Nursing and midwifery council (NMC) competencies

Assessment Brief – Reflective Essay


The reflective essay is based on Nursing and Midwifery Council (NMC) competencies (NMC, 2010) and The Code (NMC, 2015), which are used to evaluate my development as an adult nurse over the duration of the course. In addition, how current legislation, ethical frameworks and health and social care policy underpin adult nursing is also reflected in the essay. The Bowers Reflective Model is applied in the paper to answer the questions: why is the reflection important, what happened, why is important to analyze the event, what I have learned, and the action plan (Bowers, 2015).  The nursing career means that an individual has to work with adults of all ages, who suffer from short-term or long-term physical health conditions. The role of a nurse is to improve the patients’ quality of life and safety.

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How Current Legislation, Ethical Frameworks and Health and Social Care Policy Underpin Adult Nursing

The NMC (2010) stipulates that all nurses must act within the ethical frameworks to promote care for as well as safeguard the public. In addition, a nurse must autonomously and responsibly act in manner which is compassionate, safe, person-centered, evidence-based nursing that respects and maintains dignity and human rights. In addition, as an adult nurse, I showed integrity and professionalism by working with the ethical, professional, and legal frameworks. For instance, I worked in partnership with social and other health care professionals, their carers as well as families in order to promote the well-being of the adults.  Adult nurses are required to have an understanding and use current legislation without discrimination to all service users. As required by the law, I paid special attention to protect vulnerable people, especially those with multifarious needs related to ageing, long-term conditions and cognitive impairment (MNC, 2015). Some of the applicable legislation that influenced provision of care to people accessing adult services includes the Human Rights Act 1998, Mental Capacity Act 2005, and the Equality Act 2010 (Department of Health, 2012). The legislation played a major role in protecting the rights of all patients, related to mental impairment, age, and disability.

The image of nursing is influenced by the manner in which nurses themselves perceive nursing. The public image of nurses is differently portrayed by the media and this makes it differ from the image of nursing from the nurses’ perspective. According to Hoeve, Jansen, and Roodbol (2013), studies have showed that the public image of nurses is different from the nurses’ professional image, because the media may not depict nurses as autonomous professionals. This usually affects public and professional expectations of adult nurses. For instance, as a nurse, I have experienced how the media uses misconceptions and stereotypes to distort the image of nurses and nursing profession. For instance, the media has played a major part in spreading the stereotype of the nurse the doctor’s handmaiden and angels of mercy (Gordon & Nelson 2005). As a result of such images the public view nursing career as more of caring and feminine, but not as autonomous health care providers (Kemmer & Silva 2007). Thus, the depiction of nurses by the media fails to meet the professional image of the nursing. As a professional nurse, I however, displayed professional image in terms of appearance and behavior. I also respected culture, diversity, and the preferences of individual patients. This was promoted through upholding professional values, having excellent communication and interpersonal skills, especially when dealing with patients from different backgrounds.

The key policy driver for adults is putting people first and working with other stakeholders to transform adult social care. By putting people first has enhance my responsibilities related to advocacy and it shaped the manner in which I should treat and handle adult patients of all ages. I have learned that I should advocate for the rights of all patients and champion for equality in service delivery. The changing needs and the expectations in health and healthcare in the UK are some of the other drivers of the social policy. Nurses are acquired to have the knowledge, behaviors, and skills that meet the nursing professions standards. This is needed to meet the current and future challenges in the sector, enhance wellbeing and health, encourage quality and safety and use knowledge to sole health care problems. Thus, the policy drivers have shape my responsibilities as a nurses in determining how the wellbeing and care people accessing adult services is managed in appropriate environments. As a nurse I can safely use and disposes of items and decontaminates in accordance to the health policy, thus increasing the safety of the patients.

 Own Practice in Relation to The Code (NMC 2015

The Code for nurses and midwives sets standards which must be upheld by nursing professionals, including midwives and nurses in order to practice effectively, promote trust and professionalism, and preserve safety. In addition, the NMC (2015) provides standards of competence that must be upheld by nurses while practicing as a nurse in order to promote the health and well-being of patients. As a registered nurse, the journey has not been easy because it had some challenges, but the professional values competences played a major role in shaping me as a nurse. For instance, while working with individual people accessing adult services, I worked with people with elderly and people with disability as well as those from different cultures. To promote better health, I promote and supported health, rights, well-being, and the dignity of groups, people, and the adult population (NMC, 2015).  I also used effective interpersonal skills and excellent communication skills. This impacted the adults patients well because I communicated in a safe, respectful, compassionate, and effective manner with patients from different cultures and backgrounds. For patients unable to speak or understand English well, other non-verbal communications were used. As a result, the wellbeing and health of these people were improved. As required by the NMC (2008), as a registered nurse working with adults, I demonstrated the ability to listen with empathy, respond warmly, as well as positively to people of all ages who were distressed, anxious, and those facing problems with their wellbeing and health.

