Pre Registration Nursing Programmes Pre-reading and Mentor ... · complete the action plan template in appendix three. This will help you start to complete appendix four which is

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Pre–Registration Nursing Programmes

Pre-reading and Mentor Workshop Activities 2016/2017 This study booklet contains pre-reading materials and the learning activities you will undertake during the mentor workshop. You will probably have read or be aware of many of the pre-reading documents. Consequently if you are not able to read the information in advance of the workshop then you can revisit or read the documents afterwards. The reading, workshop activities and reflection on your learning can contribute towards evidencing part of your Nursing and Midwifery Council (NMC 2015) revalidation requirements. The activities in the workbook are designed to help you reflect upon your mentor/sign-off mentor role, consolidate and develop your personal effectiveness and capability in this role, and further develop your knowledge of the pre-registration nursing programme by:

Identifying and addressing key issues of relevance to your role as a mentor

Formulating action plans to: o develop your practice as a mentor or sign-off mentor o further develop the learning opportunities available to students within your practice

area Space has been provided for you to record your responses to the exercises – these are for your own use but you will be asked to share your thoughts and reflections during the feedback sessions in the workshop. Preparatory reading/references used in the workshop:

Revisit the Mentor Handbook for your field of practice. This can be found on the webpage: HTTPS://SOHSC.TEES.AC.UK/SITES/PRACTICESUPPORT/

DH (2015) The NHS Constitution Crown London https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england

Health Education England (2014) Framework 15: Health Education England Strategic Framework 2014-2029 London Health Education England https://www.hee.nhs.uk/sites/default/files/documents/HEE%20Strategic%20Framework%20%202015%20Refresh%20Final%20document.pdf

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Health Education England (2015) Raising the Bar Shape of Caring: A Review of the Future Education and Training of Registered Nurses and Care Assistants; Health Education England http://hee.nhs.uk/wp-content/blogs.dir/321/files/2015/03/2348-Shape-of-caring-review-FINAL.pdf

Health Education England (2016) Building Capacity to Care and Capability to Treat: A New Team Member for Health and Social Care in England https://www.hee.nhs.uk/sites/default/files/documents/Response%20to%20Nursing%20Associate%20consultation%2026%20May%202016.pdf

NHS England (2014) Five Year Forward View London NHS England https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf

NHS England (2016) Leading Change, Adding Value: A Framework for Nursing, Midwifery and Care Staff, London NHS England https://www.england.nhs.uk/wp-content/uploads/2016/05/nursing-framework.pdf

NMC (2008) Standards to Support Learning and Assessment in Practice https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-to-support-learning-assessment.pdf

NMC (2010) Standards for Pre-registration Nursing Education https://www.nmc.org.uk/standards/additional-standards/standards-for-pre-registration-nursing-education/

NMC (2015) The Code: Professional Standards of Practice and Behaviour for Nurses and Midwives, Nursing and Midwifery Council London https://www.nmc.org.uk/standards/code/

NMC (2015) Raising Concerns: Guidance for Nurses and Midwives http://www.nmc.org.uk/globalassets/siteDocuments/NMC-Publications/NMC-Raising-and-escalating-concerns.pdf

Public Health England (2016) Strategic Plan for the Next Four Years: Better Outcomes by 2020 London Public Health England https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/516985/PHE_Strategic_plan_2016.pdf

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Workshop Activities:

Please remember to maintain confidentiality and anonymity throughout your work. 1. Being a mentor

(a) What have been the most positive or rewarding aspects of your role as a mentor or sign-off mentor during the past year? Try to identify at least three positive aspects of your mentoring experience and list them below:

(b) For each of these elements reflect below upon why you have chosen them and what their significance is in relation to your strengths and further development of your practice:

(c) What have been the most challenging aspects of your role as a mentor or sign-off mentor during the past year? Again try to identify at least three aspects of your mentoring experience and list them below:

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(d) For each of these elements reflect below upon why you have chosen them and what their significance is in relation to your strengths and further development of your practice:

(e) Reflecting upon the above are there any areas of mentorship or Teesside University’s Pre-registration Nursing Programme that you would like clarifying during the workshop? If so please list below:

2. The Challenges and demands of contemporary and future nursing practice

(a) What do you think the challenges and demands are for contemporary and future nursing practice and the profession?

