20 COMMENT
Nurses ’ expertise is essential to support non-registered vaccinators
The use of lay vaccinators has boosted the speed of the rollout , but nurses remain indispensible for safe and effective public immunisation against Covid , writes Marilyn Eveleigh
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W hen estimates of the vaccination programme revealed the need for an expanded workforce , one of the most striking innovations was the drafting of non-registered staff as vaccinators . A national protocol now governs the administration of a prescribed vaccine by a non-registered worker , with crown immunity covering all service providers . This safeguards the use of immunisers who are not registered healthcare professionals . St John Ambulance has trained 30,000 volunteers to undertake the role .
As immunisation experts , nurses have been the backbone of this national programme . GP networks have largely used their own primary care nurses to staff their centres , while larger NHS centres have employed nurses alongside non-registered vaccinators ranging from airline staff to furloughed offi ce workers . Prescribed training is provided on safe administration of vaccines , anaphylaxis and resuscitation , patient assessment and consent . Professional accountability , however , remains with the nurse .
Yet nurses are in short supply . Although 15,000 have returned to a temporary NMC register to support the pandemic effort , there were already 50,000 NHS vacancies . The NMC register has increased by 2 % this year but the overall picture is grim and will get worse when those who delayed their retirement to support colleagues fi nally go . And as nurses return to their substantive posts , there is an increasing shortage at vaccination centres , with millions still to be vaccinated .
In the relentless bid to vaccinate the remaining public , even more non-registered immunisers are being appointed . Though welcome , their training is not always consistent , which can be challenging for the nurses who are required to oversee them . Supervising up to six simultaneous consultations in a public space is not only diffi cult in practical terms but can call for a high level of diplomacy when intervention is needed without affecting the credibility of the process . There are anecdotal reports of conversations in front of patients exposing differing views between the accountable nurse and the immuniser , potentially undermining patient confi dence . Some keen non-registered immunisers who have held senior positions may display levels of confi dence not matched by knowledge or insight .
Nurses should be able to challenge such misplaced confi dence without being criticised . We have an excellent record of successful delegation to non-registered staff : upskilling healthcare support workers , expanding services and keeping patients safe . As the most trusted profession we support new models of safe , cost-effective care .
The use of enthusiastic non-registered workers during the pandemic has set a precedent for the vaccination of the public but we should remain mindful of the evidence that organisations with a higher ratio of qualifi ed nurses also have higher safety outcomes .
Nurses have an excellent record of delegation to nonregistered staff
Marilyn Eveleigh is a nurse adviser and independent trainer in East Sussex nursinginpractice . com Summer 2021