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Professional development 

Professional development
Chapter:
Professional development
Author(s):

Maria Flynn

, and Dave Mercer

DOI:
10.1093/med/9780198743477.003.0029
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Introduction

Achieving the highest standards of nursing practice necessitates an active commitment to learning and a continual and critical engagement with ideas about nursing and healthcare. The development of both individual nurses and the nursing profession requires learners and registered nurses to commit to the sharing of knowledge and experience and for all nurses to take opportunities to develop clinical and practical skills. Registered nurses also have a professional responsibility to support and guide learner nurses and colleagues, as they acquire and develop nursing values, knowledge, and skills.

Mentorship

Guiding and supporting the development of others’ practice is central to professional nursing. The UK NMC Code expects all registered nurses to support students’ and colleagues’ learning to help them develop their professional competence and confidence.

Whilst mentorship is a concept widely employed in many professions, the concept, as it applies in the nursing profession, the role and responsibilities of the mentor can be summarised as;

  • Organizing and co-coordinating student learning activities in practice.

  • Supervising students in learning situations and providing them with constructive feedback on their achievements.

  • Setting and monitoring achievement of realistic learning objectives.

  • Assessing total student performance, including skills, attitudes, and behaviours.

  • Providing evidence, as required by programme providers, of student achievement or lack of achievement.

  • Liaising with others, practice facilitators, practice teachers, personal tutors, and programme leaders to provide feedback, identify any concerns about the student’s performance, and agree remedial action as appropriate.

  • Providing evidence for, or making decisions about achievement of proficiency at the end of a programme of study.

The importance of the role of the mentor cannot be overstated, as it is within this role that nurses are setting the template for future nursing practice, maintaining professional standards and protecting patient and public safety.

Preceptorship

It is well understood that the transition from student to registered nurse can be very difficult, and newly qualified nurses often need a lot of personal support. Alongside these challenges, the increasing complexity of healthcare provision has led the UK NHS to recommend that a period of preceptorship represents best practice in supporting this transition.

Preceptorship has been described as a period of structured transition where the newly registered practitioner is supported by an experienced preceptor. The aim is to help develop their confidence as an autonomous professional and refine nursing skills, values, and behaviours. Preceptor support should enable newly qualified nurses to:

  • Develop and apply knowledge, skills, and values gained in their pre-registration programme.

  • Develop specific competences that relate to their role.

  • Access support in embedding the values and expectations of the profession.

  • Embrace the principles of the NHS Constitution.

The period of preceptorship is also an opportunity for the newly qualified nurse to meet their personal learning needs, reflect on practice, and receive constructive feedback. The role of the preceptor is fundamental to this process, acting as a positive role model, sharing a commitment to professional values, and demonstrating empathy with the new nurse.

The impact of preceptorship on nursing practice is not easily identifiable, although it has been suggested that preceptorship has the potential to:

  • Enhance patient care and experience.

  • Improve recruitment and retention of nursing staff.

  • Reduce sickness absence.

  • Build confident nurses.

  • Increase staff job satisfaction and morale.

Where preceptorship arrangements are in place, these will be structured by the employing organization. Although an initial 12-month period is identified as normal practice, different healthcare organizations may well have other arrangements.

Preceptorship can provide a unique opportunity for both the preceptor and the newly qualified nurse to actively engage in the process of nurse decision-making and practice, and arguably support the development of excellence in nursing practice and patient care.

Revalidation

In 2016, the UK NMC introduced a new revalidation process for registered nurses and midwives. This new approach has built upon the preceding re-registration process that required nurses to evidence their learning and continuous professional development through the development and maintenance of a professional portfolio.

Significant to the newly established revalidation process is the introduction of a formal assessment of practice through the introduction of a review of reflections in practice by another registrant.

The portfolio of evidence now needs to be confirmed by the line manager or employer, ideally an NMC registrant. Revalidation is required on a 3-yearly basis, with all nurses needing to develop a portfolio of evidence which includes, as a minimum:

  • A record of practice hours—in order to revalidate, nurses must complete a minimum of 450 hours over the 3 years preceding the application to revalidate. These hours must be related to the nurse’s area of practice.