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(b) How do you think these challenges impact or may impact upon your mentoring practice now or in the future?

(c) What impact do you think these challenges may have on nursing education and why? Please note that the NMC is currently reviewing the Pre-registration Nursing Education Standards. Thinking about these questions may help you contribute to forthcoming consultations which will help influence the future direction of the profession.

(d) The Chief Nursing Officer’s new framework for Nursing has been published: NHS England (2016) Leading Change, Adding Value: A Framework for Nursing, Midwifery and Care Staff, London NHS England https://www.england.nhs.uk/wp-content/uploads/2016/05/nursing-framework.pdf

Reflect upon the ‘Triple Aims’, the ‘6Cs’ and the ’10 Commitments’ it contains. These are an expression of a collective vision for nursing. Identify below how they influence your nursing practice and how you can use them to inform your practice as a mentor and role model for students:

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(e) Think about how you support students in practice and the learning opportunities available in your area

o How can the student’s learning and support be enhanced?

o Are there any “spoke” allocations linked to your “hub” placement or service user care pathways that will enhance the student’s learning journey?

o How can you develop a student’s ability to question practice and identify areas for innovation and research?

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3. Supporting failing students:

Within your group think about the reasons students may fail practice and identify these below. For each think about the challenge this presents to mentors and how you can facilitate student learning and any support you can access to help you in your role:

Reasons for failing Challenge this presents to mentors

Actions

Group work: Read the case study and the dialogue sheets that have been completed by the mentor (appendix one). Once you have done this discuss the issues raised within the case study and the way in which feedback to the student has been documented with your group and answer the following questions: 1. What impression does the progress summary give you in relation to the student’s learning

and assessment during the three years?

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2. What learning can be derived from your group’s discussion in relation to 1 above? 3. Do the dialogue sheets for placement 6 clearly document the plan of learning for the student,

their progress and achievement? Please comment upon the initial interim and final dialogue sheets?

4. What are the student’s responsibilities in relation to: a. Bringing in the dialogue sheets from previous placements? b. Developing the SWOT analysis and learning contract? c. Attending the Thursday meetings?

5. In relation to a-c above what are the sign-off mentor’s responsibilities?

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6. The student has said that they did not know they were failing the placement and do not know why they have failed. The sign-off mentor has been very diligent in their supervision and the zoned academic did do an extra meeting with the student and sign-off mentor during week 5. This was after the interim meeting in week 4 as the sign-off mentor felt that the student was not making any attempt to address the feedback they had been given.

How can the feedback on the dialogue sheets be developed in order to make it clearer to the student and identify an action plan for the remaining period?

7. The sign-off mentor and academic mentor felt that the student was not at the standard they would have expected when they started the final placement and found the experience of mentoring the student difficult. They were upset when the student failed but clear that they had not met the standard.

(a) What are the sign-off mentor’s responsibilities in relation to the assessment of practice and what are they ultimately accountable for?

(b) What are the consequences of

failing to fail?

giving the benefit of the doubt?

not documenting feedback clearly?

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4. Supporting students who are achieving and those who excel

Now think about students who are doing well and what you can do to further their development

Characteristics and behaviours of students who are achieving/excel

Challenge this presents to mentors

Actions

5. Evidencing the mentor and sign-off mentor standards

Appendix two provides a template for you to record your mentor qualifications, attendance at mentor workshops, the number of students you have mentored over the triennial review period and, if you are working towards becoming a sign-off mentor, your supervision. You must complete this in paper based format. It is useful to complete this as it can be difficult to remember the information retrospectively. You will need the evidence as part of your triennial review and you may be asked to provide it for NMC programme monitoring reviews. Please refer to the NMC (2008) Standards to support learning and assessment in practice and the Mentor handbook for further information regarding the role and requirements.

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6. Reflection upon your practice Spend five minutes thinking about what you have learnt during the workshop and reviewing the work you completed in sections 1 and 2:

To help you consolidate your learning and develop your mentoring practice, complete the action plan template in appendix three.

