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‘Every specialist nurse should undertake specialist training’

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Recruitment and retention is a concern for all nurse employers.

As a manager of nurses for many years, I have experienced why they are attracted to work in an organisation and what helps keep them there. A plethora of research supports what I have witnessed and demonstrates which work-related issues are most important to them, including the organisation’s reputation, the leadership and management qualities of their line manager and opportunities for professional development

To an extent, all are interdependent and require systems being in place and opportunities for development being available. An organisation’s reputation is built on its value base, its patient safety record, patient outcomes and effective leadership – none of which happen without investment in the skills of the people leading, managing and delivering care.

Nurses work to a code of conduct that requires them to have the skills to meet the needs of those for whom they care. At the registration, every nurse will have met the requirements to become a registered nurse, enabling them to work as a junior member of a team. They will have the knowledge and skills to get out of the starting blocks, but much learning is required to support them as they move into more senior roles.

Specialist nursing requires specialist skills. Patients deserve better than solely relying on care by nurses who have learned specialist skills from more-experienced colleagues, reflecting a task-based era of ‘see one, do one, teach one’. Practical work-based learning, taught by qualified teachers must be underpinned by professional programmes that meet a UK-wide standard of education and practice.

Patients having heart surgery don’t just require the skills of a cardiac surgeon, but also care that is led and managed by nurses who have the specific knowledge, skills and training to provide the interventions required. Patient safety depends on it. In the community, the specialist qualification of district nursing is required to clinically lead and manage teams. Just as GPs require a UK standard of professional training, so do the leaders and members of district nursing teams.

”Programmes of education built on national standards provide transferable skills in the workforce”

So, in delivering a national health service, it is logical that there should be national requirements for the training and education for nurses in every specialist area, reflecting a full commitment to valuing patients and patient safety. The Queen’s Nursing Institute has a successful history of creating such standards for education and practice in specialist areas of nursing in the community and primary care, built on the four pillars of advanced practice.

Programmes of education built on national standards provide transferable skills in the workforce, enabling employers to recruit and retain staff, as well as building a reputation for patient safety and excellent patient outcomes. Nurses are attracted to organisations that support this professional development.

The only element that has not yet been agreed is who is responsible for funding this professional development. This requires a national approach – in the same way that our medical colleagues are supported to be educated to consultant level, so nurses require specialist training and education at all levels of the career path. I would name the funding ‘specialist nurse training’. This is preferable to ‘continuing professional development’ – a generic term that does not reflect the critical need to provide the specialist care that patients, families, carers and communities need.

Crystal Oldman is chief executive of the Queen’s Nursing Institute.

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