Questioning

Here in Manchester  this week as we reflect on the terrorist attack at the Arena and the aftermath inevitably the question being asked is why? Staff and students are urged to support everyone who is affected in any way by this tragic event. Many of our students are on placements in hospitals that are caring for those affected by the attack. AskUS is a first point of contact for students or staff if you would like to talk about what has happened.

There have been many reports commenting on the dedication, commitment and professionalism of health care professionals in the city such as this one from the Manchester Evening News on 25 May 2017

The NHS heroes who came to Manchester’s aid in the city’s darkest hour

Such an atrocity leads to individuals, families and communities needing to deal with the consequences of trauma and acute stress. You may find it helpful to listen to a Beyond Belief broadcast from 12 September 2016 which reflected upon terrorist atrocities in France, Belgium and Germany and sought to examine the reaction of individuals to trauma.

The University of Salford is a multicultural, multi ethnic and multi faith community which is committed to supporting all its students and staff.  The campus has a Faith Centre with extensive facilities which offers a safe space for everyone; whether they express a faith or not, to question ideas and experiences and build positive relationships between all members of the university community, or somewhere just to relax and contemplate your own questions in a pleasant environment in peace and quiet away from the bustle of university life. 

Whatever your beliefs the Christian, Jewish and Muslim Chaplains would be delighted to talk with you; in confidence, about anything you like. As Einstein said “the important thing is not to stop questioning”. He also commented “any fool can know, the point is to understand”.

At this time of year there are many individuals preparing to answer questions and so demonstrate their understanding; either in examinations or assignments.  Some may feel they have prepared well; others may fear they have not done enough or perhaps even some have done too much.  All probably wish to give a good answer to the questions they are asked. Voltaire reputedly said “judge a man by his questions rather than by his answers”; something for students to ponder perhaps when they are wondering whether their answers really respond to the questions of their assessors. Some individuals may feel a greater empathy with another of Voltaire’s sayings “the more I read, the more acquire, the more certain I am that I know nothing”.

Many students will be looking forward to the end of the programmes of study and for what their future career will bring.  Some will have already made that first application for their first job as a registered practitioner and some are feeling the increasing need to take that step.  Undoubtedly as part of that process will be the interview.  It is important to remember that interview should be two-way processes; the interviewer will certainly have many questions that they wish to ask the interviewee but the most productive interviews are where the interviewee reciprocates the questioning process.  Both parties have a vested interest to get to know each other as individuals and to really listen to the answers to their questions. This is not dissimilar to how practitioners should engage with their clients in order to ensure that the client’s needs are fully understood and responded to in a meaningful manner.  Assessment if we are not careful can appear like an inquisition from the patient’s perspective.  It takes real skill to gently probe a client’s history in a manner which makes them feel supported and encouraged to participate in their care. It is also important that pertinent information is shared appropriately across professional groups to avoid the criticism from clients that they are repeatedly asked the same questions by different groups of staff.

We should be encouraging our clients to ask questions about their treatment and their care.  It is our responsibility to work in partnership with our clients and to empower them to make decisions about their care.  In doing so we must facilitate their knowledge and understanding of their own health and wellbeing and actively support them to ask questions about their care and treatment and how to access relevant health and social care information.

The amount of information that is available to us today through various multimedia can be stimulating and thought-provoking but can also be overwhelming.  How do we effectively discriminate the helpful places to seek out information whether we are clients, practitioners or students? NHS choices is a useful place for individuals to start to look for answers to their questions about their healthcare.

Reflecting on our practise allows us an opportunity to question our own engagement and approach to our professional activities.  It is important to reflect upon our own individual progress; to ask ourselves what we can do now that we could not do a year ago? And what will we be able to do this time next year?  Is it more important to have done or to have said more?  Ask yourself what is the single most important thing you have learnt in the last year?  What makes you do better?  The shortest questions are frequently the most challenging; there is simply nowhere to hide when faced with challenging, direct questions.

 

 

 

Professional

Innumerable concepts could have been discussed under the letter “p” but the central and blindingly obvious concept that should be discussed in a blog which is called A-Z professional nurse; must be that of “professional”. The elephant in the room cannot be avoided.

I am fortunate to live in a community where individuals are willing to help each other out.  All of us can sometimes feel that we have little to offer those around us; but it is frequently in the everyday situations of simply being oneself and offering what one can to those around us that our true humanity is demonstrated.  A recent intervention on behalf of a neighbour has avoided a potential public health catastrophe and maintained cordial relations in the street.  In return the neighbour went out of their way to mend a fence and even took the time to obtain the appropriate covering for the fence.  The challenge was then on to make sure that this kindness was repaid by successful execution of the task.  The comment “that’s a proper professional job” was praise indeed from the diligent and proficient “do it yourself “ neighbour and was warmly received. However, whilst his comment was kind, I am not sure against what standard he had judged my efforts. A quick perusal of web-based information about fence painting contractors appeared to reveal a range of standards. Despite the majority of them claiming to offer a “professional job or service” there does not appear to be a commonly agreed and accepted standard or even a Guild or Regulator who may be able to guide fence painters.