This will help you start to complete appendix four which is an NMC (2016) Reflective account template for revalidation.

Remember to log the Mentor update on your NMC Revalidation Continuing Professional Development (CPD) form.

Thank you for continuing to support Teesside University School of Health and Social Care’s Pre-registration Nursing Programme. The success of the programme is dependent upon the strong partnerships we have with practice colleagues and the support provided by mentors to the students. Jill Foley Programme Director Pre-registration Nursing The Programme team within the School of Health and Social Care and our Practice Placement Facilitator colleagues.

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CASE STUDY: Appendix one

A third year student has been referred in their final placement allocation. They have said

that they do not understand why they referred and what they can do now to pass the final

placement. Background:

First year: The student had passed the first year mid-point competencies but feedback from

their mentor suggested that they should focus upon their communication and essential care

skills in their next year one placement period. They went on to fail the competencies at the end

of year one relating to communication skills, decision making, care planning and person-centred

care. Concerns were raised by their mentor regarding their reluctance to initiate conversations

with service users and members of the multi-disciplinary team, and ability to be proactive when

caring for people’s personal care needs. Their first year mentor had also written on the final

dialogue sheet that the student needed to be very closely supervised when documenting

assessment information as they would not always record things accurately, and did not always

recognise when the information they recorded on assessment tools required escalation in

accordance with track and trigger systems or pathways of care. They went on to pass the first

year competencies at second attempt.

During the second year feedback highlighted that although the student had passed the end of

year competencies they needed to further develop their documentation skills in the third year,

increase their knowledge of therapeutic interventions, risk assessment and prioritising skills and

pay more attention to developing medicines management skills, including knowledge of

commonly used drugs within this area of nursing practice.

During placement 5 (year three) the dialogue sheets from the student’s practice mentor show

that the student was able to care for individual service users but not able to start to develop

caseload management skills. The mentor also identified that the student did not check service

users’ understanding at the end of teaching sessions. Feedback regarding the student’s ability

to meet essential care skills such as meeting service users’ nutritional needs and hygiene

needs was good. The mentor had, however, written that on several occasions the student had

had to be reminded to wash their hands before carrying out direct care. They had participated

in some case reviews and were becoming more confident when interacting with the MDT. The

mentor had written on the final dialogue sheets that the student had a lot of work to do to meet

the end of year three competencies and needed to gain more management and leadership

experience, discharge planning skills and knowledge and skills relating to therapeutic

interventions and support for people with long term conditions and co-morbidities. They also

indicate that the student had changed their shifts on a number of occasions and consequently

they were not always available to work with them.

The dialogue sheets below are from the initial interim and final tripartite meetings for

placement 6. The zoned academic was present at the first and final meeting and came to

do an extra meeting at the sign-off mentor’s request during week 5.

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School of Health and Social Care Portfolio Dialogue Sheet

Student Name: J Anonymous Account Cohort: Field: Programme: BSc (Hons) Nursing Meeting start Time: 16.00 Finish Time: 17.00

Practice/sign-off mentor has attended a mentor workshop in the last year √

Triennial review completed √

*Practice Mentor Comments (a separate sheet to be completed by each individual) *Type of Meeting: INITIAL (*delete as appropriate) Summary of the issues discussed, including the student’s progress/achievements and action plan for on-going development

