Review of Pre-Registration Nurse
EducationHEI Workshop 16 June
2014
Kathy BransonDirector – Special Projects
Health Education East of England
www.hee.nhs.ukwww.eoe.hee.nhs.uk @HEEoENurse
Agenda9.30 – 10.00 Arrival and coffee
10.00 - 10.15 Introduction and Welcome
10.15 – 11.15 Initial findings (presentation & discussion)
11.30 – 11.45 Refreshment Break
11.45 – 13.00 Initial findings (cont.)
13.00 – 13.45 Lunch
13.45 – 14.00 Summary & Introduction
14.00 – 16.00 Workshops
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Introduction & Drivers• Frances, Willis, Cavendish, Berwick
reports identified areas for improvement• £ cost + quality• Nursing graduates - highest number in
universities• Safer Staffing
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• 8 workshops held at 7 locations in East of England• 191 people attended• Attendees - senior nurses, nurse managers, teachers,
delegates from HEIs and a small number of Students • Collected data (taped and written), analysed by key
themes• Carried out a Preliminary Literature Review – setting
the context
What We Have Done
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• 48 hours group discussions• Repetition of key themes• Common understanding of key themes• No surprises
What Happened
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• Recognition – ‘Trainer’ to be seen as a ‘badge of honour’
• Choice. Do nurses aspire to being mentors?• Practice assessment/sign off• Infrastructure, time & support
How do we demonstrate value for mentors and excellent education in practice?
Quality Mentorship
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• Technical skills – clarity about measurements• Care/compassion• Resilience• Understanding of relationship between mental and
physical health• Questioning/improvement culture
How can we articulate core skills; how are these acquired, measured and maintained?
Core Skills
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“There are not that many environments or education models where there is joint responsibility for student learning. This is a potential risk and there is a tension between the student’s rights and academic requirements versus the need to protect patients and the professional nurse’s expectations of the student.”
• Workforce planning – ‘ownership of finished product’
Partnership – quality of relationship between placement and HEI
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• ‘Fundamentals’ of care are held in high esteem• Freedom to ask questions and challenge. Blame free• Demonstrates value for staff/students and develops
their resilience• Personal responsibility ‘changing culture is my job’
How do you demonstrate the ‘right’ culture to support learning?
How do nurses make learning and reflection ‘culturally acceptable’?
Culture (Practice and HEI)
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• HEIs ‘own’ theory; service ‘owns’ practice• How to narrow or bridge the gap?• University/learning ‘without walls’• Anxiety about the meaning of evidence
based practice• Tension between intuition and knowledge
based actions
Theory/Practice Gap
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• Need to ensure they are involved in and reflected in practice• Student focus vs. service user focus• Graduate preparation for synthesising the ‘paradox of
nursing’ Standardisation vs. person centred care Meaningful encounters vs. speed of throughput
• Coaching and self-management/risk• Fundamentals – the little things that mean a lot
How do we describe this complex and difficult area so that it can really be the centre of practice?
Service User/Patient/Client
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• Individual need• Clinical need• Organisational• Political How do you prepare and support people for this and to
maintain resilience?
Managing Constant Change at Every Level
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• Management and leadership concepts and functions described interchangeably
• Personal leadership - responsibility linked to accountability
• Leaders of care/service improvements• How to ‘teach’ leadership and leadership
framework
What do the concepts of ‘team’; leadership and management each mean within the context of nursing?
Leadership
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• A core skill embedded into curriculum• Management of caseload/ward• Management of self• Management of workload/risk• What can you safely do?• Management of complexity
Management
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• Team work/integration/multi-professional/inter-agency user interchangeably
• Defining the skills and implications of the setting• Education based on patient pathways
What are the skills and attributes of a newly qualified nurse and are they really fit for purpose in a range of settings?
Preparing Nurses to Work in a Range of Settings
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• Mentorship is part of CPD• Students’ access to skilled clinicians• Purpose of placements around specialist
and advanced practitioners
CPD
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• Is this in line with your expectations?• Is anything missing?
Discussion
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WorkshopsTable 1 - Partnership & Mentorship How do we demonstrate excellent partnership in practice
Table 2 - Core skills & Theory Practice Gap How can we articulate core skills how are these acquired, measured and maintained. How do we narrow the theory/practice gap
Table 3 - Preparing nurses to work in a range of settings What are the skills and attributes of a newly qualified nurse and are they really fit for purpose in a range of settings
Table 4 - Service User/Patient/Client How do we describe this complex and difficult area so that it can really be the centre of practice?
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• 4 x Service User workshops – June• HEI Workshop – June• 5 x Student workshops – July• Interviews with key stakeholders
Next Steps
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• Monthly blog• Website on HEEoE:
http://eoe.hee.nhs.uk/our-work/fundamental-nursing-review/
• Twitter: @HEEoENurse
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