01
Nurse education and mentorship
This chapter provides an overview of the preparation nurses undertake during their pre-registration programmes, and an insight into the registered nurseās role in supporting students.
| Learning Outcomes
On completion of this chapter you should: | - have an outline view of programmes leading to nurse registration;
- understand the need for mentorship in nursing;
- be able to define the qualities required to be a good mentor.
|
Pre-registration nurse education
Background
Before the 1990s, nurse education was a traditional āapprenticeā-style training where nurses were based in a school of nursing within the hospital where they carried out their clinical work. There were then two levels of nurse qualification ā Registered Nurse (1st level nurse) and Enrolled Nurse (2nd level nurse). Registered Nurses followed a three-year training programme, while Enrolled Nurses took a more practically based two-year training programme. In the 1980s there was a push towards establishing nursing on a more professional footing, and a recognition that nurses were taking on work more traditionally carried out by doctors, with health care assistants undertaking work that had been carried out by registered nurses. This was coupled with the appreciation that there were common elements that underpinned all nursing practice, whichever ābranchā or āfieldā of nursing (mental health, learning disability, adult, child health) was studied.
The 1990s saw the advent of āProject 2000ā ā a new style of nurse training that transformed pre-registration nurse education at the time and continues to do so. As you know, nurses now study in universities (higher education institutes) and leave their programme not only with a first-level professional nursing qualification (Registered Nurse), but with a higher-educational qualification as well.
Nurse education today
The Nursing and Midwifery Council (NMC) sets the standards for pre-registration nursing education (Nursing and Midwifery Order, 2001). These are articulated in the document Standards for Pre-registration Nursing Education (NMC, 2010a). The standards are informed by the Royal College of Nursing (RCN) definition of nursing as āthe use of clinical judgement in the provision of care to enable people to improve, maintain or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until deathā (RCN, 2004a). They are also informed by the European Tuning project (Tuning, 2009, cited in NMC, 2010a), which adopted this definition of the nurse in 2003:
A professional person achieving a competent standard of practice at first cycle level following successful completion of an approved academic and practical course. The nurse is a safe, caring, and competent decision maker willing to accept personal and professional accountability for his/her actions and continuous learning. The nurse practises within a statutory framework and code of ethics delivering nursing practice (care) that is appropriately based on research, evidence and critical thinking that effectively responds to the needs of individual clients (patients) and diverse populations.
(NMC, 2010a, p. 11)
Within the Standards (NMC, 2010a) the NMC states that its aim is to ensure the public can be confident that all new nurses will:
- deliver high quality essential care to all;
- deliver complex care to service users in their field of practice;
- act to safeguard the public, and be responsible and accountable for safe, person-centred, evidence-based nursing practice;
- act with professionalism and integrity, and work within agreed professional, ethical and legal frameworks and processes to maintain and improve standards;
- practise in a compassionate, respectful way, maintaining dignity and wellbeing and communicating effectively;
- act on their understanding of how peopleās lifestyles, environments and the location of care delivery influence their health and wellbeing;
- seek out every opportunity to promote health and prevent illness;
- work in partnership with other health and social care professionals and agencies, service users, carers and families ensuring that decisions about care are shared;
- use leadership skills to supervise and manage others and contribute to planning, designing, delivering and improving future services.
(NMC, 2010a, p. 5)
The NMC does not produce a national curriculum for nursing education, but the Council does determine the content of programmes. Equally, it does not set specific requirements for the nature or range of practice learning, other than that it must enable the competencies to be acquired. University programmes have to be validated by the NMC, and are subject to regular reviews. In addition to NMC standards, universities also have to comply with standards set by the Quality Assurance Agency (QAA), which are general standards for all courses run within higher education. From 2013, all students entering a pre-registration nursing programme undertake a degree level course, which reflects the essential and complex care nurses deliver in many different settings (NMC, 2010a).
Nurses enrol on a programme for a āfieldā of nursing ā adult, child, learning disabilities or mental health ā and whichever field is studied, 50 per cent of time is spent on theoretical aspects of nursing and 50 per cent in practice areas. This equates to 2300 hours each of practice and theory with progression points at the end of each year, where both theory and practice competencies have to be achieved.
Lord Willis published a report in March 2015 (Health Education England, 2015) recommending changes to nurse training and education for the future. This included a clear training pathway and distinct qualifications for care assistants and a change to the structure of pre-registration education. He proposed greater acquisition of skills that were previously considered āadvancedā or post-registration be included within pre-registration education, and that the emphasis of a pre-registration programme should be on developing greater decision making skills and share-decision making and the routine application of research and innovation.
In terms of structure of pre-registration programmes he suggested a two-year āwhole person trainingā and then one year of āchosen specialismā (currently known as āfieldā) along with a one-year preceptorship programme. In addition to the current fields, Community Nursing would be added, which would encourag...
