The system for training occupational health (OH) nurses needs a major rethink, say researchers, after a survey found half of those in the field believe the content of OH nursing courses is “inadequate”.
The findings from the survey of more than 1,400 OH nurses suggest worrying inconsistencies in the quality and level of training, exacerbated by shortages of practice teachers and placements.
“The system for OH nurse education in the UK is inconsistent for students”
Of the 1,125 nurses who answered a question on OH nursing courses, 50% said they felt the content of courses was either “very” or “quite inadequate”.
Just 26% described course content as “quite” or “very adequate”, while the rest said they did not know either way, according to the results published in the journal Occupational Health [at Work].
Many feared graduate OH nurses were not prepared for the challenges of practice. In all, 41% said they felt the knowledge of newly-qualified OH nurses to undertake core OH nursing tasks was either “very” or “quite inadequate”.
Meanwhile, 40% questioned the ability of graduate OH nurses to work autonomously – frequently a key part of the role.
The latest findings comprise the second wave of results released from an online survey carried out in April and May last year.
Focusing on education, funding and regulation, the second round of survey research posed a number of key questions for the future of OH nursing.
Most OH nurses complete a Specialist Community Public Health Nurse (SCPHN) OH course and register with the Nursing and Midwifery Council under this category.
Higher education establishments are approved by the NMC to run such courses, with 13 providers active in the UK, according to the research paper.
“As a profession, we need to better influence key stakeholder’s thinking”
However, OH nurses are not obliged to qualify or register on the SCPHN part of the NMC register and some do alternative non-SCPHN courses or practice without OH qualifications.
The survey found just over half of respondents had completed a SCPHN course, while 5% were studying towards one. Some had automatically transferred to the status, having done an OH qualification under a previous system and the remaining 30% had done a non-SCPHN course or other training.
More than half said they felt the title of SCPHN did not adequately describe their role at work. The survey also revealed a general consensus that training alongside community nurses, such as health visitors and school nurses, did not necessarily prepare practitioners for the role of OH nursing.
“I feel the focus of current SCPHN courses is mainly for community nurses, rather than specifically OH-related subjects such as ergonomics,” said one survey respondent.
Most respondents said they felt multi-professional learning alongside other OH professional should form the basis of OH nursing courses.
The majority – 81% – said they felt a protected title like “registered occupational health nurse” should be used for those who had completed an approved education programme.
“We are aware of some difficulties, with funding and limited placements”
The research highlighted challenges in meeting NMC “guiding principles” that there should be a balance of 50% theory and 50% practice in each SCPHN course.
Just 13% of respondents described themselves as a practice teacher. Not being on the SCPHN register, lack of funding and not enough support from employers were the main reasons people gave for not becoming practice teachers, according to an analysis of survey responses.
Of 1,205 nurses who answered a question about OH student placements, 62% said these were not available at their place of work, 29% said placements were available and 9% did not know.
Scarce resources or the fact OH was outsourced were among the main reasons for lack of availability.
Report co-author Dr John Ballard, from the At Work Partnership, said the research showed courses and training needed updating to ensure students were properly prepared to go into OH roles.
“The system for OH nurse education in the UK is inconsistent for students and confusing for employers,” he said.
“Both need to be sure that the courses meet the needs of modern OH practice, so that newly qualified OH nurses can hit the ground running, without needing additional skills training before they can carry out their professional duties,” he said.
The survey results come after the launch of Public Health England’s blueprint for OH nurse education, published in November last year.
The report authors urged universities to take note of the PHE recommendations and the level of concern over SCPHN course content and quality reflected in the survey.
“This is particularly pertinent to the ongoing employability of OH nurses in a diverse employment market as, unlike other community public health nurses, the NHS is not necessarily the dominant employer, and lone working within a business environment is not uncommon for OH nurses,” said the report.
Jo Berriman, chair of the Faculty of Occupational Health Nursing Development Group, which is seeking to create a new national professional body for OH nurses, said the survey would inform the group’s discussions with the NMC about key priorities.
“Ensuring the quality and consistency of OH nurse education must be at the heart of what we do to deliver effective clinical practice and to safeguard the public,” she said.
Occupational health nurses need ‘better representation’
“As a profession, we need to better influence key stakeholder’s thinking in relation to OH nursing – what it is and what it can achieve,” she added.
The NMC said nurse education and training would be a “key focus” for the regulator over the next five years, including for occupational health.
“We are currently developing new pre-registration standards for nurses and midwives and we will then move on to review post registration standards,” said an NMC spokeswoman.
“This work will include a review of SCPHN standards for proficiency and a review of occupational health nursing proficiencies,” she said. “We will work with occupational health nurses and the new Faculty of Occupational Health Nurses as part of this review.”
She said related changes included the development of innovative ways to support students in practice across all areas of nursing and midwifery.
“We are aware of some difficulties, with funding and limited placements in some areas of practice and we will continue to engage with key nursing and midwifery representatives throughout our education programme on all challenges and proposals,” she added.