Nursing Council Research Articles

A55‘Who’s in charge? Me!’ Using simulation for band 5 nurses who are learning to lead

The ‘Standards Framework for Nursing and Midwifery Education’ set out by the Nursing and Midwifery Council states that nurses are expected to develop ‘supervision and leadership skills’ [1]. However, band 5 nurses at a NHS Trust indicated their reticence about taking on ‘nurse in charge’ roles and wanted to build their confidence in engaging in challenging conversations with an assertive approach. As an education provider, we worked alongside the Trust nursing practice development team to develop and deliver a simulation-based workshop to help improve band 5 nurses leadership skills through simulated scenarios. The workshop was integrated into a leadership development day. To encourage all nursing staff to ‘embrace their inner leader’, The Royal College of Nursing described five ways to do so – be a role model, show emotional intelligence, motivate others, create shared goals and display courage [2]. Scenarios, with actors, were developed to allow practice of these strategies whilst having difficult conversations from within a leadership role and included: listening to a colleague with personal difficulties, dealing with angry relatives, supporting a patient after unwelcome news and discussing with a clinician concerns about professionalism and kindness. Participants were provided a communication framework (STEPS: start, time, empathy, provision of support, sense check)) to assist their preparation, pacing, framing and summarizing. Of the 12 sessions completed ( Everyone was so brilliant! I was so nervous about the simulation but (the facilitator) has been wonderful. Actors were amazing. Facilitators have been so kind and knowledgeable. Attending this study day has given me better confidence in my own ability to be in charge and deal with challenging situations. STEPS has given me a very good guide in dealing with professional communication as a nurse in charge. Live actors are very beneficial for us as it gives us real life actions to follow and deal with daily situations in the ward. Immersive and interactive. This simulation-based workshop developed with RCN leadership values in mind, has supported 180 band 5 nurses with their leadership roles. It has been immensely well received and has assisted these nurses in their workplaces. Based on the success of the first 12 sessions, 12 additional sessions are planned with pre and post feedback data from attendees being collated for analysis. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

ASSESSMENT OF TIME MANAGEMENT SKILLS AMONG NURSES WORKING IN THE EMERGENCY DEPARTMENT

Nursing is a noble profession; time management is paramount to ensure the best patient care, effective management, quality education, and personal responsibilities. This study aimed to assess the time management skills of nurses working in the emergency department. A quantitative cross-sectional descriptive study design was used to assess the time management skills of nurses in the emergency department. The study was conducted at Lahore General Hospital (LGH) and Sir Ganga Ram Hospital Lahore, using purposive sampling techniques. Nurses aged over 25, working in emergency departments, having clinical experience of 3-5 years, and being registered by the Pakistan Nursing Council were included. Non-cooperative nurses and those working in departments other than emergencies were excluded. Data was collected through questionnaires that had two parts. Part I included biographic data, and Part II comprised 15 questions about time management skills. The results showed that over 50% of the nurses working in the emergency department, considered a hectic hospital unit, possessed time management skills. These skills included confidence, competence, prioritizing tasks, command and control, planning tasks or daily activities, learning from mistakes, feeling confident and competent, and writing appointments, following schedules, and rewarding themselves for their good job. The study concluded that most nurses working in the emergency department possess time management skills necessary for effective patient care. It is recommended that hospitals should provide training and resources to enhance these skills and that further research should be conducted to explore other factors that may affect time management in this setting. Overall, improving time management skills can lead to better patient outcomes, increased job satisfaction, and reduced stress for nursing staff.

The newly graduated nurse as a second victim

Objective To describe the prevalence of newly graduated nurses as second victims of adverse events and to know the conditions of support received in health institutions. Methods Cross-sectional, descriptive, quantitative study. The population consisted of newly graduated nurses who agreed to answer the online questionnaire with questions related to being hired at the institution, involvement in adverse events and management of the second victim condition. Contacted was by email, intermediated by the Regional Nursing Council of São Paulo. Descriptive data analysis and the test of equality of proportions were performed. Results The final sample consisted of 138 nurses, 54.3% were unaware of the term ‘second victim’, 44.9% were unaware of the existence of institutional protocols for emotional support to professionals and 26.8% were involved in adverse events. Of these, 94.6% presented emotional distress, frustration, guilt, sadness, stress, inability, embarrassment and insecurity to perform their duties at work as an outcome of the event; 59.5% received some type of support and 21.6% received institutional punishment. Conclusion The prevalence of newly graduated nurses involved in adverse events was 26.8%, and among those who experienced this incident, the majority presented negative feelings and insecurity in performing their work as an outcome. After the event, most of the time, the support received came from work colleagues and significant others. Regarding institutional support, the need for programs for emotional support is also highlighted, so that these professionals can overcome when finding themselves in the place of the second victim.

