United Kingdom Central Council Research Articles

Lessons of history: back to the past

British Journal of Healthcare AssistantsVol. 10, No. 2 ProfessionalLessons of history: back to the pastLinda NazarkoLinda NazarkoSearch for more papers by this authorLinda NazarkoPublished Online:15 Feb 2016https://doi.org/10.12968/bjha.2016.10.2.82AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Merrifield N (2015a) Willis: new senior HCA role would ‘bridge gap’ to registered nursing. http://tinyurl.com/zxg4bjy (accessed 6 January 2016) Google ScholarMerrifield N (2015b) Lamb backs nursing assistant role ‘akin’ to state enrolled nurse. http://tinyurl.com/z2mhabl (accessed 6 January 2016) Google ScholarMoss S, Nazarko L (1998) Careers in Nursing and Related Professions (8th edn). Kogan Page, London Google ScholarSantayana G (1905) The Life of Reason, Volume I: Reason in Common Sense. Scribner's, New York NY Google ScholarSeccombe I, Smith G, Buchan J, Ball J (1997:18) Enrolled Nurses: A Study for the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC). Report 344. Institute of Employment Studies. http://tinyurl.com/hfgsc76 (accessed 11 January 2016) Google ScholarWillis Commission (2012) Quality With Compassion: The Future Of Nursing Education. Report of the Willis Commission 2012: Executive Summary. http://tinyurl.com/js5khft (accessed 6 January 2016) Google Scholar FiguresReferencesRelatedDetailsCited byBJHCA board welcomes nursing associatesJohn Evans, Ian Peate, Angela Grainger, Vinice Thomas, Linda Nazarko8 January 2019 | British Journal of Healthcare Assistants, Vol. 13, No. 1 2 February 2016Volume 10Issue 2ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 15 February 2016 Published in print 2 February 2016 Information© MA Healthcare LimitedPDF download

Revalidation: what does it mean?

© 2 01 5 M A H ea lth ca re L td Post-registration education and practice (PREP) was introduced in 1990 by the United Kingdom Central Council for Nursing and Midwifery and adopted by the current regulator, the Nursing and Midwifery Council (NMC), to ‘ensure coherent and enforceable professional accountability’ (Gately, 1992). Since 1995, PREP has been a legal requirement for every practising nurse and midwife to maintain their registration. PREP requires confirmation of a minimum achievement of 450 practice hours over 3 years or completion of an approved return to practice programme. Also, it requires we undertake and record our continuing professional development (CPD). However, there have been many challenges to policing such requirements, especially with over 670 000 nurses registered with the NMC. After a deal of research and consultation (NMC, 2014), PREP is being replaced by a system of revalidation. From January 2015, a number of pilot sites introduced a 6-month period to test the process, forms and guidance of revalidation, with a view to refining the model ahead of its roll-out at the end of 2015.

Forensic psychiatric nursing: a description of the role of the psychiatric nurse in a high secure psychiatric facility in Ireland

The Central Mental Hospital is one of the oldest high secure mental health services in Europe dating back to 1845 but has been one of the last to introduce (forensic) psychiatric nurses. This paper describes the role of psychiatric nurses working in this high secure psychiatric facility in Ireland. The United Kingdom Central Council competency framework was considered to be a prudent starting point for beginning to understand this role in an Irish context. The study received a response rate of 74% and found that the Irish Forensic Mental Health Nurse experiences many of the same challenges as their international colleagues. A high proportion of nursing practice is focused on assessment, communication and creating a therapeutic environment based very much in keeping with the mainstream role in mental health nursing. Skills in specialist assessments and addressing offending behaviour were considered important but deficient at that time. The importance of recovery and human rights were considered paramount but challenged by the need for risk management and security.

