Nurse Preceptorship.

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What Preceptorship is.. Preceptorship should be considered as a transition phase for newly registered practitioners when continuing their professional development, building their confidence and further developing competence to practice, and not as a way to meet a shortfall in pre-registration educat

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Nurse Preceptorship.

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1. Nurse Preceptorship. Wendy Donoghue RGN, RMN. Nurse Preceptorship Lead Coventry and Warwickshire NHS Partnership Trust.

2. What Preceptorship is. Preceptorship should be considered as a transition phase for newly registered practitioners when continuing their professional development, building their confidence and further developing competence to practice, and not as a way to meet a shortfall in pre-registration education. Department of Health 2009.

3. Historical context. The High Quality Care for All: NHS Next Stage Review Final Report 2008. - ‘a foundation period for nurses at the start of their careers which will help them begin the journey from novice to expert. This will enable them to apply knowledge, skills and competencies acquired as students, into their area of practice, laying a solid foundation for lifelong learning’. - ‘funds were committed to support preceptorship so that it can be made available to all registered nurses’.

4. Historical context. Department of Health. -Preceptorship Framework 2009. CNO Christine Beasley. Modernising Nursing Careers 2009. Agenda for Change- accelerated pay progression for newly qualified staff on band 5.

5. Nursing and Midwifery Council Code of Conduct. “You must facilitate students and others to develop their competence”. “You must be willing to share your skills and experience for the benefit of your colleagues”. “You must make sure that everyone you are responsible for is supported and supervised”.

6. Nursing and Midwifery Council Code of Conduct. “You must have the knowledge and skills for safe and effective practice when working without direct supervision”. You must recognise and work within the limits of your competence”.

7. Nursing and Midwifery Council Code of Conduct. “You must keep your knowledge and skills up to date throughout your working life”. “You must take part in appropriate learning and practice activities that maintain and develop your competence and performance”.

8. Nursing and Midwifery Council. Awaiting a decision from the NMC about whether preceptorship will become mandatory. Expected late 2010. In order to “guide and support all newly qualified nurses to make the transition from student to develop their practice further”.

9. Kings College, London. Review of Preceptorship 2009. How long should preceptorship last? How formal and standardised should programmes be? How to deliver it in community and non-NHS organisations. How to meet the resource implications entailed.

10. Preceptorship Framework 2009. Developed by the Department of Health. For newly registered nurses, midwives and Allied Health Professionals. For use as a resource. Establishes clear principles of good preceptorship.

11. Implementing Preceptorship. A variety of learning methods. Self directed, one to one, training days. Reflective practice, shadowing. Preceptorship in partnership with higher education institution. Portfolio building. Web based resources eg. Flying Start.

12. Flying Start, England. A web based, electronic preceptorship programme designed for multi-professional use by NHS Education Scotland. Aimed at newly qualified practitioners during their first year of practice. Can be used for KSF development review. Can be used electronically or hard copy. First review in England in March 2010, results favourable.

13. Elements of Preceptorship for the newly qualified practitioner. Apply and develop knowledge, skills and values already learned. Develop specific competencies. Access support in embedding values and expectations. Personalised development programme. Reflect on practice and receive constructive feedback.

14. Elements of preceptorship cont. Take responsibility for individual learning and development. Continuation of lifelong learning. Enables the embracement of the principles of the NHS Constitution.

15. Elements of Preceptorship for the preceptor. Responsibility to develop others professionally to achieve potential. Demonstrate continued professional development. Discuss individual practice and provide feedback. Share individual knowledge and experience.

16. Elements of Preceptorship cont. Have insight and empathy during the transition phase. Act as an exemplary role model. Receive preparation for the role. Enables the embracement of the principles of the NHS Constitution.

17. Elements of Preceptorship for employers. A process to be quality assured. Embeds the KSF. Promotes and encourages an open, honest and transparent culture. Supports the delivery of high quality efficient health care. Demonstrates the employers delivery of key policies. Indicates the organisations commitment to learning.

18. Benefits of Preceptorship to the newly qualified practitioner. Develops confidence. Increased job satisfaction. Feels valued and respected. Feels invested in and enhances career aspirations. Personal responsibility for maintaining up to date knowledge.

19. Benefits of Preceptorship to the Preceptor. Develops appraisal, mentorship and supportive skills. Enhances ability to progress through AfC gateways. Supports their own lifelong learning. Engenders a feeling of value to their organisation. Identifies a commitment to their profession and the regulatory requirements.

20. Benefits of Preceptorship to the Employer. Enhanced quality of patient care. Enhanced recruitment and retention. Reduced sickness and absence. Identify staff who need extra support. Registered practitioners who understand the regulatory impact of the care they deliver and develop an evidence based approach.

21. My role. Funding made available by the NHS West Midlands for Trusts to have preceptorship budgets. Creation of Nurse Preceptorship Lead. -Conduct a review of current practice, identify barriers and propose a preceptorship strategy.

22. Process of review. Face to face interview with 47 preceptees and 35 preceptors, from all areas within the Trust, inpatients and community. Feedback from many Operational managers, service leads, team leaders and ward managers.

23. Analysis. All preceptees interviewed had qualified within the last 18 months. Preceptors were bands 5,6 and 7. Preceptorship quality and support varied. Varying levels of responsibility. Clinical team support. Clinical supervision.

24. Barriers to the process. Workload of the area. Preceptor interest and knowledge. Shift patterns. Policy not available on the intranet. Lack of support for the process by clinical team. Lack of organisation of protected time for supervision and learning.

25. Improved clinical skills. Increased confidence. Improved baseline knowledge. Documentation. Multi professional liaision. Communication skills. Management and leadership skills. Delegation of junior staff. Management of medication.

26. Wish list. Having clear expectations. Having a clear role. Regular supervision/feedback. Consistent support. An interested and knowledgeable preceptor. To feel more confident. Competency action planning. Work more regularly with preceptor.

27. On a positive note. A few preceptees stated that their preceptorship was exactly as they would have wished for!

28. Competencies. One set of competencies to be used by every newly qualified nurse was reviewed. Tailored competencies for -adult mental health -older adult mental health -learning disabilities -eating disorders and substance misuse -CAMHS (children and adolescent mental health services)

29. Competencies. Ethical Practice. Maintenance of personal and professional standards. Evidence Based Practice. Mental Health Care. Effective communication. Drug administration. Leadership and management.

30. Policy review. Currently in process of being redrafted for multi disciplinary use. New standards being created as a result of feedback. -clinical supervision documentation -supernumary status -competency action planning -medicines assessment for nurses administering medication -portfolio folder containing preceptorship policy, KSF outline, job description, competencies, training and supervision documentation

31. What can a preceptee expect? Allocated preceptor. Supernumery time. 1-1 time with their preceptor. Documentation appropriate to their speciality. Visits from the Preceptorship Lead. Incremental rises at 6 and 12 months.

32. Developments. Preceptor workshops. Third year student sessions. Preceptorship module being developed by Coventry University. Continued 1-1 support for preceptees and preceptors. Collaborative working with Practice Educator.

33. Thank you for listening. Any Questions? Wendy Donoghue. 024 76 321489. 07776 225984.

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