Supervisor preparation TNA Supervisor preparation

Programme Aims The programme aims to: Produce compassionate, competent and confident nursing associates at academic level 5 Nursing associates qualified to deliver a wide range of clinical, care and inter-personal skills underpinned by a systematic knowledge base. Nursing associates able to practice safely and effectively within their parameters of practice, demonstrating appropriate values and behaviours in a wide range of health and care settings. Preparation with NMC regulation in mind

Areas for learning and assessment Domain 1: Professional Values and Parameters of Practice: Domain 2: Person-Centred Approaches to Care: Domain 3: Delivering Care: Domain 4: Communication and Inter-Personal Skills: Domain 5: Duty of Care, Candor, Equality and Diversity: Domain 6: Supporting Learning and Assessment in Practice: Domain 7: Team-working and leadership: Domain 8: Research, Development and Innovation:

A work based programme Trainee nursing associates will be employed in one of three heath and/or care settings: Away from Home Close to home At home. The setting in which the trainee nursing associate is employed will be their primary placement. In addition, the trainee nursing associate will experience at least two alternative substantial external placements, one in each of the other two settings, in order to demonstrate breadth of experience across settings and achieve the specific learning outcomes of the programme.

NA expected to Support nursing care across a wide range of settings Work under leadership and direction of RN Work within all aspects of nursing process HOWEVER The registered nurse will retain responsibility as primary assessor, planner and evaluator of care.

They will: appreciate the importance of the registered nurses’ role in performing a holistic assessment prior to planning care. appreciate the need for them, as nursing associates, to utilise their own skills of ongoing assessment and evaluation in order to identify when an individual needs their plan of care re-visiting, be this due to improvement, deviation or deterioration of needs. extend the capacity and capability of the nursing workforce allowing registered nurses to focus more specialist care and advanced practice.

NA’s will not Act autonomously to change the prescribed plan of care Act autonomously in situations where they may be limits to confidentiality, for example in safeguarding situations Decide to make specialist referrals Decide to share information across multi-agency boundaries Resolve and interpret of risk issues (they must be able to identify risk and halt practice if necessary). Decide to discharge an individual from a service Manage situations of conflict or risk beyond immediate actions to maintain safety. Administer medicines under a patient group directives. Prescribe medicines

Generic Characteristics a) knowledge of and critical understanding of the established principles in their field of study, with awareness of the limits of their knowledge b) knowledge of the main methods of enquiry in the subject and the ability to use established techniques to undertake critical analysis of information to propose solutions c) the ability to critically evaluate the appropriateness of different approaches to solving problems and to apply these in a work context d) the ability to apply knowledge and skills to new situations, including in the workplace e) effective communication skills in a variety of forms, for a range of audiences

Work Based learning a) is a well-established educational theory. b) can take many forms and should be designed to meet the specific needs of the Nursing Associate Training Programme and the trainee nursing associate’s working role, the relevant employment sector and the type of employer. c) could involve any (or all) of the following work-based learning types; learning through work, learning for work and learning at work.” d) Placements should provide appropriate environments for trainee nursing associates to achieve specific, negotiated learning outcomes. The work environment should be able to support learner- managed, reflective learning and practice at the appropriate levels. e) constructed around developing and using specific and transferable skills. f) should provide authentic opportunities for trainee nursing associates to work, develop and learn and to apply the skills and knowledge that they have acquired. Working in itself is not sufficient.

Supervision Supervision is primarily concerned with: sharing, demonstrating and providing support; confidence-building; encouraging and developing reflective practice; developing appropriate skills and competence; supporting learning; providing any required guidance, sign-posting and information and helping the trainee nursing associate to make progress.

Supervision Trainee nursing associates should have: appropriate supervision in any/all work-based contexts. appropriate supervision across the whole programme that will monitor and direct a trainee nursing associate’s progress over time. Such supervision will provide proper support in the trainee nursing associate making the necessary clinical and educational progress.

