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New education standards give clarity to nurse role

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On 16 September we launched our new standards for pre-registration nursing education at Queen’s University, Belfast.

The importance that the public put on the quality of nursing in the UK is evidenced by the significant contribution that more than 5,000 individuals and organisations across the UK made to the new standards.

Patients and the public told us that a nurse should be caring and compassionate, and should make sure that their essential needs are addressed. In addition, employers told us that future newly qualified nurses will need to have a higher level of assessment skills, be able to think critically and have the confidence to make decisions based on their assessments.

‘We faced an enormous challenge. The standards had to produce the compassionate nurse people expect but with the level of competence needed to deliver highly technical care’

We faced an enormous challenge. We had to deliver a set of standards that, on the one hand, would produce the caring and compassionate nurse that people expect, but with the level of competence and confidence needed to deliver highly technical and skilled care across all healthcare settings. I believe this has been achieved and would like to extend my thanks to colleagues and to everyone who contributed their time, expertise and views throughout the review.

Higher education institutions across the UK now have the task of developing new programmes and, over the coming months, we’ll be supporting them to do that through a series of roadshows. Innovation and partnership will be essential factors to the success of the new programmes. Universities will need to work closely with their partners to respond to the challenges of meeting the very different expectations their future students will have about what it will mean to be a registered nurse.

Certainty about what it means to be a nurse is fundamental to being able to deliver safe and effective care. This is as true for today’s nurses as it will be for those entering the profession in the future. In order for nurses to work effectively within a multidisciplinary team, they must first be clear about what the role of the nurse is, and what it is not. Only then will they be empowered with the confidence to thrive - and to lead teams to deliver complex care across all healthcare settings.

Theories about the role of the nurse can be found as far back as the 19th century. How that role is defined is evident when we consider the relationship between the nurse and the patient throughout the ages. For example in Florence Nightingale’s (1820-1910) seminal work, Notes on Nursing, nurses are positioned to ensure that care is matched to patient need, while Margaret Newman’s theory in 2008 asserts that the role of the nurse is “to assist people to recognise the power that is within them to move to higher levels of consciousness”. What can be seen in more recent theories is that there is a clear shift from the nurse being the authority figure who administers care, towards a more collaborative approach where the nurse empowers the patient to manage their own heath choices.

But that’s not to say that as new theories emerge, their predecessors cease to have relevance. We still see aspects of Mary Seacole’s (1805-1881) theory alive and thriving in today’s patient centred approach to care. Dorothea Orem’s (1914-2007) theory about the patient’s need to self care slots neatly into the contemporary emphasis on the nurse’s role to support people in maintaining their own health and helping them make informed decisions about their care. But whatever the theory, the health and wellbeing of the patient remains at our centre - a constant in an ever changing profession.

With more services moving out of the traditional hospital setting and into the community, and opportunities to enter non-NHS employment pathways, such as the military and independent sector, from the point of registration, nurses must be certain about their role within the wider multidisciplinary team. They need this certainty to ensure that the essential and often complex needs of the people in their care are met, regardless of the setting they are in. This has been addressed in the standards with the introduction of a progression point at the end of the first year so that those qualities will be formally assessed at the end of each year they complete.

We recognised early on that services are changing and we were able to reflect those changes in the new standards. There is now the stipulation that practice placements must include time in community settings. This will ensure that newly qualified nurses have the required level of experience, along with the knowledge and skills that is needed to deliver care safely and with confidence outside the health service.

There will be more opportunities for shared learning between all student nurses irrespective of the field they are pursuing. This will ensure that nurses in the future will be able to meet the physical and psychological requirements of the people and families in their care. The new programmes will also pave the way for future pre-registration student nurses to develop a mutual understanding of, and respect for, other health disciplines. This in turn will create the foundation for the future success of multidisciplinary teams, improved delivery of patient care and a new generation of nursing theorists.

Professor Dickon weir-hughes is chief executive and registrar at the Nursing and Midwifery Council

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