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Afraid of revalidation? Let us put you at ease

Nurses outside the larger trusts may have worries about revalidation, such as who to have the reflective discussion with and how they will fulfil the CPD requirements. Evidence from the pilots suggests that these challenges can be overcome surprisingly easily.

Revalidation presents a challenge to all nurses, but those who work in settings that are isolated professionally or geographically have raised particular concerns.

Such nurses are less likely to have access to the same level of support available to staff in most larger NHS organisations.

The good news is that many who have started the process of revalidation have found it easier than they expected.

‘I’m hearing some positive things from people. Once they start the process they have found it a lot less difficult than they thought,’ says RCN head of policy and international affairs Howard Catton.

He is concerned that nurses in these settings who are due to retire may feel it is not worth revalidating.

He points out that revalidation will keep their options open if they want to do part-time work. And adds that the overall feeling about it – even for nurses in more challenging settings – seems positive.

General practice

Revalidation can seem daunting for practice nurses. Concerns include securing protected study time for continuing professional development (CPD) and getting support from GPs and managers. Some in smaller practices are unsure who to approach for their reflective discussion.

A recent Queen’s Nursing Institute survey of practice nurses found one in five had not considered how they would meet the requirements of revalidation. With one third of all practice nurses surveyed due to retire by 2020, it is worrying that those close to retirement might leave rather than bother with the new system.

I get excited about it – I wrote more than five reflective accounts

It is easy to feel overwhelmed and isolated but some boards and clinical commissioning groups (CCGs) are organising sessions on revalidation, and GPs can act as confirmers. Forums and meetings can also help, allowing practice nurses to swap experiences and find someone to have their reflective discussion with.

Practice nurses in the area covered by Bracknell and Ascot CCG took part in an NMC revalidation pilot. Deputy director of nursing Jo Greengrass emphasises that practice managers, who are often nurses’ line managers, as well as GPs, can have a role in revalidation.

She went through the process herself and found it a positive experience. ‘I got excited about it. I wrote more than five reflective accounts because it was good to write about and discuss my work with another nurse,’ she says. ‘It is a good way to reflect on your practice.’

Helen Goldsmith (pictured right), clinical nurse lead for Local Care Force, helps agency nurses prepare for revalidation

Care homes

Carol Barr, a nurse and home manager at Bupa’s Claremont Care Home in Ayrshire, found the feedback element one of the easiest parts during the pilot. ‘What I like is that you can get feedback from residents and relatives. And you don’t have to ask for feedback face to face. As a manager, I could use thank you letters, questionnaires and the care inspectorate grades as well.’

Taking part in the pilot has changed how she works, she adds. ‘It has brought home just how important reflective accounts are and the need to complete them regularly. I now often say to my nursing team “you could do a reflective account on that” to get them in the habit of doing it.’

Her advice to care home nurses is simple: ‘Open your NMC Online account, find out when you need to revalidate and get yourself organised. I’ve set up a folder of all the forms from the NMC for all nurses to look at to help them get organised.’

Agency work

The position for agency nurses may vary according to how much work they do and who they work for. Some agencies have been proactive in offering support; others less so. Some have provided workshops to explain the system and will generate forms showing practice hours. Others have bought into the RCNi Portfolio, allowing their nurses access to tools to support revalidation.

Helen Goldsmith, clinical nurse lead for Local Care Force in Leeds, says that the first cohort of nurses working for her agency is ready to submit. ‘The feedback is “I don’t know what I was worrying about”,’ she says.

‘There can be a reluctance to do the reflective accounts about anything that has gone wrong,’ Ms Goldsmith notes. ‘I suspect the reflections are going to be very positive.’

However, this may be common to all nurses rather than specific to agency nurses.

Agency nurses – and those who are self-employed – need to ensure they are aware of their revalidation dates and are not in danger of falling off the register. If this happens to a nurse employed by a trust their employer may allow them to take on tasks away from the front line while the situation is sorted out. Self-employed nurses will risk losing income.

Prison health care

Nurses in prisons often work in small teams in an unusual environment which their patients have not chosen. They may be slightly separate from their employing trust. Despite this, preparation for revalidation has gone smoothly for the team providing an integrated mental health service at New Hall prison in West Yorkshire.

‘When Nottinghamshire Healthcare Foundation NHS Trust asked us to take part in the pilot they identified a number of people who would meet the criteria but we decided that everyone would take part,’ says clinical matron Anthony Fitzhenry.

Every two weeks the team had a meeting to work through the requirements for revalidation and bounced ideas off each other. Some members of the team realised their preparation amounted to a collection of loose documents and started being more rigorous about collecting evidence.

‘Everyone in our team has a portfolio and are well aware of the criteria they need to meet to continue practising. One of the things that people did not do was routinely collect feedback,’ he says.

Despite the challenges of working in a prison, feedback has been easy to get – whether it is from inmates, other staff or prison governors. The team say many prisoners do spontaneously offer feedback at some point in their contact with them.

Some of the nurses who were not officially part of the pilot, but attended the meetings, have to revalidate in September and are ready to go, says Mr Fitzhenry. The experience allowed them to pinpoint any CPD needs. ‘As a team we are aware that revalidation is a professional issue,’ he says.

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