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The intermediate level nurse: A case of misplaced optimism?

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  • Full or part time
    Dr J Brooks
    Prof C Hallett
  • Application Deadline
    Applications accepted all year round

Project Description

To examine the position of the Enrolled Nurse (EN) in general and mental health hospitals in Britain between 1943 and 1988.

On 17 December 2015, the Health Minister Ben Gummer announced the creation of a new nursing role, that of ‘nursing associate’. The intention of the new position is that it will bridge the gap between registered nurses (RN) and healthcare support workers. Whilst cautious support has been offered from some quarters, there have been a number of concerns raised by nursing organisations and leaders of the profession about the potential pitfalls of the scheme. The concerns include the funding of the regulation of ‘nursing associates’, ‘stepping off’ points, ‘protected functions’ of the RN, details of accountability and responsibility and anxieties that it was too much like the EN of the mid-late twentieth century. Recommendations were made that the Government and profession look to the history of the EN as a way of ensuring mistakes are not made. There have however to date been no critical studies into the EN as an antecedent to the new role.

This study will be a historical PhD study, combining both archival work and oral history. The oral histories will be undertaken using a semi-structured interview. Retired and current ENs will be asked about their experiences working in either mental health or general nursing. Questions asked will relate to: a) the level of responsibility they were given and if this was consistent; b) whether they were expected to practice outside the accepted remit of their position or their ability; c) their ability and willingness to question practice; d) their engagement with student and pupil nurses; e) whether conversion to RN was encouraged and paid for by their employer and f) the impact their RN conversion education had on their practice.

It is anticipated that the study will illuminate some of the problems and issues that ENs faced in order to provide a critical awareness of the possible ramifications of an intermediate level nurse

Training/techniques to be provided:

The student will be given training in archival work by supervisors and provided with critical skills in the specific disciplines of the history of nursing education and practice.

The Oral History Society and the Wellcome Trust provide essential oral history training and the student will be expected to attend a workshop organised by either of these providers.

Funding Notes

For this particular project, we expect applicants to have achieved a 1st Class Bachelors degree (or overseas equivalent) in either nursing or history, or a related subject. Students are also expected to have a master’s degree, or equivalent, in a subject related to history, or the history of nursing.

Please see for fees. For information on how to apply for this project, please visit our website (

Informal enquiries may be made directly to the primary supervisor.


Brooks, J. (2015) A poverty of leadership: Nursing older people in British hospitals 1945-1980. In Fealy, G., Hallett, C.E. & Malchau Dietz, S. (eds.) Histories of Nursing Practice. Manchester: Manchester University Press

Department of Health (2015) Nursing associate role offers new route into nursing, [accessed 17 May 2016].

Glasper, A. (2016) Can a nursing associate role fill the void left by enrolled nurse training? British Journal of Nursing, 25 (3): 178-179.

Hallett, C.E. & Cooke, H. (2010) Historical Investigations into the Professional Self-Regulation of Nursing and Midwifery: 1860 – 2002: Volume I: Nursing. London: Nursing and Midwifery Council.

Lomas, C. (2016) Nursing associates: A return to State Enrolled Nurses? Nursing Management, 22 (9):10-11.

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