Therapeutic characteristics of nursing staff in a medium secure setting

The forensic nursing role is complex, creates tensions within itself and is underpinned by core values, knowledge, skills and personal attributes; often referred to as ‘good nurse’ characteristics (Smith & Godfrey, 2002). Forensic nurses perform unique, multifaceted roles; they are viewed by patients as ‘a source of treatment, comfort and advice’, but also as ‘part of the system that deprives them of their liberty’ (United Kingdom Central Council for Nursing, Midwifery and Health Visiting & University of Central Lancashire (UKCC & UCLAN), 1999: 42). This is problematic both for nurses and patients. Although appearing as opposites, security and therapeutic characteristics of nurses can and do co‐exist in forensic nursing (Peternelji‐Taylor & Johnson, 1996). Through critical analysis of dialogue from interviews and focus groups, this paper depicts forensic practice with people with a learning disability through a study that explores apparent ‘truths’ about such people detained in forensic settings (here referred to as ‘the men’) and the staff who work with them. Beliefs about nursing characteristics were exposed through discourses present in dialogue between the men and the staff. General research questions included: (1) What are the discourses related to learning disability and forensic practice? (2) What ideologies underpin and justify forensic practice? (3) What in particular are the positive discourses? Related discussion is primarily concerned with the way that staff and men share relationships and with characteristics of the nursing staff. Findings generally suggest that the staff may be viewed as prison wardens, leading to relationships of mistrust. Paradoxically, there are also positive discourses identifying warm and therapeutic relationships and good nurse characteristics of the staff. This may have practice implications, such as enabling staff to hear positive views expressed by the men and begin to develop metrics of ‘good’ forensic nurse characteristics that may positively affect treatment.

Bridging the theory‐practice gap in student nurse training: an evaluation of a personal and professional development programme

A key challenge facing pre‐registration nurse educators is to turn out students who are fit for practice by the end of their training (United Kingdom Central Council for Nursing, Midwifery and Health Visiting, 1999). This includes developing their understanding of professionalism (Department of Health, 2003; Nursing and Midwifery Council, 2004; 2007). This paper provides an evaluation of a special personal and professional development scheme for mental health student nurses implemented to improve the learning and development process. The scheme required that in addition to individual meetings with personal tutors, students would meet in small groups of 12‐15, every six weeks, facilitated by their personal tutor and a clinician. The meetings provided a space for students to discuss nursing topics, their clinical experiences and performance to improve their understanding of professional standards in their role transition.The outcome was that over 80% of the respondents were satisfied with the structure, facilitation methods, contents, group size and the time allocated for the meetings. They also reported an increase in knowledge and level of understanding, awareness of professional expectations, making better theory‐practice links of learning and becoming more self‐aware. The authors suggest that nurse training departments should collaborate with their clinical partners and adopt a similar framework to help bridge the theory‐practice gap and enhance the transition process from student to qualified practitioner.

New landscapes, new horizons, new regulator

The Nursing and Midwifery Council (NMC), its predecessors the United Kingdom Central Council for Nurses, Midwives and Health Visitors (UKCC), and the General Nursing Council (GNC) have taken the statutory role of regulating the nursing and midwifery professions. Their aim is to safeguard the health and wellbeing of the public.

Student nurses’ experiences of community-based practice placement learning: A qualitative exploration