The weight of “the keys”: two autoethnographic accounts of how mental health nurse training has changed over the decades

Purpose This paper aims to critically compare the impact and preparedness for practice of two types of mental health nurse training in the UK. One being a hospital-based apprenticeship model from the 1980s; the other a university-based and more academically focussed approach from this millennium. Design/methodology/approach This autoethnographic reflective commentary describes and reviews the effectiveness of two training curricula for Registered Mental Nurse (RMN) training. The first being the certificate-level 1983 syllabus of the UK Central Council for Nursing, Midwifery and Health Visiting, which was replaced in the late 1990s by diploma and degree-level Project 2000 training of the General Nursing Council. Using a reflective narrative approach to describe the lived experience of two qualified nurses, it compares, reviews and critiques both initiatives. Findings The author/researchers found both benefits and negatives inherent in each model. These were grouped into five key headings, which are a sense of belonging/identity; exposure to clinical practice; differences in training modality; development of clinical management skills and clinical preparedness; and academic merit. The older curriculum lacked an academic or research base, whereas the more recent approach encouraged and enhanced this element. However, with regard to preparing the clinician/registered nurse to feel confident in addressing a range of clinical and managerial challenges, the older style training seems to deliver better outcomes. They conclude that a move towards a “middle ground” between the two models may be of benefit to future RMN preparation. Research limitations/implications This study reports on the experience of two registered nurses. Therefore, the sample size is small. However, autoethnography is acknowledged as an effective means of delivering qualitative research; in addition, the authors access and use material from the wider literature to triangulate and critique their approach. This paper adds to the literature but also allows for duplication by others to further test the findings. Practical implications This type of study provides an opportunity for others to review, compare and contrast nursing or other multi-discipline changes in training/curriculum. The research method is one that is transferable and can be used within areas of practice, which have resource limitations. It provides an opportunity to replicate it in other services or jurisdictions. Social implications Nursing in the UK has experienced significant change over the past four decades. For RMNs, the move from hospitals into the community has been transformational. In addition, the influence of higher academic standards and the influence of the recent pandemic have challenged the profession and individuals within it. This study demonstrates positive and negative elements of the dilemma faced by nurses and offers a further contribution to this area. Originality/value There are a number of academic papers, media stories, statutory reports and guidance that explore the impact of changes within nurse training. This paper uses a first person autoethnographic study of the impact and effectiveness of these changes at a human level, the nurse on the ground. It uses the ward medicine keys as the vehicle to represent the huge responsibility that newly qualified nurses must face; this is not widely represented elsewhere in the literature!

Nursing and midwifery research priorities for Kenya: Results from a national Delphi survey.

The International Council of Nurses and the World Health Organization have prioritized evidence-based nursing and midwifery practice derived from nurse-led research. However, in a low-resource country like Kenya, there is a need to identify research priorities to optimize utilization of limited existing research infrastructure and funding. Kenya lacks a nursing and midwifery research strategy to guide research prioritization. The goal of this study was to identify and describe nursing and midwifery research priorities for Kenya. A cross-sectional Delphi survey using two iterative rounds of electronic data collection was used to reach a consensus about priorities for nursing and midwifery research in Kenya. NVivo-12 was used to analyze the qualitative data to identify categories, sub-themes, and themes; descriptive statistics were used to analyze quantitative data. Participants included 159 nurse managers, administrators, and educators representing regional, county, and national referral, private, and faith-based hospitals, nurse training schools, research institutions, and nursing organizations in Kenya. Staffing challenges, motivation, remuneration, and funding for higher education were ranked as the top critically important issues using a cutoff point of≥70% agreement. There is a need for the development of a National Framework for Nursing and Midwifery Research Priorities in Kenya to guide research that builds excellence in meeting nursing and midwifery human resource concerns and ultimately improves patient care practices and outcomes. The objective of Kenya's health goals delineated within three key national health documents cannot be attained without adequate numbers of nursing and midwifery professionals and policies that address nursing and midwifery staffing challenges, remuneration for employment, and improved funding for higher education.

