The recent approval of new education and proficiency standards for nurses is to be welcomed for several reasons, but there is also a danger assessment could suffer.
In publishing its new standards, the Nursing and Midwifery Council has confirmed mental health nursing – and other fields – will remain as a distinct area of practice. For Mental Health Nurse Academics UK, this is encouraging for us to see.
We also support the NMC’s decision to remove the cap on the number of simulation hours used during learning.
This is a change that will be essential for mental health nursing students to be taught many of the new technical procedures required by the NMC. (Though investment will be required for simulation of mental healthcare; it is difficult to reflect the dynamic, interpersonal and sometimes unpredictable nature of care in this setting.)
A revised definition of supernumerary status is also positive. The NMC’s statement that students should be able to have decreasing levels of supervision as their competence improves is recognition of the fact their contribution is likely to change as they gain the confidence to work more autonomously.
Since its consultation, the NMC has also refined its requirements for new supervisor and assessor roles.
“Trainees could end up being signed off by a nurse from a different field of practice to the one they expect to be registered in”
It is encouraging to see that practice (and academic) assessors should undertake preparation for this role to show they have knowledge of assessment processes and interpersonal skills.
While this falls short of the NMC benchmarking minimum standards, it does offer a guideline for professionals, healthcare employers and higher education institutions to promote the quality of practice-based assessment.
However, the flexibility within these guidelines means there are likely to be challenges for consistency of assessment and monitoring their use.
What is more concerning is that, despite clarification that assessors must understand the proficiencies a student is trying to achieve, trainees could end up being signed off by a nurse from a different field of practice to the one they expect to be registered in.
There is a danger assessors may have to make judgements of students’ abilities - including in the final part of the course - without having expertise in the field.
This could have an impact both on the validity of the assessment and potentially the preparedness of students for practising within mental health settings – or any of the other fields.
Another worry, specifically for mental health nursing, is the NMC’s decision to maintain its emphasis on physical healthcare procedures
“Another worry is the NMC’s decision to maintain its emphasis on physical healthcare procedures”
Although the regulator has now emphasised a student’s level of knowledge will vary depending on their chosen field, there is still an issue in that the procedures do not fully account for the way mental health nursing care is delivered; they largely relate to hospital-focussed, acute medical and surgical care.
The range of core mental health nursing skills within the annexes is restricted and we remain concerned about the implications of this gap for the education of mental health nurses.
Although the consultation on the draft standards attracted wide-ranging responses, the amendments introduced in the final version approved last month are limited.
While that means many of the MHNAUK’s suggestions have not been picked up, it is beneficial in that universities will be in a relatively good position to redesign courses by the final deadline of September 2020.
MHNAUK is looking forward to seizing the opportunity to work alongside colleagues from other fields to support all nursing professionals to deliver holistic care that addresses both a person’s physical and mental health.
Dr Anne Felton is lead for Mental Health Nurse Academics UK’s education standing group