Initial meeting placement 6. Discussed the year three competencies and the evidence required to demonstrate their achievement. The student did not bring their previous dialogue sheets to the meeting and must bring these in for review by the end of the week. The student needs to complete the medicines management assessment tool and learning log in this placement and be assessed on at least 5 additional episodes of administration as they have said they only completed one assessment in the previous placement. They also have the teaching elements to complete in this allocation. We discussed the learning contract to be developed by the student, this must include learning about commonly used medicines within the acute care setting; developing their knowledge and skills relating to case load management (they must be able to manage a caseload of 6 service users during this allocation), discharge planning, developing their knowledge and skills relating to teaching service users and junior staff, therapeutic interventions and understanding of quality assurance and service improvement initiatives within this setting. We have discussed risk management and the unit’s priorities, CQUIN targets and the use of the patient safety thermometer – student to look this up and feed back to me next week as they said they were unaware of this initiative. I have identified which audits are currently being carried out in the unit and who to speak to so that they can get involved in collecting data and other service improvement initiatives. Discussed SWOT analysis and completing this – the student has said they have not done one for the third year – we have emphasised their responsibility for this and organising the fortnightly reviews. We have gone through the essential evidence tools and use of the CPE tool – these have been related to the inpatient unit. Case reviews are held on Thursdays and the student is to attend as many of these as possible – plan to take the lead in presenting cases by week 5. 360° interpersonal skills assessment tool discussed - again the student has said they have not completed these in the previous placement and consequently they must get all of these completed here. They must bring the portfolio in so that we can review feedback from other

Discussion has covered Learning objectives/priorities: √ Support needs in relation to:

Professional development/practice outcomes √ Practice skills development √ Academic development √

Personal support needs:

Specific health issues/disabilities/specific learning difficulties e.g. dyslexia : None declared

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placements and from the spoke areas. We have discussed working with service users who require additional support in relation to understanding the information provided and assessment of capacity. The zoned academic mentor has gone through the written assignment and portfolio requirements and suggested that the student book a tutorial and write a draft plan for the reflection as soon as they can. Student says they understand what is required of them and have enjoyed the first week. I have asked them to let me know which of the specialist nurses they would like to spend time with – advised to pick two as they need to spend the majority of their time in the unit to develop leadership and caseload management skills. Number of days sickness/absence and hours that would have been worked each day *Practice Mentor/Academic Mentor/Student Name: A Mentor (*delete as appropriate)

Signature: A Mentor Date: End of week one

==================================================================

Interim meeting text:

Student making progress, we have discussed the areas the student needs to improve upon to pass the placement. I have asked them to make sure they bring in their fortnightly review document as they have not done so. Still looking after individual service users - I do not feel that the student is ready to start managing a caseload of more than two, although they have asked to do so. Pharmacology knowledge seems to be weak - half day with pharmacist has been arranged to look at ordering and storage of medicines and to go through commonly used drug groups. One teaching session completed – student needs to be clearer on objectives. Needs to make sure that they work the same shifts as I do. Number of days sickness/absence and hours that would have been worked each day (to be completed at final meeting)

*Practice Mentor/Academic Mentor/Student Name: A Mentor (*delete as appropriate)

Signature: A Mentor Date: 3 weeks later

================================================================ Final meeting text:

The student has done well in the placement. Unfortunately they have not passed all of the practice competencies. They have made good progress in the final weeks but they have had difficulties managing a caseload and prioritising care. Although I advised them to attend Thursday meetings they did not roster themselves on those days and changed their off duty at the last minute on a number of occasions. Student needs to develop in confidence and also to communicate more effectively with the MDT. Knowledge of patient safety issues and pharmacology is still quite superficial. Teaching skills have improved but still not checking service users understanding at the end of the session.

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Plan to develop a learning contract for reassessment period – N.B. student has still not brought in the dialogue sheets from previous placement and their learning contract for this placement did not include all the elements we asked them to put in. Number of days sickness/absence and hours that would have been worked each day: None But changed shifts frequently

*Practice Mentor/Academic Mentor/Student Name: A Mentor

(*delete as appropriate)

Signature: A Mentor Date: Week 8 of placement

=============================================================================

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Teesside University School of Health and Social Care Mentor/Sign-off Mentor Record

The purpose of this document is to provide a record of your mentorship qualification/s, role and experience. It should be included within your professional portfolio and used as part of your triennial review in order to evidence how you have maintained your mentor/sign-off mentor status. Mentor Name: ……………………………………………………………………………..……….…….

Nursing and Midwifery Council (NMC) PIN: ………………………………………..…...………….

Mentor Qualification: ……………………………………………………………………..……...……..

Background:

NMC Mentor Standard: “An NMC mentor is a registrant who, following successful completion of an NMC approved mentor preparation programme – or comparable preparation that has been accredited through an Approved Education Institution (AEI) as meeting the NMC Mentor requirements – has achieved the knowledge, skills and competence required to meet the defined outcomes.