Politics of nursing leadership: Reflecting on the 29th Congress of the International Council of Nurses and on nursing organizations’ political role more broadly

Réflexion sur le 29e Congrès du Conseil international des infirmières et, plus largement, sur le rôle politique des organisations infirmières

Neonatal Nurses Association (NNA) and Council of International Neonatal Nurses (COINN) News Page

Neonatal Nurses Association (NNA) and Council of International Neonatal Nurses (COINN) News Page

Ethical issues in the operating room: A scoping review.

For the patients receiving care in the operating room, it emphasizes that the ethical behavior and attitude of health professionals should be aligned with patients' basic human rights. Surgical ethics may provide an ethical alternative in a specific operating room context. However, it is unclear how actively research is being conducted in this regard. This study determines the direction of future research by identifying ethical issues experienced in the operating room. This scoping review is based on the methodological framework suggested by Arksey and O'Malley in 2005. PubMed, CINAHL, EMBASE, WOS, Cochrane, KISS, and KMbase databases were searched from January 2012 to May 2022. Two researchers independently screened the searched articles by reviewing the titles, abstracts, and full texts. Consequently, 19 studies were selected. Five categories were identified: Professional ethics, Organizational ethics, Patients' rights, Patient safety, and Allocating resources. The derived categories covered all the same content as the International Council of Nurses' (ICN) code of ethics, with the exception of one element, that is, global health. This study highlights ethical issues in the operating theatre and emphasizes the need for individual and organizational strategies aligned with the ICN code of ethics. Future research should cover a wider range of issues, employ diverse perspectives and methodologies, and enhance ethical practices to improve understanding and ethical practices in the field.

What's in a name? The complex conundrum of prescribing nomenclature in practice

Health professionals who can legally prescribe medication and medical devices, but who are not doctors or dentists, come from a wide range of backgrounds, including the Nursing and Midwifery Council, General Pharmaceutical Council, and some Health and Care Professions Council registrants. The professionals are often grouped together and defined as ‘non-medical prescribers’. This may or may not be a useful collective term as, depending on professional registration, these professionals may be afforded differing prescribing rights, which may include a combination of independent/supplementary prescribing, independent prescribing (only), supplementary prescribing (only), or community nurse practitioner prescribing activity. This article explores the confusing nomenclature around prescribing, and the impact the names and terms used in practice have on professions. The naming and identification of role should be facilitative, to allow others to understand the legal context of prescribing activity, boundaries, and role expectations.

A global survey on national standard care for newborn bathing.

To describe national standard care for newborn bathing and its influential factors. A global survey was conducted using a web-based questionnaire. The targeted countries were 166 member countries of either the International Confederation of Midwives (ICM) or the International Council of Nurses (ICN). An eligible person included someone well informed of midwifery education/training or neonatal care, including newborn bathing, in their country. To examine the factors associated with the standard care for newborn bathing, information on mean annual temperature, precipitation, gross domestic product per capita, and basic water coverage was collected as external factors. Student's t tests and Chi-square tests were used for analysis. Care standards were identified in 46 countries: seven from Africa, eight from the Americas, 15 from Asia, 14 from Europe, and two from Oceania. In most countries, newborns were bathed with warm water in a tub within 10 min. Bathing frequency, moisturization, and use of soap or cleanser varied by country. There were significant associations between bathing frequency and temperature and between moisturization and precipitation. The national standard care for newborn bathing in each country was unique. Standard bathing care was associated with the climate. More consideration should be given to the differences in standard care for newborn bathing between countries when interpreting existing studies and conducting future studies on neonatal skin care.

Development of disaster nursing in Nepal: Opportunities and challenges for advanced practice.