Who can supervise? Supervision might be undertaken by: an appropriate manager or registered healthcare professional. The term ‘manager’ is used to identify an occupationally competent person who may be in a position to supervise and or delegate to support workers. The term ‘health and/or care professional’ refers to a registered health or care professional from any profession. For the purposes of this programme the term ‘supervisor’ is used to cover both health and social care.

Supervisors and Support Base placement: primary supervisor ? associate supervisor Alternative placement: Secondary supervisor Additional Support: University Link Clinical Link

Levels of supervision Direct/guidance supervision (Year 1) - the trainee nursing associate must be in the line of sight of the supervisor who is present to observe tasks and activities and can intervene immediately if required. Direct supervision should be maintained until the trainee nursing associate is assessed as being safe to leave alone to undertake the directed activity(ies).

Levels of supervision Have had appropriate training Indirect /remote supervision/ (Year 2) – where there is reliance on processes being in place to provide guidance and support without the supervisor actually being present. This requires the trainee nursing associate to: Have had appropriate training Have been assessed as competent to perform the task safely and effectively without direct supervision (competence – knowledge, skills, attitudes and ability to practice) Know their limitations Know when and how to seek advice from the supervisor.

Supervision Phased sign off in staged movement from direct to indirect supervision forms the basis of assessment on this programme. However While retaining accountability, registered nurses may hand over responsibility to trainee nursing for specific tasks or areas of work that are within their competence and confidence. Registered nurses may also assign specific tasks or areas of work (within their competence and responsibility) to trainee nursing associates. That is, they can hand over responsibility and accountability.

Areas to think about in supervision: Exploring a new and different emphasis on working holistically with individuals in settings that are different from those experienced in the trainee nursing associate’s primary placement. Gaining a greater appreciation of unfamiliar roles and services. Gaining an improved understanding of more strategic and wider considerations in health and care. Gaining insight into pre-life to end-of-life care. Understanding of nursing in and across different settings and the perspectives and pathways of individuals, their families.

Competence Evidence of attainment of competence is required for or successful completion of the trainee nurse associate programme. Competence is regarded by the Nursing and Midwifery Council as a holistic concept that they define as: “The combination of skills, knowledge and attitudes, values and technical abilities that underpin safe and effective nursing practice and interventions” (Adapted from Queensland Nursing Council 2009). This same principle will be applied in this programme.

Evidence of achievement A clinical skills map in which it their responsibility to demonstrate developing competence across a range of skills. The levels of achievement are: You have observed the procedure in the practice setting - Level 1 You have participated in the skill under direct supervision - Level 2 You have performed the skill on a number of occasions and required minimal supervision - Level 3 You can perform the skill safely and competently, giving the rationale for your actions - Level 4 You have taught the skill to others – Level 5

The skills map The trainee nurse associates may be at a level around 3 in some skills at the beginning of the programme and it is anticipated that they will be able to identify these with their clinical lead/manager. The programme really aims to get these individuals to be practicing at levels 4/5 and the important difference for them is to give rationale and teach others.

Other forms of assessment The Practice placement documents which assess the application of professional knowledge and evidence across the following domains: Professional and ethical values Care delivery Care management Personal and professional development The portfolio which enables the trainee to reflect on their developing skills

Points of review Preliminary: Within the first week to meet with primary supervisor to develop a plan of learning that will enable the trainee to meet their outcomes in both primary and alternative placements. NB: No super-numerary status but still trainees/learners and action plans need to reflect learning needs and action points. Intermediate: As many times as the primary/secondary supervisor feels necessary and, at these points, they may identify areas that have been met and areas that need developing further. Professional values will also be assessed at this point. If there is any indication that a trainee is likely to fail or is not progressing the supervisor(s) should contact the programme leader in order to develop a learning plan. Final: To undertake final signing of competencies at PASS/FAIL

Record of hours A record of hours in practice must be kept by the trainee and confirmed by the super visor at the end of each unit. This is important for when the role becomes regulated by the NMC and the NA seeks registration.