Sunday, 12 April 2020

Covid-19 and the nursing response

Roger Watson, Editor-in-Chief

Covid-19 is infecting thousands of people, including nurses and doctors, and killing some of these. The crisis has shown that the United Kingdom National Health Service (NHS) may not have enough nurses to cope. Also, nursing students are being badly affected by this as their nursing education is going to be affected for several months and this will affect their ability to qualify and practice as nurses.

Rumours have spread that many retired nurses will be brought back into practice and that these will not be safe to practice in the health service. Another rumour is that final year nursing students will be ‘fast-tracked’ to qualification and will, also, not be safe to practice. Strictly speaking neither of these is true. I wish to clarify what the situation is.

In the United Kingdom, nursing is regulated by the Nursing and Midwifery Council (NMC). When nurses qualify, they must have passed their final year university examinations and have spent at least 50% of their programme in clinical practice. Then they become Registered Nurses. This means that their names are recorded on the Nursing Register held by the NMC. Nurses who are already registered must continue to meet high standards of practice and continuing education or they can be removed from the register.

In the present crisis the NMC has taken two actions:

Returning retired nurses to the wards
The NMC has created a Covid-19 temporary register and only nurses who have retired within the past three years will be eligible to join this register. These nurses will not have to pay to join this register, but they will have to meet all the standards expected by the NMC. These nurses will only be on the register for as long as they are needed to help with the Covid-19 crisis. Having only left practice in the past three years and, mostly being very experienced, they should quickly fit in an regain their skills. They will have to get up to date with some recent legislation affecting the NHS such as data protection and safeguarding. They will also have to be up to date on observation skills for patients and resuscitation.  These will include ‘early warning’ so that they can spot patients whose condition is likely to get worse and who will need intensive care.

Nursing student education and training
For nursing students the NMC has instructed universities to suspend clinical practice for first year nursing students. They will make up for this in the next two years of their university programme. If first year nursing students wish to work on the wards to help with the Covid-19 crisis then they may do so at their own risk. The time they spend on the wards will not count towards their nursing education and registration.

All other students will spend 80% of their time in clinical practice and 20% in education. At the time of writing, with universities closed to students, the education will be delivered online. Universities will be given more flexibility over where final year nursing students practice in their final six months to make sure that they are able to qualify safely.

The role of Universities
To make all this happen, universities are central to the process. They have had to make enormous changes to the way they deliver education to all students, including nursing students. Students, like nursing students and medical students who must spend time with patients, pose an extra challenge. University nursing departments are already making huge changes to their programmes and timetables to make these new arrangements work. They are also working out how to support nursing students working on the wards in hospitals. University nursing departments are responsible, along with the NHS, in making sure that those nurses being admitted to the Covid-19 temporary register are properly prepared to look after patients safely.

The present situation has shown how important nurses are in the NHS and at this time. The NMC, the NHS and the universities are working closely to ensure that the number of nurses will increase, that nursing students will be able to register and that patients will be looked after safely.

Editorial note: entries to JAN interactive are not reviewed and are published at the discretion of the Editor-in-Chief and may be subject to editing or removal by Wiley. We welcome replies, rejoinders, comments and debate on all entries provided they are not offensive or personal.

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