27/03/2012 - The NMC Code of Conduct

#NurChat discusses "The NMC code of conduct" Tues 27th March 8pm 


"The code is the foundation of good nursing and midwifery practice, and a key tool in safeguarding the health and wellbeing of the public" (NMC The code 2008) There is no doubt that the NMCs Code of Conduct is the cornerstone of nursing practice as it is the standard to which all nurses and midwives must adhere to - failure to do so could bring our fitness to practise into question.  However,  the code is currently undergoing a review by the NMC, some things may be added in and some may be taken out but if it were up to you what ammendments would you make ?

The fundemental principles of the existing code are:

  • make the care of people your first concern, treating them as individuals and respecting their dignity
  • work with others to protect and promote the health and wellbeing of those in your care, their families and carers, and the wider community
  • provide a high standard of practice and care at all times
  • be open and honest, act with integrity and uphold the reputation of your profession
As a professional, you are personally accountable for actions and omissions in your practice and must always be able to justify your decisions. You must always act lawfully, whether those laws relate to your professional practice or personal life. (NMC The code 2008)

Given these principles is there anything that you believe shouldn't be a standard to which nurses should abide by ? Or is there anything that you feel isnt covered but should be?  If you were in charge at the NMC what would you take out or put into the code?

Please click on the picture to download a printable / emailable flyer to share with other nurses

Below are some links to background reading that you may find useful - please feel free to add your own links via the comments section.

The Code - NMC

The NMC Code:  conduct, performance and ethics - Nursing Times

Understandingthe NMC code of conduct - a student perspective - Nursing Standard

Members code of conduct - GMC

Codes of Practice for Social Care Workers - GSCC

Code of professional conduct for nurses in Austrailia - ANMC


Summary by Teresa Chinn RN
______________________________________________________
Chat Summary

View our Nursing Times Blog for this chat

The aim of this NurChat was to explore the NMC code of conduct and given the fundamental principles of the code explore if NurChat participants believed that these principles should be in the code.  It also set out to look at what participants would like to see added into the code …. However NurChatters had their own idea and the discussion took a somewhat different course….

The chat kicked off with a comment from @BennyGoodmanUoP “The code proved to be useless in safeguarding pts at MidStaffs & elsewhere. Continues to be useless except 4 discussion”  NurChat continued this theme and asked if the code was useless ? Some stated that the language was very much open to interpretation so meant different things to different people and some stated that we shouldn’t need a code as good, holistic care is just part of being a nurse. Others expressed that the code is the cornerstone for good care but has no driving force in the quality of care.

The discussion swiftly moved on and participants asked if nurses really knew the code and asked about the role of nurse leaders in monitoring and enforcing the code – participants expressed worries that leaders weren’t developed and supported enough to do this.  It was then asked who’s responsibility it was to ensure individual nurses are aware of the code? Opinions varied with some looking to nurse leaders and some stating that it is the individuals responsibility and some adding that often resources were needed in order to comply.  Nurchat asked if it was more of an issue that nurses need a greater understanding of the code .. and not the wording ? One participant stated that the code is a useful learning document but the issue is really the interpretation and context.

The discussion then explored the code as a punitive document. There was some debate around this and some participants thought that there is too much emphasis on it being punitive rather than assisting nurses to strive for excellence.

NurChat asked if leadership was a key theme that should go into the code?  The general opinion was that nurses lead at all levels and the code and training should reflect this.  

The point in the code that states “you must uphold the reputation of your profession at all times” was discussed and NurChat asked if this was needed? Most NurChatters agreed that it was needed as nurses are advocates for their organisations and the NMC and nursing in and outside of work.

NurChatters generally agreed that examples of the code in practice would be very useful.  All agreed that both patient and staff stories were powerful tools

The way in which situations in working life can sometimes cause nurses to not abide by the code was debated, short staffing levels affecting care, two emergencies at once, poor organisational culture.  It was agreed that this can make nurses vulnerable.  It was suggested that maybe in this situation nurses could use the code to raise awareness with employees of the standards of care.  

Towards the end of the chat NurChat asked if there was one thing that participants could add in or take out of the code what would it be?

@moosewild stated “I’d add the NMC will support you in applying the code to practice-humour me please ;)”

@EileenShepherd tweeted “Practical application”

@dgfoord said “I would add leadership in, at point of care and for nurses in more specific leadership roles”

Summary by Teresa Chinn RN

______________________________________________________
Chat Cloud - click to expand

This chat cloud shows the key themes of the chat

______________________________________________________
Chat Transcript (via Storify)

13/03/2012 - Should we bring back the EN ?

#NurChat to discuss “Should we bring back the EN?” 8pm 13/03/2012 Share with a   

The Enrolled Nurse (EN) role started in 1943 due to a period of staff shortages and financial pressures, the great depression, in the 1930’s that led to more unregulated nursing assistants being employed. (RCN)  In 1986 the UKCC (now NMC) said that the role was no longer fit for purpose and training for ENs was phased out.

Many recent reports have criticised nurses for not getting fundamental care right and even Prime Minister David Cameron identified recently that the standards of nursing need to be raised. So is there a place for EN’s in modern nursing? Do we need a two tier nursing system ? Should the NMC use part two of the register to re- introduce the EN? Or is the role of the practical EN now defunct in our highly educated nursing workforce? 


Thanks goes to @cherylwilson2 for this discussion suggestion

Please click on the picture to download an emailable & printable flyer to share with other nurses

Below are some links to some background reading – please feel free to add to this, via the comment box, if you find something useful to share.


Summary by Teresa Chinn RN

_______________________________________________________________

Post Chat Summary

View the Nursing Times blog for this chat

“Should we bring back the EN?” was a discussion subject suggested by @cherylwilson2 and it is a subject that has been touched upon in a few NurChat discussions, but never really discussed in full. The chat started by asking if anyone remembered the role of the EN? There were a few nurses who had trained as ENs and had either converted or were still on Part 2 of the register. Many participants remembered ENs as having good hands on skills and being experienced and committed.

One participant suggested that it was a sad day for nursing when the EN went and many agreed it was pointed out that RNs delegate fundamental care often to unskilled/ untrained HCAs and ENs were needed to bridge that gap. Another participant mentioned that we should not bring back the EN as this would lead to a 2 tier system and patients often get confused over who is who with RNs and  HCAs.

The role of the Assistant Practitioner was discussed and one of the participants was an AP. It was discussed that some trusts are bridging the gap between RN and HCA with the use of APs.  However it was pointed out that APs are unregulated.  Why AP’s cant be registered was discussed and most chatters agreed that there would be room on Part 2 of the register. Some stated that we do need to give new professionals a means to register.

Some NurChatters were unsure of what the role of the EN was so this was discussed: NurChatters stated that the EN was a hands on nurse who was not trained in management but for good hands on care. It was explained that there were several routes to be coming an EN – some had 2 years of pupil training, some had failed their RN final exams and some were long service Nursing Auxiliaries.

Finaly NurChat asked if we should bring back ENs? Answers ranged from a resounding yes to we have to move with the times and maybe the AP role could be adapted and put on Part 2 of the register.  

Summary by Teresa Chinn RN

_______________________________________________________________
Chat Transcript (via storify.com)