m e ^ a s u e a in e colu m n
A case for continuing education George Castledine, Birmingham Polytechnic
f you have ever been tempted to work in a nursing home on a cas ual basis to supplement your income — then think again. Evidence from a recent U K C C professional con duct hearing demonstrates that tak ing on added responsibilities and ex panded roles without adequate edu cation and preparation may lead to a charge of professional misconduct. The case involved a registered nurse who had worked several nights in an accident and emergency unit. For economic reasons she wanted to work some more nights. Unfortunately the hospital was well staffed and was unable to meet her requests.
I
Easy option She therefore arranged to work in a nursing home thinking that this would be an easy option and a good supplement to her income. This ar rangement led to six charges of pro fessional misconduct. These were: la. That you, for an unknown per iod between said dates, while em ployed as a registered nurse at said nursing home, adopted the practice of failing to complete rounds to check on patients at the home during Professor Castledine is Head of Department of Nursing and Community Health, Birmingham Polytechnic, Perry Barr, Birmingham B42 2SU
246
the course of your night duty, lb. That having adopted such a prac tice . . . you are guilty of misconduct. 2a. That you, for an unknown per iod between certain dates, while em ployed as a registered nurse at said nursing home, adopted the practice of falling asleep during the course of your night duty. 2b. That having adopted such a prac tice . . . you are guilty of misconduct. 3a. That you, on the night of a cer tain date while employed as a regis tered nurse at said nursing home, slept during the course of your night duty. 3b. That having so slept . . . you are guilty of misconduct. 4a. That you on a certain date, while employed as a registered nurse at the said nursing home, told two nursing assistants to say that you had turned a patient at approximately 3 a.m. to 4 a.m. during the preceding night shift when you had not done so, and that having so advised two nursing assistants to say that you had turned a patient at such a time when you had not, you are guilty of miscon duct. 5a. That you, on a certain date, while employed as a registered nurse at said nursing home, advised two nursing assistants that you had checked a patient at 3 a.m. when you had not done so. 5b. That having advised two nursing assistants that you had so checked a patient when you had not, you are guilty of misconduct. 6a. That you, on a certain date, while employed as a registered nurse at the said nursing home, advised two nursing assistants that a patient must have died at some time between 3 a.m. and 6 a.m. when you had no indication that this was the case. 6b. That having advised two nursing assistants that a patient must have died at this time, when you had no indication of this, you are guilty of misconduct.
The nurse was found guilty of misconduct on all six charges and in vited to account for her misdemean ours. From her hospital references and what she said it was obvious that although she was reasonably prepar ed in one area of work, i.e. emerg ency nursing, she was not up-todate in the other sphere of nursing, i.e. care of the elderly and the dying patient. In fact she said she had re ceived no post-registration continu ing education and that opportunities and support for her from her em ployers were not forthcoming. So whose fault was it — the employers for not sending her on educational courses or the nurse herself for not trying to keep up-to-date and edu cated?
PREPP From my experience of listening to professional conduct cases such as this one and from my travels around the U K it seems that there is a sig nificant number of nurses who do not know what PREPP and continu ing education are all about. Without going into a detailed review of PREPP (U K C C , 1990) I think it is fairly clear that PREPP means con tinuing education and not in-service training or staff development. Al though these terms are often used interchangeably by nurses they should not be seen as synonymous. In-service training is a traditional term which relates to a hospital’s in terest in helping its nurses maintain and gain skills which ultimately will help the organization. Generally, inhouse learning programmes and sessions are developed by employees of the institution. The teaching, of ten by unqualified teachers, is con ducted on hospital premises or in the work setting. Staff development is broader but is often used to describe the same kind of learning programme and fre quently includes learning experi-
British Journal of Nursing, 1992,Voi l,N o 5 Downloaded from magonlinelibrary.com by 130.237.122.245 on January 18, 2019.