The NMC (2015)

This is not the case for nurses and midwives who have a Regulatory Body, the Nursing & Midwifery Council;(NMC), and a set of professional standards of practice and behaviour set out in The Code. Professionals are individuals who perform a role that requires specialist education, training and skills which are recognised and licensed or registered; as is the case with nurses and midwives, by a professional body; acknowledging the individual as being fit to practise.

The NMC set, review and maintain the Standards for education nursing and midwifery education and practice at both pre and post-registration levels. These standards are required to be met by all nursing and midwifery students on NMC approved programmes prior to entry to the register. This will ensure they are fit to practise at the point of registration. New education Standards are expected to be published by the NMC during 2017.

Here at Salford we have just had the pleasure of facilitating the completion and sign off of the pre-registration nursing programme for individuals who began their professional journey three years ago and so permit their transition to becoming fully fledged professional registered nurses.  It has been as intriguing; as ever, to review some of the comments of those neophyte professionals as they reflected upon what it means to be fit to practise.  In year three of the pre-registration nursing programme students are asked to consider real life case studies to help them appreciate the importance of always following and upholding the standards set out in The Code; not just in their practice as a registered nurse but in their everyday lives.  This approach has helped emphasize their accountability for their practice and that everything they do must be in the interests of the health, safety and wellbeing of the clients in their care.  These neophyte professionals recognise the privilege it is to be a registered nurse and the necessity of ensuring that they continue to develop and extend their competence throughout their professional careers. This week the School has welcomed its latest cohort of pre-registration nursing students and next week they will begin to explore the standards set out in The Code which will guide their development towards becoming a professional registered nurse.

To practise lawfully as a registered nurse in the United Kingdom, practitioners must hold a current and valid registration with the NMC. It is illegal to practise if your name does not appear on the Register; something the School’s most recent completing students absolutely appreciate as they await the arrival of their Personal Identification Number (PIN) with eager anticipation. Further The Nursing and Midwifery Order 2001 makes the illegal use of the protected titles ‘registered nurse’ and ‘midwife’, an offence. None of us would wish to be cared for by an individual masquerading in a professional role for which they were not effectively and lawfully prepared. The title “registered nurseis a protected title; the title “nurse” is not a protected title in the United Kingdom; it is in America, New Zealand and Australia. A petition to Make ‘Nurse’ a protected title to the UK Government and Parliament in April 2014 attracted only 256 signatures. Do you think Making “Nurse” a protected title would restore public confidence and professional pride as the petition suggested?

cc PSA

The Professional Standards Authority  help to protect the public through their work with organisations that register and regulate people working in health and social care. Part of their work involves performance review reports to question the regulators they oversee about their work. Their latest review of the NMC 2015/16 was presented to the NMC on 25 January 2017. The review concluded that the NMC “Met all of the Standards of Good Regulation for Registration”.

Registration Standard 5 is as follows: “Risk of harm to the public and of damage to public confidence in the profession related to non-registrants using a protected title or undertaking a protected act is managed in a proportionate and risk-based manner”.

It is the interests of all registered nurses and the public that the NMC continues to meet this standard.

 

 

Objective

“It is the mararistotle-bustos-756620__340k of an educated mind to be able to entertain a thought without accepting it.” Aristotle

What exactly does it mean to be objective as a Nurse or Midwife?

Nurses and midwives must treat people as individuals and uphold their dignity NMC (2015). In doing so they must remain unprejudiced and non-discriminatory in all aspects of care delivery. Nurses and Midwives should make it their business to challenge poor practice and any discriminatory behaviour and attitudes in relation to client care. Care must be delivered based on facts; not assumptions.

impartial-683942__340Any information or advice which is given by Nurses and Midwives should be evidence-based and not swayed by commercial or financial imperatives. Nurses and Midwives must be impartial and act with honesty and integrity at all times all times. The decisions that Nurses and Midwives make about care interventions should be fair and equitable; they should not be biased in any way. Nurses and Midwives who carry out their practice in this manner will be objective in the delivery of care.

tennis-court-443267__340Relationships with clients, families and carers must always remain professional and not transgress professional boundaries. It can be a challenging task to remain objective and un-involved given the circumstances in which Nurses and Midwives meet with clients and their families. Clients require intervention at times when they are at their most vulnerable but Nurses and Midwives must never to exploit that vulnerability. Perhaps some Nurses and Midwives find it difficult to remain dispassionate and yet still compassionate. Perhaps they worry that their objective engagement with the client may be perceived as impersonal, disinterested or detached; that their objectivity may be seen as just being cold and clinical. Nurses and Midwives are not devoid of emotions and the situations in which they engage are frequently emotionally charged and to suggest otherwise is to deny the reality of care engagement. Being with a family when they have just been told some devastating information is a difficult place to be but also places Nurses and Midwives in the privileged position of being able to support individuals at real points of crisis. Remaining objective at such times contributes to the professional and effective means of support.

Another aspect of the word objective offers a challenge to many students and registrants as they make plans for their careers in the short and long term. An objective is something we plan to do or achieve; a measurable point along the way to achieving a goal; a specific target target-1414775__340 towards a goal.

Objectives are usually short term and goals long term. Objectives may be thought of as the stepping stones stepping-stones-763985__340which we use to cross the river to achieve the goal of reaching the other side. goal-setting-1955806__340