A mentor is a mandatory requirement for pre-registration nursing and midwifery students” (NMC 2010). Once you have met the initial mentor standards you will be entered on the local mentor register. In order to remain on the register you must:

Attend an annual mentor update

Mentor at least two students with due regard in each three year period

Demonstrate through your triennial review that you have maintained your mentorship knowledge and skills, and continue to meet the mentor/sign-off mentor standards.

NMC Sign-off Mentor Standard: Only sign-off mentors and practice teachers who are on the same part of the register and in the same field of practice may confirm that students have met relevant Competencies/Standards of proficiency for the programme leading to registration or a qualification that is recordable on the NMC register. They must be identified on the local register as a sign-off mentor or practice teacher. They must have been supervised on at least three occasions signing off proficiency by an existing sign-off mentor (the final period of practice and practice competencies within the programme). All midwife mentors must be sign-off mentors.

Please read in conjunction with NMC (2008) Standards to Support Learning and Assessment in Practice, NMC Standards for Mentors, Practice Teachers and Teachers https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-to-support-learning-assessment.pdf

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Name of Mentor: Annual update: All mentors must attend an annual update to maintain their mentor status

Date attended: Type of update: e.g. Mentorship for Pre-registration Nursing Programmes or Midwifery Programmes

Record of mentorship: You must mentor at least 2 students with due regard in each three year period in order to maintain your mentor and/or sign-off mentor status. This means that you must be registered in the same part or sub part of the NMC register as the student that you are to assess and for the nurses’ part of the register be in the same field of practice (adult, children’s, mental health or learning disability) as the students you act as mentor or sign-off mentor for.

Student (please give details of placement number and field of practice rather than the student’s name)

Placement start date

Placement end date

Please identify type of mentorship you provided: Mentor or Sign-off Mentor

Please identify whether you were being supervised in order to become a sign-off mentor: Yes/NA (supervision in this context must be for a final placement student)

If this episode was supervised by a sign-off mentor: Name of the sign-off mentor supervisor

Verified by: Signature of manager or zoned academic mentor and sign-off mentor if applicable

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Student (please give details of placement number and field of practice rather than the student’s name)

Placement start date

Placement end date

Please identify type of mentorship you provided: Mentor or Sign-off Mentor

Please identify whether you were being supervised in order to become a sign-off mentor: Yes/NA (supervision in this context must be for a final placement student)

If this episode was supervised by a sign-off mentor: Name of the sign-off mentor supervisor

Verified by: Signature of manager or zoned academic mentor and sign-off mentor if applicable

Record of triennial review: This is usually completed as part of your annual appraisal

Date Reviewer’s name Reviewer’s role Triennial review requirements met? Yes/No

Signature of reviewer

Please inform the person who holds the mentor/sign-off mentor database of the outcome of the triennial review meeting (the Practice Placement Facilitator for NHS Trusts or Alison Robinson, Placement Co-ordinator Teesside University, if you are from the independent sector)

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Appendix 3: Action Plan Template

Personal Development Objectives To develop my mentoring practice and/ or the learning environment

Rationale Why is this important?

Actions What actions will I take to achieve this?

Timescale When will I review this? Set a target date/timescale for each action identified

Evaluation What evidence will I have of success or progress? For each action identify an evaluation criteria

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You must use this form to record five written reflective accounts on your CPD and/or practice-related

feedback and/or an event or experience in your practice and how this relates to the Code. Please fill

in a page for each of your reflective accounts, making sure you do not include any information that

might identify a specific patient, service user or colleague. Please refer to our guidance on preserving

anonymity in Guidance sheet 1 in How to revalidate with the NMC.

Reflective account:

What was the nature of the CPD activity and/or practice-related feedback and/or

event or experience in your practice?

What did you learn from the CPD activity and/or feedback and/or event or

experience in your practice?

How did you change or improve your practice as a result?

How is this relevant to the Code?

Select one or more themes: Prioritise people – Practice effectively – Preserve safety – Promote

professionalism and trust