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'Do new education standards reflect patient needs?'

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In the last few weeks we ran two stories that will make interesting reading for anyone who is trying to visualise the direction of nursing in the next 10 years.

The first was the launch of the RCN’s voluntary credentialing scheme for advanced nursing practice, which stipulates that advanced nurse practitioners require a prescribing qualification along with an ability to demonstrate their experience, qualifications and competence to a group of expert assessors.

I must admit to being a little perplexed that prescribing has been included as a pillar for advanced practice.

“I must admit to being a little perplexed that prescribing has been included”

While I understand why some ANPs would find the qualification invaluable, I have spoken to nurses practising at an advanced levels who feel that undertaking an intensive prescribing course will have no benefits for their patients. These ANPs currently work with patient group directions that cover the very limited range of drugs their patients require.

Should they really be excluded from a scheme that acknowledges their specialist skills and knowledge because of a professional decision about their education, which they have made based on their patients’ needs and the service they provide?

The second story relates to the inclusion of prescribing theory in the NMC’s draft education standards for undergraduates, published last week. The suggestion is that undergraduate nurses will be provided with a foundation in prescribing so that they can undertake the community practitioner prescribing course immediately after they qualify. They will then be able take the independent prescribing course after a year.

“Newly qualified nurses may feel pressurised to undertake prescribing courses”

This reminded me of the golden rule governing independent prescribing – you only prescribe according to your level of competence. What worries me about these draft proposals from the NMC is that newly qualified nurses may feel pressurised to undertake prescribing courses before they feel competent in their practice, by employers who are looking to solve medical resource problems.

I wonder if this drive to increase access to prescribing courses for newly qualified nurses is fuelled by an anxiety about medical staffing levels and the default assumption that nursing is the most convenient staff pool to fill the gap. Clearly the role of the registered nurse is changing; the nursing associate role will increasingly take on some traditional nursing responsibilities, but are these shifting boundaries good for patients or just an expedient way to address long-term failures in workforce planning?

“Staff shortages, shrinking incomes and new hoops to jump through”

As we pile pressure on newly qualified nurses to develop new skills they need the support of highly skilled and experienced colleagues.

However, huge numbers of these very nurses are approaching the age when they can take early retirement. Staff shortages, shrinking incomes and new hoops to jump through – such as a requirement to gain a prescribing qualification that will bring no tangible benefit for their patients – hardly encourage them to remain in the profession.

Directors of nursing across the NHS tell us that many of these nurses are choosing to leave the profession because it has become so stressful, and I am sure some probably feel left behind and uncertain about their future.

What these two stories reveal is how much the role of the nurse is set to change over the next 10 years.

The RCN’s credentialing scheme has already launched (although that doesn’t mean it can’t be amended if aspects of it are unhelpful), but there will be a full consultation on NMC’s draft standards for undergraduate education. It’s vital for nurses at all levels – and aspiring nurses – to understand the implications of both developments and to express our views.

Our voices must be heard on the future shape of the nurse’s role.

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