A case for continuing education
cnees outside the hospital or em ploying agency. Sometimes outside training agencies are brought in spe cifically to target certain employees and give them the information they need in order to function effectively. This often occurs when a complaint has been made or assessment reveals weaknesses in the system. O f necessity, a large proportion of such programmes are devoted to orienta tion, safety, security, quality assur ance, standards, personnel policies and indoctrination into the general policies and procedures, goals and objectives of the institution. Such in formation is, of course, very valu able and will increasingly become more varied as the number of NH S trusts develop their own styles of management and organization. Unfortunately, much ol the knowledge gained in this way is not necessarily going to relate or be transferable to another situation. There is also the problem of the in stitution’s educational interests tak ing priority over professional nurs ing requirements and the individual nurse’s needs. Orientation indoctrination is a perfectly legitimate pursuit, for it is
not continuing education and at present employers are not obliged to provide anything else. It could be ar gued that it is a good thing that they do not get too involved in continu ing nurse education because if they did they may go for the cheapest and simplest option which may stifle and narrow the scope of a nurse’s prac tice. D u ty The U K C C expects that once regis tered, each nurse, midwife and health visitor has a duty to keep upto-date and be responsible and ac countable for his/her own education and personal development. Broadly speaking that is what continuing education is all about. It consists of planned systematic learning experi ences, designed to enlarge the knowledge, skills and attitudes of a nurse so that it not only keeps a nurse’s practice current, but devel ops his/her potential professionally and personally. Continuing education is a life long process and, judging from the high average age of people graduat ing from Open University courses, more and more older people are now
able to partake in such activities. Nowadays the strategies used in continuing education are not limited to traditions of classical education, e.g. the formal classroom lecture. Today more unconventional ap proaches are being used to meet the special needs and demands of adult learners (Burnard and Chapman, 1990). However, it is not always easy to identify experiences that will en hance nursing practice and develop the individual nurse. Knowledge deficits usually fall into two categor ies — information lost, i.e. forget ting, and newly discovered knowl edge from research. Clearly each nurse must accept the professional responsibility for identifying and seeking the learning experiences that will meet his/her own special needs. If they do not, then the number of cases of professional misconduct re lating to lack of continuing educa tion may rise. f Burnard P, Chapman C (1990) Nurse Educa tion. The Way Forward. Scutari Press, London. U K C C (1990) The Report of the Post-regis tration Education and Practice Project. U K C C , London.
MAKE SURE OF YOUR COPIES OF BJN If you are having trouble obtaining a copy of British Journal of Nursing from your local newsagent then please get in touch with us immediately and we will ensure that your copy of BJN keeps on coming. Now post this form to: The Publisher BJN, Croxted Mews, 288 Croxted Road, London SE24 9DA. (Tel: 081-671 7521).
NAM E.... ADDRESS
SPECIALTY............................................................................TEL No NAME AND ADDRESS OF LOCAL NEWSAGENT........................
BrUish Journal of Nursing, 1992, Vol 1, No 5
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Downloaded from magonlinelibrary.com by 130.237.122.245 on January 18, 2019.
A case for continuing education George Castledine, Birmingham Polytechnic
f you have ever been tempted to work in a nursing home on a cas ual basis to supplement your income — then think again. Evidence from a recent U K C C professional con duct hearing demonstrates that tak ing on added responsibilities and ex panded roles without adequate edu cation and preparation may lead to a charge of professional misconduct. The case involved a registered nurse who had worked several nights in an accident and emergency unit. For economic reasons she wanted to work some more nights. Unfortunately the hospital was well staffed and was unable to meet her requests.
I
Easy option She therefore arranged to work in a nursing home thinking that this would be an easy option and a good supplement to her income. This ar rangement led to six charges of pro fessional misconduct. These were: la. That you, for an unknown per iod between said dates, while em ployed as a registered nurse at said nursing home, adopted the practice of failing to complete rounds to check on patients at the home during Professor Castledine is Head of Department of Nursing and Community Health, Birmingham Polytechnic, Perry Barr, Birmingham B42 2SU
246
the course of your night duty, lb. That having adopted such a prac tice . . . you are guilty of misconduct. 2a. That you, for an unknown per iod between certain dates, while em ployed as a registered nurse at said nursing home, adopted the practice of falling asleep during the course of your night duty. 2b. That having adopted such a prac tice . . . you are guilty of misconduct. 3a. That you, on the night of a cer tain date while employed as a regis tered nurse at said nursing home, slept during the course of your night duty. 3b. That having so slept . . . you are guilty of misconduct. 4a. That you on a certain date, while employed as a registered nurse at the said nursing home, told two nursing assistants to say that you had turned a patient at approximately 3 a.m. to 4 a.m. during the preceding night shift when you had not done so, and that having so advised two nursing assistants to say that you had turned a patient at such a time when you had not, you are guilty of miscon duct. 5a. That you, on a certain date, while employed as a registered nurse at said nursing home, advised two nursing assistants that you had checked a patient at 3 a.m. when you had not done so. 5b. That having advised two nursing assistants that you had so checked a patient when you had not, you are guilty of misconduct. 6a. That you, on a certain date, while employed as a registered nurse at the said nursing home, advised two nursing assistants that a patient must have died at some time between 3 a.m. and 6 a.m. when you had no indication that this was the case. 6b. That having advised two nursing assistants that a patient must have died at this time, when you had no indication of this, you are guilty of misconduct.
