Exploring the historical experiences of former enrolled nurses to consider the role of the nursing associate

Background The enrolled nurse (EN) role (second-level registration) was formalised in the UK in 1961 but phased out from the mid-1980s and training courses leading to second-level registration had ceased completely by 1992. The training and practice experiences of former ENs have garnered interest in recent years due to the similarities between the EN role and the nursing associate (NA) role, which was introduced in England in 2017 to help bridge the gap between healthcare assistants and registered nurses. Aim To explore the past experiences of former ENs to provide a historical lens through which the contemporary role of the NA can be considered. Method Semi-structured interviews were undertaken with nine former ENs in learning disability and mental health. Findings Thematic analysis of interview transcripts generated four main themes – ‘the numbers’, ‘just an enrolled nurse’, ‘a stepping stone’ and ‘considerations for the NA’. Participants valued their EN training and role and believed it had provided them with a foundation on which they could make important contributions to nursing care throughout their careers. However, they also described having a perceived ‘lower status’ than registered nurses, but at the same time were expected to assume responsibilities beyond their scope of practice during workforce shortages. Participants welcomed the concept of the NA role and regarded it as a way of building a strong and reliable nursing workforce but were concerned that NAs could be exploited as a ‘cheaper nursing workforce’ and about the lack of role clarity among the wider nursing and healthcare workforce. Conclusion Lessons from the historical experiences of former ENs should guide the ongoing development of new roles such as the NA, particularly in relation to ensuring the wider nursing and healthcare workforce are clear about the scope of the role.