This article discusses the evolution of the field of disaster nursing in Nepal and its challenges and ways to protect the health and well-being of the community during disasters. It also discusses the alignment of field activities with the International Council of Nurses' (ICN) competencies in disaster nursing. Disaster nursing has become increasingly important due to the increasing frequency and impact of disasters on health. In Nepal, disaster nursing is a relatively new field, but it has grown over the years with nurses playing a vital role in providing holistic care during disasters, emergencies, and crises. Literature review and experience from the field. Following the Nepal earthquake, the concept of the "epidemiology nurse" evolved in Nepal which trained local nurses with disaster nursing knowledge and skills using the digital information, communication, and technology (ICT) toolkit for collecting real-time information. Nurses monitored the environment, conducted physical and mental health assessments, identified the needs of vulnerable populations, provided basic aid, offered mental health support, and shared data with authorities. However, their competencies are not yet enough to fully align with those given by ICN nursing standards. Recognizing the valuable contributions of Nepalese nurses in the field, their initiatives can serve as a foundation for advancing their roles in disaster nursing. It is essential to implement national disaster plans and invest in specialized university courses for disaster nursing training. The field experiences of disaster nursing reflected in this article can contribute to the development of policies and practices related to disaster management in adherence to the ICN' guidelines.

Two cases of nursing older nursing home residents during COVID-19.

Two ethical challenges of nursing home nurses during the COVID-19 pandemic in Sweden are discussed in this paper. Historically, the nurse's primary concern is for the person who is ill, which is the core of nurses' moral responsibility and identity. In Sweden, person-centered care is generally deemed important in nursing older nursing home residents. To chart moral responsibilities of nursing home nurses in two cases involving older residents during the COVID-19 pandemic in Sweden. We used Margaret Urban Walker's framework for moral responsibilities and the International Council of Nurses (ICN) code of ethics for nurses (2021) for our normative analysis. Written and verbal consent was obtained before the interviews, and information was given that participation was entirely voluntary and possible to cancel at any time before the work was published. The Swedish Ethical Review Agency gave an advisory opinion stating that there were no ethical objections to this research project (Dnr. 2020-05649). Case #1: a palliative older nursing home resident who was coercively tested for COVID-19, and case #2: a COVID-19-infected resident with dementia who was isolated using sedation. The decision that was finally made in the respective case was analyzed in the light of either consequentialist/utilitarian or non-consequentialist/deontological reasons. Empowerment of nurses as moral agents is required for the application of practical wisdom in the balancing of different care relationships (responsibilities), moral identities (professional virtues), and competing moral values. This requires resources and opens possibilities for profound ethical reflection in nursing education and at work. During the COVID-19 pandemic, the moral and professional responsibility of nursing home nurses to deliver person-centered care was sometimes problematically abandoned in favor of a more utilitarian manner of ethical decision-making.

Working conditions of nursing professionals in the context of COVID-19

Introduction: the COVID-19 pandemic has increased the number of hospitalizations and is responsible for increasing the workload of nursing professionals with a deficiency in human resources and personal protective equipment. Objective: to analyze aspects related to the working conditions of Nursing professionals in the context of COVID-19. Methods: documentary research recorded under narratives in the databases of the Federal Nursing Council, the Regional Nursing Councils of Espírito Santo and Pernambuco, the Federal Public University and Social Media. Results: are presented and analyzed according to the categories: a) nursing work conditions, threatening the worker’s health and life; b) the autonomy of nurses in the full exercise of their profession and the cultural aspect of the dominant ideology; c) the Federal Nursing Council and the Regional Nursing Councils of Espírito Santo and Pernambuco as disciplining, normalizing, managing and controlling bodies for the professional practice of nursing. Conclusion: the narratives found in this study demonstrate the precarious working conditions, exacerbated by the pandemic, and the role of nursing in coping with COVID-19.

Professional competencies of oncology nurses: Recognizing advanced practice in nursing

ObjectiveTo identify the competency profile of advanced practice nurses involved in the care process of cancer patients. MethodsCross-sectional and descriptive study. The study included all nurses involved in the cancer patient care process in a tertiary hospital in Barcelona. Competence profile data were collected using the instrument for defining the role of the advanced practice nurse (APRD), as well as sociodemographic and occupational variables. Sociodemographic and occupational data were compared against the performance of advanced practice activities. ResultsA total of 29 (82.9%) nurses participated with a mean age of 42.6±12.54 years. 9 (31%) nurses were identified as meeting the standard in all 6 domains on the APRD scale to be considered advanced practice nurses. Of these 9 (31%) nurses, 7 (24.1%) met the training standards required by the International Council of Nurses (ICN) with an official master’s degree and 2 (6.9%) with a PhD. ConclusionsThere are nurses who carry out their activity in the oncology field of the hospital analyzed with the EPA profile. The identification of advanced practice nurses (APNs) in our health system is essential to be able to recognize the competencies of these professionals and create specific positions that help to address chronicity, patients' quality of life, their survival, and the optimization of health resources. Our study highlights the importance of chronicity and cancer as areas for the development of the APNs.