United Kingdom (UK) health policy has adopted an increasing community and primary care focus over recent years (Department of Health, 1997; Department of Health, 1999. Making a Difference: Strengthening the Nursing, Midwifery and Health Visitor Contribution to Health and Health Care. Department of Health, London; Department of Health, 2004. The NHS Knowledge and Skills Framework (NHS KSF). Department of Health, London). Nursing practice, education and workforce planning are called upon to adapt accordingly (Department of Health, 2004. The NHS Knowledge and Skills Framework (NHS KSF). Department of Health, London; Kenyon, V., Smith, E., Hefty, L., Bell, M., Martaus, T., 1990. Clinical competencies for community health nursing. Public Health Nursing 7(1), 33-39; United Kingdom Central Council for Nursing, Midwifery and Health Visiting, 1986. Project 2000: A New Preparation for Practice. UKCC, London). Such changes have major implications for pre-registration nursing education, including its practice placement element. From an educational perspective, the need for increased community nursing capacity must be balanced with adequate support for student nurses' learning needs during community-based placements. This qualitative study explored six second year student nurses' experiences of 12 week community-based practice placements and the extent to which these placements were seen to meet their perceived learning needs. The data came from contemporaneous reflective diaries, completed by participants to reflect their 'lived experience' during their practice placements (Landeen, J., Byrne, Brown, B., 1995. Exploring the lived experiences of psychiatric nursing students through self-reflective journals. Journal of Advanced Nursing 21(5), 878-885; Kok, J., Chabeli, M.M., 2002. Reflective journal writing: how it promotes reflective thinking in clinical nursing education: a students' perspective. Curationis 25(3), 35-42; Löfmark, A., Wikblad, K., 2001. Facilitating and obstructing factors for development of learning in clinical practice: a student perspective. Issues and innovations in Nursing Education. Journal of Advanced Nursing 34(1), 43-50; Priest, H., 2004. Phenomenology. Nurse Researcher 11(4), 4-6; Stockhausen, L., 2005. Learning to become a nurse: student nurses' reflections on their clinical experiences. Australian Journal of Nursing 22(3), 8-14). The data were analysed using content analysis techniques, exploring their contextual meaning through the development of emergent themes (Neuendorf, K.A., 2002. The Content Analysis Guidebook. Sage Publications, London). The identified themes related to elements of students' basic skill acquisition, the development of their working relationships with mentors, patients and others, the learning opportunities offered by community practice placements and the effects that such placements had on their confidence to practice. These themes are discussed with regard to the published literature, to arrive at conclusions and implications for future nursing education, practice and research.

An investigation of nurse educator’s perceptions and experiences of undertaking clinical practice

Educational policy (DOH, 1999. Making a difference: strengthening the nursing, midwifery and health visiting contribution to health and healthcare. Department of Health, London; UKCC, 1999. Fitness for Practice. United Kingdom Central Council for Nursing, Midwifery and Health Visiting, London; Nursing and Midwifery Council, 2006. Standards to support learning and assessment in practice. Nursing and Midwifery Council, London) and current nursing literature (Griscti, O., Jacono, B., Jacono, J., 2005. The nurse educator's clinical role. Journal of Advanced Nursing 50 (1), 84-92; Owen, S., Ferguson, K., Baguley, I., 2005. The clinical activity of mental health nurse lecturers. Journal of Psychiatric and Mental Health Nursing 12, 310-316), place increasing emphasis on nurse educators undertaking clinical practice to facilitate their clinical confidence and competence. This study investigated nurse educators' perceptions and experiences of undertaking clinical practice. A qualitative design and descriptive, exploratory approach were used. A purposive sample of 11 nurse educators in one nursing department, took part in two focus group interviews, one with 5 and the other with 6 respondents, to identify and discuss their perceptions and experiences of undertaking clinical practice. A process of thematic content analysis revealed three broad themes relating to the meaning and importance of clinical practice, perceived benefits and barriers which are examined and discussed. The paper concludes that despite policy recommendations, barriers highlighted in this study such as insufficient time, heavy workload and a lack of valuing of the clinical role have been raised over the past few decades. The effect of undertaking clinical practice, particularly on the quality of teaching is argued to be valuable armoury in the battle to secure sufficient resources to support engagement in clinical practice. Financial and organisational commitment; valuing of clinical practice and research evidence are crucial to realising clinical practice for nurse educators. Alternative interpretations of what may constitute the clinical role such as joint research projects and supporting and supervising students are offered, which need to be assessed against clear, specific and realistic aims for the clinical role of the nurse educator.

What do mentors find difficult?

