Comment

Let the NMC know nurses need kindness, not blame

The regulator is changing its tune, with potentially big implications for fitness to practise

The regulator is changing its tune, with potentially big implications for fitness to practise

An illustration highlighting the NMC's role in protecting patients as well as registrants

Nursing and Midwifery Council (NMC) chief executive Andrea Sutcliffe has articulated a change in the regulator’s approach: to be kinder, open and transparent, and to gain trust. 

She wants to nurture a culture of humanity in the organisation. This will benefit both the regulator’s nurse and midwife registrants and also the public that it protects.

Next steps for the NMC

Feedback from research earlier this year showed that stakeholders wanted the NMC to :

  • Take a wider, more proactive view of its place in the healthcare system.
  • Pay more attention to workforce pressures and planning.
  • Become more dynamic and enact change more quickly.
  • Be more sensitive to the needs of each of the UK countries.

Respondents to the NMC’s research also wanted the opportunity to comment on issues where they can influence the outcome.  

Consultation on the five-year strategy

We have one such opportunity now. The NMC is consulting on a new five-year strategy that will shape its future, engaging with the public, partners and professionals. The consultation closes on 16 October.

The strategy covers five areas:

  1. Shaping practice.
  2. Building relationships with the public.
  3. Closer collaborations.
  4. Sharing research, data and intelligence.
  5. Strengthening relationships with the professions.

Within each there are areas such as ensuring public confidence in the NMC and ensuring that standards are responsive to changing models of care and new ways of working.

However, the one that really interests me is the commitment to strengthening relationships with the professions.

Nurses’ FtP concerns

For a long time regulation has concentrated on the public protection role and taken lesser account of the needs of nurses, especially those who become embroiled in fitness to practise matters. Nurses often worry that if they make a mistake or something goes wrong they will ‘lose their PIN’ – be removed from the register. 

For most, this feeling of threat will never become a reality. But for some it does. I have read case reports where I have considered that the issue should never have reached the NMC because systems and people have let the nurse, and patients, down.

‘Where a referral is justified, based on the evidence, not an emotional reaction, there are potentially devastating consequences whether the person is cleared or not’

There are also situations where good management and leadership from a more senior person in the organisation, and effective systems and workplace practices, would have prevented or resolved matters. 

As a nurse director I was only too aware that fallacious reports about nurses are sometimes made to the NMC and that when something goes wrong an initial reaction may be to advocate suspension from work and referral to the NMC. I resisted this knee-jerk reaction – a wrong decision risked not protecting patients while also meaning negative consequences for the nurse.

Even where a patient has been injured there are usually myriad actions or omissions in the healthcare system that lead to it, rather than the fault of a single nurse.

And where a referral is justified, based on the evidence, not an emotional reaction, there are potentially devastating consequences whether the person is cleared or not.

A duty of care to colleagues and registrants

The NMC’s Annual Fitness to Practise Report revealed that since April 2018 four registrants have died by suicide while under a Fitness of Practise (FtP) investigation.

This is the first time the NMC has recorded such data, following a welcome move earlier this year to introduce emotional support packages for registrants undergoing the FtP process.

Leaders in healthcare need to look at the culture in their organisation to ensure nurses can practise safely, are supported and well managed. The regulator, colleagues and the wider profession owe them a duty of care; this is where kindness comes in.

Don’t miss your opportunity

The strategy the NMC has put out for consultation recognises that those on the register want the regulator to focus more on the things that lead to good practice and to ‘be vocal’ about factors that make it hard for nurses to give good care. 

That will not just protect patients but nurses too. Don’t miss this opportunity – review the proposals, have your say and influence the future of nursing regulation.


Caroline ShuldhamCaroline Shuldham is chair of the RCNi editorial advisory board and a former nurse director. She is an independent adviser on research, teaching and mentoring

 

 


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The NMC's Shaping the Future consultation

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