Much of the content on our site is available to our registered users only. If you're already registered, just click the 'Log in' button then enter your email address and password.
If you're not already registered on the site, you'll need to do so in order to gain unrestricted access to all our content. There are two types of registration:
1. If you're a current subscriber, you can register for access to our protected content at no additional cost. You'll need your subscription number in order to complete your registration, which is on the polythene wrapper in which your journal is delivered. Click the Register button to begin your registration.
2. If you don't currently subscribe you can do so now by taking out a secure online subscription. Not only will this give you instant access to our protected online content, but you'll also get every issue of Nursing Standard - the UK's best selling nursing journal - delivered straight to your door. Click the Register button to begin your subscription and registration.
Paul Smith-James, an assistant practitioner at Southmead Hospital, North Bristol NHS Trust, works on a urology ward.
'I insert and remove catheters, do wound dressings, remove stitches and manage drains, among many other things. I have training in medicines administration, but cannot carry out drug rounds because I must learn about each drug individually, then add it to my portfolio. I can put up intravenous fluids such as saline and flush cannulae, and soon I will be able to insert cannulae.'
Mr Smith-James used to care for people with learning difficulties. He then started adult nurse training, but did not complete all the modules so he returned to his care assistant job. 'I was surprised to be offered the assistant practitioner (AP) post, but I was fast-tracked because I have a diploma in health and social care,' he says.
Mr Smith-James feels he has more interaction with patients than nurses do.
'Although I am a band lower than ward nurses, there is not much difference in pay and I am free from the managerial work that ties the nurses up,' he says. His ambition is to move into emergency care. 'Although I am happy as an AP, I may reconsider nursing later.'
Mr Smith-James believes the AP role is used well in his trust. 'I have been assessed as competent in my area and am well trained, whereas nurses can be moved from ward to ward. I have a nurse mentor and we work to increase the medications I can give. The ward manager drew up a list of skills she wanted me to be competent in and if I need help, I get it.'