(i) To assess whether mentors had a positive or negative attitude towards their role; and (ii) to discover what aspects of the role they found easy or difficult. The fact that mentorship is an important element in nurse training was recognized by Sir Leonard Peach, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting and the Nursing and Midwifery Council which has recently published new standards to support learning and assessment in practice, which include standards for the preparation of Mentors, to be implemented by September 2007. There are many anecdotal reports of the problems which face mentors, but little firm evidence. This paper reports a study of those problems. It used a Thurstone scale to assess role satisfaction among mentors (n = 86, response rate 89%) and two Likert scales to assess where problems, if any, lay. Unlike anecdotal reports, the Thurstone scale found that, overall, mentors regarded the role positively. In addition, a principal components analysis of responses to the Likert scales showed that there were two clearly delineated factors. The first (interpersonal/organisational factors) had been widely discussed in the literature. The second (cognitive/intellectual factors) has been rarely discussed and could with profit be more strongly stressed in mentor training. (i) Mentors had a positive attitude towards their role and enjoyed it. (ii) When looking at what caused mentors difficulty, in addition to the commonly discussed dimensions of organisational constraints (workload, skill mix) and interpersonal factors, there was clearly an additional cognitive one. Knowledge, not just personality, mattered. Mentors and those who train them could with profit pay more attention to cognitive components of the role, even if that meant laying a lesser stress on the interpersonal ones.

Professional regulation in nursing. Part 2: political change

The current Government came to power in 1997. In their manifesto, changes in ideology towards the provision of health and the place of those who provided health care were evident. As well as the issue of acceptable standards of healthcare provision, the issue of the regulation of nurses and other health workers was perused. This article reviews the political manifestos of 1997 and 2001, and reflects on the changes averred to in the context of the effects to the nursing profession in respect of professional regulation and central control by the Government of the profession as a whole. A conclusion is reached that political changes, not based on theoretical models of care, but rather on reports commissioned by Government, have resulted in far reaching consequences for nursing. This includes the replacement of the regulatory body (United Kingdom Central Council for Nursing, Midwifery and Health Visiting) with a new body (Nursing and Midwifery Council) and the inclusion of public persons into the management of nurses to the extent that for the first time, lay persons would have an influence in the outcomes of professional disciplinary hearings and sanctions.

Nursing competence 10 years on: fit for practice and purpose yet?

This paper examines how nurses are prepared to be clinically competent and safe at registration, so that they are fit for practice and purpose. It follows up two papers on competence published in 1997 and 1998 and investigates subsequent developments. In 1979, major changes in nursing affected nurse education and preparation for competence. In the following two decades, it became clear that nurses lacked clinical skills. This paper examines subsequent changes and asks the question whether this crucial shortcoming has now been remedied. This paper considers the background and context of change in nursing and nurse education in the 1980s. It looks at the new ideology, to prepare the 'knowledgeable doer' and examines the consequences of the change on nursing competency from the 1990s to the present day. This is a position paper. Professional policy documents from the English National Board for Nursing, Midwifery and Health Visiting, United Kingdom Central Council for Nursing, Midwifery and Health Visiting and Nursing and Midwifery Council, government reports and legislation on nursing and relevant nursing literature are examined and critically analysed and conclusions drawn. From 1923-1977, mandatory nursing syllabuses set by the General Nursing Council of England and Wales required the registered nurse to have acquired certain specific clinical skills. These were rigorously tested to an explicit standard set by the General Nursing Council before a nurse was awarded state registration. Twenty-five years later, the loss of this system for ensuring this competence and the implications of this loss, have been widely recognised. As a result, many nurse training institutions have introduced clinical skills laboratories, simulation of practice and the Objective Structured Clinical Examination. However, to the authors' surprise and contrary to their initial expectations, the Nursing and Midwifery Council has not made these systems uniform or mandatory and so still has no way of ensuring all nurse training is producing safe nurses in the United Kingdom. The authors conclude that the untested educational ideology that brought root and branch change to nurse training in 1983 and which failed to produce nurses 'fit for practice and purpose' may still prevail. The present paper demonstrates that United Kingdom nurse training still has no uniform and mandatory system in place to ensure, as far as is possible, that all registered nurses are clinically competent and safe to practice.