Council of International Neonatal Nurses (COINN) News page

Council of International Neonatal Nurses (COINN) News page

Leading and Learning in Post-COVID Healthcare Systems.

As summer slowly gives way to autumn, I find myself reflecting on the activities of the summer. One memory that stands out is attendance at the 29th International Congress of Nurses held in Montreal in July 2023. Cohosted by the International Council of Nurses and the Canadian Nurses Association, it was an amazing opportunity to meet and learn with nurses from all over the world. It was wonderful to be able to get together in person and feel the palpable energy created by more than 6,000 delegates from 123 countries gathered together for a common purpose. Check out the videos at the following link to see what I mean: https://icncongress2023.org/.

Opportunities for professional development in nursing-Indian nurses

In accordance with the State of the World's Nursing (SOWN) 2020 study, there were 27.9 million nursing staff members as of 2018, including 19.3 2.6 million (9%) unclassified nurses, million (69%) professional nurses, 6.0 million (22%) associate professionals, and million (69%) professional nurses. The research also notes that there was a 5.9 million nurse deficit worldwide in 2018. There would be 35.9 million nurses worldwide, according to the study. As a result, just an estimated 5.7 nurses would be required. Million, with 89% of those needed in low- and middle-income nations. By 2030, it is predicted that 10.6 million more nurses would be required worldwide to meet the demand. The International Council of Nurses (ICN) reports that 74% of countries want to recruit more nurses, and 54% have pledged to enhance the working conditions for those who are already employed. because the COVID-19 pandemic temporarily disrupted the supply of nurses internationally, it was anticipated that the destination nations would move towards self-sufficiency by strengthening their domestic training. To overcome the shortage by 2030, it would be necessary to hire an additional 8% of nursing graduates year and keep the current workforce of nurses in all nations.

Nursing Shortage in Pakistan

The health workforce including Medical, Nursing and Allied Health Professionals is the foundation of any health care system. Investment in the health sector reduces disease burden, improves productivity and ultimately contributes positively in economic growth of the country. Pakistan is generally confronted with dire shortage of qualified health professionals especially the nursing staff that is the backbone of every healthcare systems across the world. Nurses have incredible contribution in assisting the doctors in every aspect of patient care, thus ensuring that individuals receive the best possible care at all stages [1]. The nursing profession continues to face shortages due to a lack of potential educators, high turnover, and inequitable workforce distribution. The nursing staff employed in the hospitals is primarily responsible to provide all kind of nursing care to the admitted patients i.e., monitoring of vital signs, fluid management, and administration of medication in line with the orders of the attending physicians. Nurses are also responsible to monitor the nutrition intake, look after personal hygiene of patients and care of bowels, prevention of bedsores etc., maintain medical record and ensure the ambiance conducive to recovery. Their role therefore, requires essential nursing skills, apart from commitment and vigor. There are however, issues of quality in nursing education, particularly regarding development of proficiency in basic nursing & midwifery skills [2]. Nursing Institutions lack in quality output, due to deficiencies in nursing faculty, infrastructure and professional supervision. It is expedient to remain abreast with contemporary advancements in nursing education and practices to produce competent and skillful nursing workforce for better clinical outcomes. According to the Pakistan Economic Survey 2020-2021, Pakistan had a total of 116,659 registered nurses in 2020 for a population of about 200 million people. In the general wards of Pakistani hospitals, the current nurse-patient ratio is 1: 40, while the Pakistan Nursing Council recommends a nurse-patient ratio of 3:10 [3]. The deficiency in the actual number of nurses rendering services is further aggravated by positions remaining vacant due to shortage of skilled nurses, thus compromising quality of nursing care. This shortage in nursing strength is also worsened by an urge to move overseas particularly the Gulf countries, as large number of nurses opt for employment abroad for better financial incentives [4]. The situation is even worst in the private sector particularly, in the smaller hospitals that end up with hiring semi- qualified and poorly trained or self-trained staff on meager salary and poor employment terms on the pre-text of shortage of qualified nurses. Larger private setups often resort to make shift arrangements by engaging nurses employed in the public hospital for second shift. Such nurses are therefore, required to work for up to 16 hours a day, thus, further compromising quality of care. It is highly recommended to increase the number of nursing training opportunities and slots to overcome this serious shortfall and to ensure availability of sufficient number of nurses in the public as well as private sector to comply with the recommended Nurse: Bed ratio and to fill vacancies as per the sanctioned strength in public hospitals on priority basis. Also to improve the training facilities at Nursing Colleges in terms of qualified faculty and proper infrastructure to improve quality of training of the nursing cadre. Introduction of Continuous Professional Development (CPD) Programs for nurses with mandatory completion of credit hours on regular basis for continually building the skills and improving the quality of nursing and midwifery services can also prove to be a great initiative [5]. Enrolling more male nurses can help provide nursing care at hospitals located in the relatively hard to reach areas.

