Advanced Practice Toolkit 

11. Advanced Practitioner wellbeing and retention 

TIP: Protect study time, break time, supervision time and encourage use of personal and professional networking. 
TIP: Ensure that there are safe, open ways to raise personal and professional concerns. 
Across the NHS, the impact of COVID-19, the cost-of-living crisis and continued short staffing means that many staff members are under considerable personal and professional stress. In the case of Advanced Practitioners, they are also transitioning into a role that may have more study than previously, and that may be more isolated and independent than their previous role. They also highlight that the role boundaries may be emergent; that is, new roles to a practice without many clear precedents may evolve in terms of their tasks, responsibilities and practices. Some Advanced Practitioners report pressure to work beyond their own clinical capabilities to support colleagues [48], and with unclear boundaries to the role [e.g. 27]; this can cause high levels of stress. Evans [10] reports one participant in their study who had stopped wearing eye make up to work because they spent too much time crying. 
Although some circumstances are hard to mitigate, employers can articulate clear role and task boundaries. They can make their support and respect for Advanced Practitioners obvious, and ensure reasonable working conditions. Reasonable conditions include: 
supporting the whole team to take breaks and to eat meals. 
ensuring reasonable finish times wherever possible. 
allowing flexibility to attend personal medical appointments. 
reducing pressure for people to come in if they should be at home, for example if they are unwell and “soldiering on.” 
Peer support, both face to face and through platforms like WhatsApp, can be extremely supportive. As with all employees, having a safe and open way to raise concerns about both work and personal stress or problems is supportive. Supervision should not be routinely cancelled for “clinical pressure”, and support time should be prioritised. 
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