Peeling back the layers of learning: A classroom model for problem-based learning

This paper aims to provide an informative discussion with underpinning rationales about the use of a problem-based learning (PBL) classroom model, supported by a structured process for undertaking PBL. PBL was implemented as a main teaching and learning strategy for a diploma in nursing programme as advised by the Department of Health [Department of Health., 1999. Making a difference: Strengthening the Nursing, Midwifery and Health Visiting Contribution to Health and Health Care. Department of Health, London.] and the United Kingdom Central Council for nurses, midwifes and health visitors [United Kingdom Central Council for Nursing, Midwifery and Health Visiting, 1999. Fitness for Practice. UKCC, London.]. The implementation and change to the PBL approach is not without challenges, and so it was considered important to facilitate this change effectively. Through ongoing reflection, peer discussions and continuous review of the literature following studies at Masters Level, it was identified that the design of a model may guide students and facilitators who were new to the PBL process to help students identify relevant learning needs and thus enable them to achieve the learning outcomes of a dynamic curriculum [Darvill, A., 2000. Developing Problem-based Learning in the Nursing Education Curriculum: A Case Study. Unpublished MSc Dissertation, University of Huddersfield, Huddersfield; McLoughlin, M., 2002. An Exploration of the Role of the Problem-based Learning Facilitator: An Ethnographic Study of Role Transition in a Higher Education Institution 'Paradigm Shift or New Ways of Working'. Unpublished MSc Dissertation. University of Huddersfield, Huddersfield.]. In this paper the key components of the model will be described.

Nurse Practitioners, Practice Nurses and Nurse Specialists: what's in a name?

Nurse Practitioners, Practice Nurses and Nurse Specialists: what's in a name?

A collaborative approach to developing “learning synergy” in primary health care

Supporting and enhancing clinical learning for pre registration nursing students continues to be a challenge for nurse educators. The drive of recent and contemporary nurse education policy in the United Kingdom (UK) has re-emphasised the need for nurse educators to be instrumental in the support and development of clinical learning [United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC), 1999. Fitness for Practice (The Peach Report). UKCC, London; Department of Health, 1999. Making a Difference. Strengthening the Nursing, Midwifery and Health Visiting Contribution to Health and Healthcare, DOH, HMSO]. This paper presents a preliminary study of an action research project, identifying how nurse educators can facilitate new ways of learning in practice. Predominantly, a first person inquiry approach is adopted, supplemented by qualitative approaches, reflecting the journey of the author in relation to her role as nurse educator in practice. This was enriched by engaging with students and mentors from the author's clinical link area, who had participated in a new initiative to develop small tutorial groups designed for students undertaking their primary health care placement, within year two of a Fitness for Practice programme within the UK. Students' and mentors' experiences and stories, were appraised using qualitative and self-reflexive techniques. The role of the nurse educator in clinical practice is demonstrated, as is the importance of successful collaboration between educators and practitioners to establish high quality learning environments for students.

Situated cognition and cognitive apprenticeship: A model for teaching and learning clinical skills in a technologically rich and authentic learning environment