Council of International Neonatal Nurses (COINN) News page

Council of International Neonatal Nurses (COINN) News page

Quality Assurance in Nursing and Midwifery Education in Pakistan; Issue and Challenges

Quality is a subjective term that means excellence and reliability of performance. Quality assurance (QA) is concerned with reviewing the performance of services after the utilization of the services. QA is the systematic process of determining whether the services meet specified requirements. The concept of QA is rooted in middle ages, and its practices became more indispensable and popular in the USA during World War II.1 It is disclosed by current research that QA develops and maintains a set of requirements for manufacturing steadfast products or services. Indeed, the QA system considerably enhances customer confidence and credibility as well as the productivity of the organization which improves work process and efficacy.2,3 In higher education, the term quality assurance is increasingly used to refer to academic standards; that is, the level of academic excellence achieved by graduates not only maintained but improved consistently. Ensuring quality in higher education is critical for production of competent graduates.4 Nursing is considered the backbone of any health system; therefore, maintaining an optimum number of competent nurses is one of the key priorities of any health system. Pakistan is facing a critical shortage of nurses for its rapidly growing population, and the country is estimated to have a shortfall of up to 1.3 million nurses as per the nurse population ratio.5 To cope with this huge shortage, Pakistan has recently allowed the opening of more nursing colleges; however, this has posed certain challenges to the system, including assuring and maintaining quality in these new schools. World Health Organization, Eastern Mediterranean region, has identified six standards for nursing and midwifery education; these include; a governance structure that encourages autonomy, an administrative structure with the responsibility to carry out the policies of the institution, a conducive teaching and learning environment, graduates of the programs must be prepared for professional practice according to standards, a sufficient number of faculty and sufficient infrastructure and teaching learning strategies.6 There is a need to ensure quality in nursing and midwifery education in Pakistan to ensure graduates possess the required competencies and can work competently at local, national, regional, and international level.7 The challenges to ensure these standards are strengthening regulatory bodies, ensuring an optimum number of faculty and infrastructure, induction of quality students, and provision of optimum clinical training facilities for students.8 QA is recognized as increasingly essential for nursing education to ensure high-quality nursing delivery to sick patients. It is established that there is little evidence to endorse the existence and implementation of a comprehensive and vigorous QA system in Pakistan. Pakistan Nursing Council (PNC), as a regulatory body of Nursing in Pakistan, is mandated to establish minimum criteria for establishing nursing, midwifery, or a public health school institute.9 PNC is the country’s key regulator of nursing and midwifery education. Along with this, with the establishment of BSN programs across the country, the health sciences universities are also one of the key stakeholders of nursing and midwifery education regulation. Likewise, the Higher Education Commission of Pakistan sets the curriculum for undergraduate nursing programs in liaison with the Pakistan Nursing Council. To ensure minimum quality, there is a need for strong coordination among key regulatory bodies. There is a need to develop a robust mechanism for ensuring minimum standards in nursing and midwifery education nationwide.