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Appendix One
Draft guidance from the Nursing and Midwifery council on the role of registered nursing staff during an influenza pandemic
The Nursing and Midwifery Council ( NMC) is the UK regulatory body for nurses and midwives. Our primary aim is to protect the public. The NMC is required by the Nursing and Midwifery Order 2001 1 (the Order) to keep a register of practitioners eligible to work in the UK, and to set standards for education, training and conduct for those on the register (registrants). Currently, there are more than 682,000 nurses, midwives and specialist community public health nurses on the register.
The Order also requires the NMC to establish, and keep under review, effective arrangements to protect the public from registrants whose fitness to practice is impaired.
1. Scope of practice for nurses, midwives and specialist community public health nurses ('registrants')
The NMC code of professional conduct: standards for conduct, performance and ethics informs the professions of the standard of professional conduct and provides a benchmark for practice.
There is no legal definition of a nurse or specialist community public health nurse. However, only a registered midwife with a current Intention to Practice ( ITP) can provide care or advice to a woman in relation to her pregnancy, whether antenatally, intranatally or postnatally. Midwives can extend their scope of practice to provide nursing duties if they are competent to do so.
All registrants are expected to practice within their competency level and acknowledge the limitations of their professional practice. If faced with any aspect of practice that is either outside their area of registration or beyond their competency level, they must seek supervision or advice from a competent practitioner.
In accordance with the NMC code of professional conduct, all registrants are accountable for their actions or omissions regardless of advice or guidance given by another professional. As such, registrants are able to extend their scope of practice, within the healthcare legal framework, but must ensure they have the knowledge and skills to do so in a competent manner. If competency levels are not adequate, support and supervision must be sought from a competent practitioner.
If working outside their normal area or scope of practice, registrants must consider their duty of care to the public. Their first consideration in all activities must be in the interests and safety of the patient/client.
Registrants will not be professionally compromised provided they are competent (and have been assessed as such) to carry out any practice being requested by the employer. They remain answerable at all times for their actions or omissions.
Medicine legislation is very specific about the administration of medications under Patient Group Directions ( PGDs). Registrants must not delegate the administration of these medications; only the registrant identified on the PGD documentation can supply and administer them (Add link to NPC).
2. Registration
Nurses who are not registered with the NMCcannot work as registered nurses in the UK. They can, however, be utilised in a supportive capacity. If unregistered nurses are utilised in this way, their role must be clearly identified in order to protect the public.
Employers and managers are responsible for checking whether their employees are registered with the NMC. Further information on how to do this can be found on the Confirmation Services page of the website www.nmc-uk.org
3. Students
Students of nursing and midwifery are required to undertake the approved curriculum of the programme they join, and to complete that programme in five years full time or 7 years part time. Any minor modification of their programme can be made by the HEI, but where these modifications impact on regulatory requirements, the matter would need to be referred to the NMC.
Students should remain on their programme whenever possible but where contingency plans are activated, the action taken should not disadvantage them. Within contingency planning, where the situation is deemed safe and appropriate, it would be appropriate for students to participate in the giving of care as long as they are considered competent to do so. Similarly, they must be provided with an appropriate level supervision depending on their stage of training and the care they are providing. Should the experience not be considered suitable or safe, the decision should be taken to remove students from the situation until it is considered safe or appropriate for them to return. The usual approach would be for this time to be used for study.
It would be unacceptable for students to be temporarily removed from the programme and utilised as healthcare assistants. Should the student wish to provide volunteer work as a healthcare assistant in their own time, or apply for a role as such, they have the right to do so as a member of the general public. However, they should not feel compelled to undertake this role.
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