Competence, education and careers in neonatal nursing: RCN guidance

1. Competence, education and careers in neonatal nursing:RCN guidance Debra Teasdale MSc, PGCLT, RN, ENB 405, 998, A19. HoD Health, Wellbeing and Family, Canterbury Christ Church University RCN PNIC Forum - now RCN Acute Care Forum

2. 1. Career Development for Neonatal Nurses Must be equitable, transparent and transferable 5 key components; 1. Level of practice 2. Minimum professional / educational requirements 3. Competence level / broad description of role 4. Continuous professional development 5. Relationship to SfH Career framework (2006) ( NB this is not the same as the KSF banding )

3. Novice / New Entrant (Level 5 SfH)

4. The novice neonatal nurse… • …may remain at this level, maintaining competence but should be encouraged and supported to develop further to prepare for the specialist course. • Or undertake post registration qualification in Neonatal nursing (special, high dependency and intensive care) to support development of Competence and Core Skill as neonatal nurse (QIS) status • And works towards Neonatal Nurse (QIS) Competence and Core Skills under direct supervision of NMC qualified mentor in high dependency and Intensive care environments……to become….

5. Competent QIS Nurse - SfH Level 6

6. The Competent neonatal nurse may….. • The neonatal nurse may remain at this level, maintaining competence or may choose to develop further. • Undertake study in neonatal nursing at honours degree/postgraduate level to support development of competence and core skill at experienced neonatal nurse status and potential role development. • Works towards competence and core skills for experienced neonatal nurses under the supervision of an experienced nurse with sign-off mentor qualification.

7. Proficient QIS nurse – SfH level 6/7

8. The Proficient Neonatal Nurse may… • The neonatal nurse may remain at this level, maintaining competence or may choose to develop further. • Undertake postgraduate study to support future role development and the development of competence as an expert neonatal nurse. • For clinical practice role development works towards Core Skills for expert neonatal nurses (or locally determined equivalent) under supervision (expert nurse with an NMC approved sign-off mentor qualification or an appropriately qualified member of the medical team)

9. Expert QIS nurse – SfH Level 7/8

10. The ANNP role • All the problems with QIS recognition across the country are mirrored within the ANNP role • The guidance recognises that ANNP development is a journey and that roles are disparate • To address this it provides exemplar job outlines agreed by representatives across all 4 countries for trainee, ANNP, Senior ANNP

11. 3. Competences: What has been determined?

12. RCN Guidance; Competences for Neonatal Nursing Careers • Family centred and developmental care implicit • Competences embedded across career journey. • KSF (NHS, 2004) core dimensions. • Clear relationship to levels of practice with increasing complexity as careers progress • Where the primary remit is clinical, this includes demonstration of a core skill set • Communication and interpersonal relationships • Personal, professional and people development • Health, safety and security • Service development • Quality • Equality, diversity and rights • Responsibility for patient care (Core skill set)

13. EG; Communication and Interpersonal relationships • Including data processing and management, production and communication of information and knowledge, and the design and production of visual records. • The neonatal nurse will use a wide range of media to communicate effectively with babies, parents, carers and health care workers. • The neonatal nurse will demonstrate interpersonal behaviour and skills conducive to developing and maintaining therapeutic and professional relationships. The elements of this are; • Communicate effectively with babies, families, relatives, carers and other professional colleagues. • Act as the neonate’s advocate. • Maintain effective and supportive communication within the neonatal nursing team and with other professionals. • Contribute to creating an environment that fosters open communication and trust with families and colleagues. • Liaise with health care professionals and individuals in other disciplines from within and outside the organisation to support quality patient care.

15. 3a) CORE SKILLS SET Core skills specifically relate to patient care (Responsibility for patient care). • Fluid, electrolyte, nutrition & elimination management • Neurological & pain management • Respiratory & cardiovascular management • Skin, hygiene & infection control management • Temperature management • Bereavement management • Investigations & procedures • Equipment

18. 4. Recommendations Four Areas for action • Recruitment and retention • Partnerships with educational providers • Developing a relevant curriculum • Continuing professional development

19. RCN guidance - working in practice. Foundation Course ; • New entrant competences provides focus for in-house course in practice under supervision of mentor / practice educator QIS Staff new to the unit; • Competence grid can be used to assess capabilities and then create action plan where development needed, or provide clear rationale for accelerated career progress. Established staff; • Allows prior practical experience of staff to be acknowledged and education plan individualised • Supports network approach to maintaining currency of knowledge and skills (rotational posts) .

20. Partnership with education providers Educational needs analysis • Use to inform and map workforce development and educational plans in practice Working with education partners; • ‘Competent’ level competences and skill set to determine practice outcomes for QIS courses in APT • Placements to support care level development • Influence child and midwifery pre-reg’ programmes so potential recruitment pool becomes wider (must have neonatal content and 4 week placement)

21. Demonstrating FtP Developing robust performance management; • Use the Career grid to guide expected educational attainment/ development pathways • Use competence levels to determine the required FtP standard to be met to as part of appraisal and/or promotion process Commissioners • Using this as a benchmark in commissioning process for neonatal nursing care delivery • Should extend to educational commissioning also

22. Thank you