The acquisition of a range of diverse clinical skills is a central feature of the pre-registration nursing curriculum. Prior to exposure to clinical practice, it is essential that learners have the opportunity to practise and develop such skills in a safe and controlled environment under the direction and supervision of clinical experts. However, the competing demands of the HE nursing curriculum coupled with an increased number of learners have resulted in a reduced emphasis on traditional apprenticeship learning. This paper presents an alternative model for clinical skills teaching that draws upon the principles of cognitive apprenticeship [Collins, A., Brown, J.S., Newman, S., 1989. Cognitive Apprenticeship: teaching the crafts of reading, writing and mathematics. In: Resnick, L.B. (Ed.) Knowing. Learning and Instruction: Essays in Honor of Robert Glaser. Lawrence Erlbaum Associates, New Jersey, pp. 453-494] and situated cognition within a technologically rich and authentic learning environment. It will show how high quality DVD materials illustrating clinical skills performed by expert practitioners have been produced and used in conjunction with CCTV and digital recording technologies to support learning within a pedagogic framework appropriate to skills acquisition. It is argued that this model not only better prepares the student for the time they will spend in the practice setting, but also lays the foundation for the development of a clinically competent practitioner with the requisite physical and cognitive skills who is fit for purpose [UKCC, 1999. Fitness for Practice: The UKCC Commission for Nursing and Midwifery Education. United Kingdom Central Council for Nursing Midwifery and Health Visiting, London].

The surveillance of nursing standards: An organisational case study

Background: Quality assurance has acquired increasing prominence in contemporary healthcare systems and there has been an ‘explosion’ of audit activity. Some authors have begun to investigate the impact of audit activity on organisational and professional cultures. This paper considers data from a wider study of the management of the ‘problem’ nurse. Nurses and managers had contrasting perceptions of the value of different methods of assessing ward standards and their views are presented here. Design and setting: The study involved organisational case studies in three healthcare Trusts in the north of England. The fieldwork for this study was funded by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting under their research scholarship programme. Methods: Multiple methods were employed including observation, interviewing and documentary analysis. A total of 144 informal interviews were carried out with ward nurses and their managers. Findings: The study demonstrated different viewpoints regarding the surveillance of nursing standards at top management, middle management and ward levels. The paper considers the discrepancies between these different viewpoints. Conclusion: None of the participants placed a high value on audit as a method of assessing ward standards. Complaints data and informal methods were more highly valued by managers. Ward nurses stressed the importance of presence and vigilance in assuring high standards of nursing care.

Higher level practice in community nursing: part 1

Part one of this article describes the development of the nurse practitioner role in the UK. Part two reports on a research study examining whether or not community nurse practitioners were able to achieve a 'higher level of practice' as envisaged by the United Kingdom Central Council and will be published in next week's Nursing Standard.

Guest Editorial

Guest Editorial

New rules for safe practice

In April 2002 the Nursing and Midwifery Council (NMC) was established as the UK regulatory body for nursing and midwifery, and the rules and standards of the previous regulatory body (United Kingdom Central Council for Nursing, Midwifery and Health Visiting) were adopted. Since then, new rules for education, registration, midwifery and fitness to practise have been introduced.

An investigation into adult nursing students’ experience of the relevance and application of behavioural sciences (biology, psychology and sociology) across two different curricula

Curriculum development for nurse education is constantly changing to reflect the sociopolitical context and medical advancement. Throughout this process the contribution of the behavioural sciences to each curriculum has been widely debated. Nurse educators encourage students to acquire and develop academic knowledge to underpin their practical skills and professional competencies. However with new political agendas science content within the new curricula is being marginalised, [United Kingdom Central Council for Nursing Midwifery and Health Visiting, 1999. Fitness for Practice. London, UKCC]. This qualitative study investigated adult branch nursing students' experiences of the behavioural sciences while studying two different curricula: one a new integrated delivery of the sciences, the other involving discrete science modules. The study utilised focus group interviews at two distinct phases of their courses: 12-18 and 24-30 months. Each interview was tape recorded, transcribed verbatim and inductive thematic analysis [Hayes, N., 1997. Doing Qualitative Analysis in Psychology. Psychology Press Erlbaum Taylor & Francis Ltd.] was applied. This article reports the findings and discusses the relevance of the sciences to students and their patient care, and how the sciences underpin their view of health and illness.