The nurse was found guilty of misconduct on all six charges and in vited to account for her misdemean ours. From her hospital references and what she said it was obvious that although she was reasonably prepar ed in one area of work, i.e. emerg ency nursing, she was not up-todate in the other sphere of nursing, i.e. care of the elderly and the dying patient. In fact she said she had re ceived no post-registration continu ing education and that opportunities and support for her from her em ployers were not forthcoming. So whose fault was it — the employers for not sending her on educational courses or the nurse herself for not trying to keep up-to-date and edu cated?
PREPP From my experience of listening to professional conduct cases such as this one and from my travels around the U K it seems that there is a sig nificant number of nurses who do not know what PREPP and continu ing education are all about. Without going into a detailed review of PREPP (U K C C , 1990) I think it is fairly clear that PREPP means con tinuing education and not in-service training or staff development. Al though these terms are often used interchangeably by nurses they should not be seen as synonymous. In-service training is a traditional term which relates to a hospital’s in terest in helping its nurses maintain and gain skills which ultimately will help the organization. Generally, inhouse learning programmes and sessions are developed by employees of the institution. The teaching, of ten by unqualified teachers, is con ducted on hospital premises or in the work setting. Staff development is broader but is often used to describe the same kind of learning programme and fre quently includes learning experi-
British Journal of Nursing, 1992,Voi l,N o 5 Downloaded from magonlinelibrary.com by 130.237.122.245 on January 18, 2019.
A case for continuing education
cnees outside the hospital or em ploying agency. Sometimes outside training agencies are brought in spe cifically to target certain employees and give them the information they need in order to function effectively. This often occurs when a complaint has been made or assessment reveals weaknesses in the system. O f necessity, a large proportion of such programmes are devoted to orienta tion, safety, security, quality assur ance, standards, personnel policies and indoctrination into the general policies and procedures, goals and objectives of the institution. Such in formation is, of course, very valu able and will increasingly become more varied as the number of NH S trusts develop their own styles of management and organization. Unfortunately, much ol the knowledge gained in this way is not necessarily going to relate or be transferable to another situation. There is also the problem of the in stitution’s educational interests tak ing priority over professional nurs ing requirements and the individual nurse’s needs. Orientation indoctrination is a perfectly legitimate pursuit, for it is
not continuing education and at present employers are not obliged to provide anything else. It could be ar gued that it is a good thing that they do not get too involved in continu ing nurse education because if they did they may go for the cheapest and simplest option which may stifle and narrow the scope of a nurse’s prac tice. D u ty The U K C C expects that once regis tered, each nurse, midwife and health visitor has a duty to keep upto-date and be responsible and ac countable for his/her own education and personal development. Broadly speaking that is what continuing education is all about. It consists of planned systematic learning experi ences, designed to enlarge the knowledge, skills and attitudes of a nurse so that it not only keeps a nurse’s practice current, but devel ops his/her potential professionally and personally. Continuing education is a life long process and, judging from the high average age of people graduat ing from Open University courses, more and more older people are now
able to partake in such activities. Nowadays the strategies used in continuing education are not limited to traditions of classical education, e.g. the formal classroom lecture. Today more unconventional ap proaches are being used to meet the special needs and demands of adult learners (Burnard and Chapman, 1990). However, it is not always easy to identify experiences that will en hance nursing practice and develop the individual nurse. Knowledge deficits usually fall into two categor ies — information lost, i.e. forget ting, and newly discovered knowl edge from research. Clearly each nurse must accept the professional responsibility for identifying and seeking the learning experiences that will meet his/her own special needs. If they do not, then the number of cases of professional misconduct re lating to lack of continuing educa tion may rise. f Burnard P, Chapman C (1990) Nurse Educa tion. The Way Forward. Scutari Press, London. U K C C (1990) The Report of the Post-regis tration Education and Practice Project. U K C C , London.
MAKE SURE OF YOUR COPIES OF BJN If you are having trouble obtaining a copy of British Journal of Nursing from your local newsagent then please get in touch with us immediately and we will ensure that your copy of BJN keeps on coming. Now post this form to: The Publisher BJN, Croxted Mews, 288 Croxted Road, London SE24 9DA. (Tel: 081-671 7521).
NAM E.... ADDRESS
SPECIALTY............................................................................TEL No NAME AND ADDRESS OF LOCAL NEWSAGENT........................
BrUish Journal of Nursing, 1992, Vol 1, No 5
247
Downloaded from magonlinelibrary.com by 130.237.122.245 on January 18, 2019.
