Evaluating the integration of professional nurse and midwifery advocacy roles within a large healthcare organisation: assessing service utilisation and benefits– a cross-sectional survey

<p dir="ltr">Aims: To assess nursing and midwifery staff's awareness, use, and perceived benefits of the Professional Advocate role in clinical practice. </p><p dir="ltr">Background: Nursing and midwifery staff face growing challenges, including heavy workloads, burnout, and staff shortages. In response to rising attrition and dissatisfaction, the Professional Nurse Advocate and Professional Midwifery Advocate roles were introduced to provide professional support, improve working conditions, and enhance staff wellbeing. However, there is limited evidence on their effectiveness, particularly regarding staff retention and wellbeing. </p><p dir="ltr">Study Design: This evaluation employed a mixed-methods approach across four phases. This paper focuses on Phase 2, which involved a cross-sectional, self-report survey of 407 nursing and midwifery staff. Participants completed a self-administered questionnaire between October 2023 and January 2024. </p><p dir="ltr">Findings: The study highlights significant gaps in awareness and access to Professional Advocate (PA) services, with 64.9% of participants unaware of the role and 80.6% reporting no prior engagement. However, 95.3% expressed interest in future use, indicating strong positive attitudes toward the role and its support. Midwives reported greater familiarity with and access to PA services, likely due to longer exposure to the role, while nurses showed higher interest in repeated use. Informal communication channels, such as word-of-mouth, were prevalent, highlighting the need for more formal communication strategies. Participants valued the PA role for its emotional support, advocacy for staff rights, and career development, with confidentiality and accessibility identified as key priorities. Barriers to access included time constraints, concerns about confidentiality, and the need for greater organisational support. The PA role was perceived as empowering, positively influencing staff wellbeing and job satisfaction. </p><p dir="ltr">Conclusions: Effective integration of PA services has the potential to empower nursing and midwifery staff, improving wellbeing and retention. Addressing access barriers and enhancing service delivery are essential to maximising the impact of PA services in supporting staff wellbeing and professional growth. Relevance to Clinical Practice: The study identifies critical gaps in PA service awareness and uptake, particularly regarding confidentiality concerns. Strengthening formal communication, ensuring secure and accessible services, and fostering managerial support are key to optimising service use. The perceived benefits of PA services for staff wellbeing and professional development highlight their potential to create a more empowered and sustainable healthcare workforce. Investing in these services could enhance staff retention, morale, and the quality of care.</p>