  • Continuing professional development—a minimum of 35 hours of learning activity must be completed, of which a minimum of 20 must be learning with others. Learning with others is important, as it enables the sharing of knowledge, learning from others, and having an opportunity to challenge and question practice.

  • Practice-related feedback—five pieces of feedback relevant to a nurse’s domain of practice are required. The inclusion of feedback, both positive and negative, is important in focusing on other people’s perspectives and learning from others’ experiences of nursing work.

  • Reflective accounts—the inclusion of reflective accounts supports a critical engagement with practice, identifying learning, and opportunities to improve personal practice.

  • Reflective discussion—this requires the nurse to discuss their five reflective accounts with another registrant. The process enables the reflections on practice to be validated, but importantly it provides an opportunity for nurses to have a professional conversation in relation to their practice and how they uphold the NMC Code in their everyday work.

  • Professional indemnity arrangements—this is usually met by nurses’ employing organizations if they are working for NHS organizations; however, if nurses are working within independent organizations, they must provide evidence that professional indemnity arrangements are in place.

  • A health and character declaration.

  • Confirmation—this final part of the process is to verify the information collated for the portfolio.

To support this revalidation process, all UK-registered nurses are encouraged to register with the NMC online. Online registration enables the registrant to not only receive updates on NMC policy, but also to be provided with reminders of the revalidation process. The revalidation process is completed online, with key documentation and extensive guidance provided by the NMC (Professional development www.nmc.org.uk).

Nursing career development

Although many nurses have personal ambition that does not extend beyond direct patient care, there are now myriad opportunities for nurses to develop their individual careers in many different directions, all of which make an important contribution.

  • In the clinical arena, in any sector of the service, opportunities can include promotion, advanced practice roles, and specialist nursing roles, all of which maintain a level of direct contact with patients and families.

  • There are also multiple opportunities for nurses to progress to formal leadership and management roles such as ward managers, community matrons, and directors of nursing services.

  • In addition, nurses can pursue research activities, either working as a nurse member of a medical, multi-professional, or sociological research team. They can also pursue independent nursing research through PhD studies or funded research projects.

  • There are also opportunities for nurses to contribute to nurse education and scholarship at many different levels such as clinical practice tutors, clinical demonstrators, and nurse lecturers.

Whichever route individual nurses choose to pursue their personal professional development and career ambitions, it is most likely that they will need to undertake further academic study. This may be at Bachelors level (level 6 studies) or Masters level (level 7 studies), and may be in the form of certificated study days or workshops, short specialist courses, or full programmes of study.

Undertaking further academic study can be challenging for nurses working in full-time clinical or other roles, but for both personal and professional development, critical engagement with nursing ideas and knowledge will ultimately be of benefit to the ideals and values of the profession.

The majority of academic programmes of study will be designed to foster key transferable skills, develop knowledge, and critical engagement. This will require professional nurses to have the independent learning ability required to advance nursing knowledge, skills, and understanding.

Examples of knowledge and skills relevant to developing nursing practice and careers include, but are not limited to:

  • Understanding and critical awareness of a complex body of knowledge informed by the latest evidence in nursing.

  • Knowledge and understanding of the contextual issues which impact on nurses and their practice.

  • Critical understanding of the global socio-economic and political factors which impact on nursing.

  • Knowledge of the contribution and scope of nursing in healthcare.

  • Understanding of how the boundaries of nursing knowledge are advanced through research and scholarship.

  • Skills in the application of knowledge to practice, whether clinical, leadership, research, or education.

  • Skills in communicating complex information in any circumstances.

  • Ability to utilize information and communication technology skills in furthering professional knowledge and expertise.

  • Skills in reflecting critically on learning, for oneself, colleagues, and nurses in training.

Useful sources of further information

Department of Health (2010) Preceptorship framework for newly registered nurses, midwives and allied health professionalsProfessional development http://webarchive.nationalarchives.gov.uk/+/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_114073

NHS Employers. Preceptorships for newly qualified staffProfessional development www.nhsemployers.org/your-workforce/plan/education-and-training/preceptorships-for-newly-qualified-staff

NMC. Standards to support learning and assessment in practiceProfessional development www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-to-support-learning-assessment.pdf

NMC. Revalidation Professional development http://revalidation.nmc.org.uk