Charlie Middleton, PNE, Cambridge and Peterborough NHS Foundation Trust
- Courtney Mavor-Cook, PNE, West London NHS Trust
- Dale Simpson, PNE, Sussex Partnership NHS Foundation Trust
- Danielle Wilkinson, PNE, Humber Teaching NHS Foundation Trust
- Emily Newman, PNE, Essex Partnership University NHS Trust
- Jennifer Thompson, PNE, Greater Manchester Mental Health NHS Foundation Trust
- Laura Shannon, PNE, Greater Manchester Mental Health NHS Foundation Trust
- Polly Daly, PNE, West London NHS Trust
- Sam McAuley, PNE, Cambridge and Peterborough NHS Foundation Trust
- Timi Eguruze, PNE, Central and North West London NHS Foundation Trust
Publication reference: PRN00583_i