The Royal College of Nursing has welcomed a number of major changes to nurse education being considered by the UK regulator, but has raised concerns about proposals on training for new mentorship roles and the removal of medicines management standards.
It has specifically warned of a potential risk to patient safety due to proposals to remove medicines management standards for nurses, which are part of wider proposals being put forward by the Nursing and Midwifery Council.
“There is a significant risk…if training for the [new mentor] roles no longer conforms to a mandatory standard”
RCN response to NMC consultation
However, in contrast, the college said the NMC’s plans to increase simulation activities, and the inclusion of more prescribing theory, were all welcome revisions to pre-registration training.
Also praised by the RCN were proposals to ensure all newly registered nurses could achieve the same set of clinical and communication skills, and the ability of all nurses to provide both physical and mental health assessment.
The NMC is currently in the process of modernising its standards for the education and training of nurses and midwives. In May this year it published proposals and held a three-month consultation on them, which closed last week.
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In its submission to the NMC’s consultation, the college said that, while it agreed with splitting the role of mentors into supervisors and assessors, it had concerns about the support and training that would be provided for them.
In the future, the regulator wants to see students supervised by any registered health or social care professional, regardless of whether they are a nurse or not.
Meanwhile, students would be assessed by “a nominated practice assessor” and also a “nominated academic assessor”, who would be required to be a registered nurse or midwife.
But the NMC proposals do not state that supervisors and assessors would need to have completed a formal training course approved by the regulator – as is the current standard for sign-off mentors.
“Many of our members rely on the [medicines management] standards in their daily work”
RCN response to NMC consultation
Splitting mentorship would address past problems with the “failure to fail” students by mentors when assessing their competence, said the RCN, in its response to the consultation, which was based on the views of more than 7,000 of its members.
However, the college called for formal mandatory training for assessors so that they were knowledgeable and confident to judge students’ abilities.
There was also a “clear need” to increase skills among the existing nurse workforce to support students, which would require funding for continuing professional development and protected time, warned the RCN.
“There is a significant risk…if training for the roles no longer conforms to a mandatory standard. This would have an adverse effect on investment in continuing professional development (CPD),” said the RCN.
“The mentorship preparation programme had beneficial elements, for example, on how to carry out assessments in practice…Further, because it was a mandatory programme, it ensured a minimum training standard for all mentors,” said the RCN.
The college argued that past problems with mentors were down to the unsuitability of nurses in these roles – because they often only viewed it as part of their career progression – rather than the training programme.
Meanwhile, the NMC’s plans to remove its medicines management standards posed “an increased risk to patient safety” said the RCN.
It acknowledged that the current standards were out of date, but said that, instead of removing them and leaving it to employers to set guidance, the NMC should replace them with an updated version.
“Many of our members rely on the standards in their daily work. Similarly, the RCN has historically based much of the advice it gives to members on the standards,” said the college in its consultation response.
“[The new standards] have the potential to ensure that nurse education responds to the changing population health needs”
Meanwhile, it welcomed NMC plans to include more pre-registration theory around pharmacology, pharmacokinetics and medicines management to ensure newly-qualified nurses could go on to achieve prescribing qualifications earlier on in their careers.
From an RCN survey of around 7,300 members, 68% said they agreed with the NMC’s proposals to ensure new registrants were “prescriber-ready”.
The poll of nurses also revealed that 73% said they believed the NMC’s plans to allow simulation to be used for up to half of the 2,300 hours students must spend learning in practice offered an opportunity to learn new skills, but not necessarily achieve proficiency.
The RCN instead called for the maximum time spent on simulation activities to be raised from the current 300 hours to 600. The college suggested this form of learning should be assessed through objective structured clinical examinations (OSCEs).
Separately, the RCN said a UK-wide practice assessment document was “vital”, suggesting the NMC look to Wales where an equivalent document was already in place. It also called for a standardised national final examination.
The RCN’s head of professional learning and development, Anne Corrin, said the NMC plans had the potential to ensure nurses continued to provide high standards of nursing care in the future, but underlined the need for funding for ongoing training.
“We look forward to working with the NMC to further develop and implement these exciting new standards,” she said.
“They have the potential to ensure that nurse education responds to the changing population health needs and ensure that nurses continue to provide high standards of nursing care in the future,” said Ms Corrin.
“However, we also note the importance of investing in the current nursing workforce to ensure these new standards can be fully implemented in practice,” she added.
The NMC has said it will now report back on the feedback from its consultation and ask its council to approve the final version of the new standards in spring 2018. It anticipates that all approved education institutions will adopt them by September 2019.