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More details are needed on skill levels in its new education plans, nurses tell NMC

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The Nursing and Midwifery Council has been told by nurses that its new education plans lack details about the level of knowledge and capability that students will require across a range of skills.

More information should be provided that lays out the minimum proficiency needed by nurses, said members of the profession at an event in Manchester last week, which was hosted by the NMC

“If indicated, we will address this confusion by working with groups of stakeholders to make our intentions clearer”

Geraldine Walters

The regulator’s draft standards for pre-registration training include an extensive list of more than 100 technical and communication skills that all nurses should be able to do – regardless of their field of practice – by the end of their course.

They also indicate which fields of nursing – adult, children’s, mental health and learning disability – will require more in-depth teaching in certain areas.

It is part of a series of changes being proposed in a major overhaul of nurse training, which the NMC is consulting on ahead of universities introducing new courses by 2019.

NMC head of education Dr Geraldine Walters told Nursing Times that the event last week had revealed that nurses were unclear which skills students should have an awareness of by the end of the course and which ones they should be proficient enough in to carry out in practice confidently.

“The question was: can we be really specific about what needs to be a practice proficiency at registration, and what needs to be a level of awareness that we want people to have and not necessarily something they might have practised extensively during their training,” she said.

“Some students will get to practise some things on placement more than those who have been in different placements”

Geraldine Walters 

She reiterated that all branches of nursing would have to reach the same minimum level of proficiency across the list of skills – designed to ensure nurses receive an equal grounding in both physical and mental healthcare – and then additional teaching would be required on top depending on their field.

But Dr Walters acknowledged that different students would be exposed to certain skills more times than others depending on their placements.

“Some students will get to practise some things on placement more than those who have been in different placements,” she told Nursing Times. “What we want to get them onto is a minimum level of proficiency.”

Nursing and Midwifery Council

Geraldine Walters

Geraldine Walters

Dr Walters said conversations with the profession so far had indicated that the number of skills did not need to be reduced – but that the regulator needed to provide more information about them.

“When we have the full results of the consultation, if indicated, we will address this confusion by working with groups of stakeholders to make our intentions clearer,” she added.

She noted that the NMC would also be producing field-specific programme requirements for universities, which would offer more details.

Meanwhile, in response to recent criticism that the list of skills is too focused on physical healthcare and hospitals, Dr Walters highlighted they had been developed with experts across all of the fields of nursing and stressed that standards did not mention hospitals at all.

She acknowledged that the list of physical healthcare proficiencies “would probably take up more room on the page”, but noted that mental health skills were often based around communication, which could not be counted in the same way.

“We haven’t forgotten it, but if mental health nurses would like to see more in there that are more specific, we would be happy to receive those,” added Dr Walters.

The NMC’s event in Manchester on 27 June was attended by around 50 senior nurses, two thirds of whom worked in education and the rest within services.

It is one of five meetings planned by the NMC in major cities across the UK during the summer, as well as five other events looking at specific parts of the education plans, ahead of the public consultation on the proposals closing on 12 September.

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Readers' comments (2)

  • I recently sat through a Mentor update, wondering when I was going to hear something fresh and interesting- much like all mandatory sessions. Towards the end- skills sets were mentioned and how the decision to spend more time on simulation was supposed to make you a better nurse, you could feel the tension in the room, the groans of dissatisfaction audible. It was mentioned most of us didn't need simulation as most of what was in the programme was learned first hand at the bedside with nurses teaching as you worked and by the time you qualified with few exceptions you were prepared for the wards. Skills performed confidently almost from day one.
    Then came the best bit- she saved the best bit till last- a 4 year paid apprenticeship based on the pre P2K model but theory at post P2K model level. An extra year- but a skills based theory supported paid training. I was never happy with the bursary system, I am not secure in my faith of a pay for yourself Uni BSc/BA providing enough nurses for the future and its elitist denial of really good candidates being denied the opportunity of becoming a nurse. This 4 year course would be an answer to getting more nurses before we run out. For a nurse to qualify unable to do everything they need to do from day one has always been something that I see as a failure of th current system and puts unnecessary staring on wards with new nurse heavy staffing

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  • I feel that there should be a minimum number of times a student should have to perform a skill in order to be described as 'competent' in it.
    I was unfortunately placed in many lower acuity placements where I simply could not perform a great deal of the clinical skills provided of me. I had to organise a great many day trips to other units
    Of course in some circumstances one should be prepared to do this, but nowhere near as much as I was forced to. I even had to extend my sign off placement three weeks in order to do so.
    I am a highly intelligent and organised person and obtained a first class degree. On my first placement of first year (and also of second year) I had no clinical skills signed off which I flagged up to my personal tutor and she did NOTHING to help me.
    Complaints about being unable to fulfil my learning needs fell on deaf ears and I was given 8 weeks in day surgery at a private hospital (cataracts, so many cataracts), 11 weeks in Outpatients, 12 in District Nursing, 16 in a Nursing Home (all very independent residents, nothing but drug rounds) and finally 14 on a rehab ward.
    Therefore there was a great deal of "cramming" for certain skills on the few acute wards I was placed (4 and 6 weeks) and I was signed off after performing these once so as to stop pestering the staff nurses and to get back to my rightful place as a dogs body there to do their personal cares for them.
    Am I confident in my ability to perform these skills now as a new staff nurse about to start at CDU? Hell no! But I'm supposedly "competent" in a whole host of them... It baffles me that this would be allowed to carry on. How can 3 long years of working for the NHS for free leave me with such a cursory training experience?
    And the worst part is nobody cared because they saw me speaking nicely to patients! Kind I may be but surely I cannot call myself a 'nurse' unless I possess the skills to back this up? Something has to change...

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