Trainee ANPs' experiences of having a clinical practice facilitator introduced into a Hospital at Night team

In Scotland, the majority of trainee advanced nurse practitioners (ANPs) are registered nurses undertaking postgraduate education through a collaborative pathway between employer and a higher education institute. Core modules undertaken often include advanced patient history taking and clinical examinations, work-based learning and independent non-medical prescribing to achieve a minimum requirement of a Postgraduate Diploma in Advanced Practice. Some are working towards a Master's in Advanced Practice. The majority of the nursing team in Hospital at Night (H@N) services are recruited as trainees in the first instance, and the service will support them to the role of ANP.

Montgomery et al (2021) acknowledged the challenges of supporting staff to undertake training in the out-of-hours period. Despite a real willingness to learn, Haslam (2021) argued that lack of access to clinical support and supervision remains the most significant barrier. Similar to the findings from other clinical environments, it would appear that the majority of clinical supervision for advanced practice comes from medical colleagues (Guevara et al, 2020; Mundy and Pow, 2021; Lee et al, 2023). This model for supervision is particularly problematic for trainee ANPs in a H@N context for a number of reasons. These include the high volume of trainees needing support against a low number of experienced ANPs; rotating medical colleagues meaning supervision is often ad hoc with little consistency; and medical consultants working during the ‘in hours’ period. This results in ANP trainees doing much of the necessary learning in their own time, outside working hours.