According to NMC (2010), “All nurses must practice in a holistic, non-judgmental, caring and sensitive manner that avoids assumptions, supports social inclusion; recognizes and respects individual choice; and acknowledges diversity” (p. 13).  Thus, while practicing nursing I practiced in a holistic manner by ensuring that I was not sensitive or judgmental while providing care to the patients. In addition, to ensure that the needs of the patients are met, I avoid assumptions and respected individual choices. For instance, I would ask the patients to provide their medical history, signs and symptoms. Respecting and recognizing the choice of an individual patient ensures that autonomy. In accordance to the NMC (2014), a nurse is required to practice in a manner that addresses the potential power imbalances between health care professionals and person experiencing health problems. For example, as a nurse I acted as an advocate of patients by assisting people exercise their rights and keeping safeguards. Thus, as a nurse must in practiced autonomously, safely, skillfully, and compassionately to promote health and wellbeing of the patients and maintain dignity. Therefore, as a nurse I understood that the people were from different cultures and that I had to considered it. Subsequently, this helped in ensuring that the public health priorities, health outcomes and illness of the patients played an integral role in planning and delivering care.

Nursing is based on professionalism and working. This requires professional relationships and boundaries that may have influence on care delivery. As a nurse with leadership skills, I work professionally, and respected other professionals in the hospital. I must point out that I was professionally accountable for my activities and understood that the wellness of the patients lied in my hands. The NMC (2008) states that nurses must “work effectively across professional and agency boundaries, actively involving and respecting others’ contributions to integrated person-centered care” (p. 11). In this context, I involved other nurses and professionals within the health care setting in provision of care. Person-centered care is necessary when dealing with adult patients. Therefore, together with other professionals, person-centered care was promoted to enhance provision of holistic care, shared decision making, engagement, and sympathetic presence from the care provider (McCormack, 2003). Elderly and adult accessing care require person-centered care because which focuses on individual health and social needs. To this regard, as a nursing care nurse i applied the concept of person-centeredness to develop plans as well as relationships for care (McCance et al., 2011).  Through the use of individualized care for adult person, it was possible to promote health care, after I particularized the patient as a person, thus developing a strong required for effective delivery of services.

Personal Achievements and Development as an Adult Nurse Fit for Employment and Prepared for Future Learning

There are a number of achievements and challenges I have faced in developing as an adult nurse. For instance, I acknowledge the limits of my competence and acting accordingly. Notably, before the preceptorship I had limited experience and knowledge as well as competence required to enhance customer safety. The NMC (2008) has described Clinical Supervision as a process that allows clinicians to realize professional experience via workplace supervision.  For instance, personal achievements include development of knowledge and skills required to improve care. In addition, as a practitioner I can now identify solutions and solve nursing problems. Before, I had challenges related to ethical issues, but now the level of understanding has improved, which is as a result of improved knowledge and skills. Prior to preceptorship I had challenges related to working as a team. However, clinical supervision has encouraged the development of professional skills such as effective leadership and communications skills as well as problem solving skills.

Nursing practice requires nurses to have confidence and resilience as required by NMC (2010) Standards of Competence. The code and preceptorship gave me the opportunity to develop confidence and resilience, required to transition from a beginner to an employed nurse with skills and experience. Through the preceptor program, confidence and competency were increased because I was guided and given the opportunity to know my weaknesses and strengths. For example, my fear was replaced with competency and confidence, which improved my resilience levels. As I prepare for employment, I no longer feel incompetent, emotionally fatigued, and with inadequate self-confidence (Valdez, 2008). Thus, identification of my strengths and weaknesses has developed my confidence and resilience required for better service care provision.

Both clinical supervision and preceptorship in healthcare can support professional development and promote safe practice among nurses. For instance, preceptorship provides guidance and support that allows qualified nurses to the transit from a student to a more confident practitioner in the nursing profession and practice in accordance with NMC standards (NMC, 2015). From clinical supervision, a nurse becomes professionally accountable and can effectively clinical governance processes improve and maintain nursing standards and practice of healthcare. In addition, it helps nurses with the skills and experience required to respond confidently and autonomously to uncertain and planned situations. Also, such a nurse develops leadership and management skills which allow effective management of self and others. For instance, during my period of preceptorship I developed, I have developed further management and leadership skills required to improve the quality of health care (MNC, 2015). Carlson and Bengtsson (2015) noted that clinical supervision and preceptorship in healthcare can support professional development and promote safe practice by not only improving nurses’ confidence but also enhancing communication skills. For instance, after the completion of the preceptorship, nurses can communicate with confidence and effectively with fellow nurses and also with staff members. Moreover, the competence related to the provision of collegial support and management of newly employed nurses is also improved. Lastly, preceptorship eases the transition by a nurse into professional practice and improves the ability to fit into the new role. Clinical support and preceptorship the nurse is equipped with the experience and skills needed to solve any concerns or clinical issues.

References List

Bengtsson, M., & Carlson, E. (2015). Knowledge and skills needed to improve as preceptor: Development of a continuous professional development course – a qualitative study part I. BMC Nursing, vol.14, no.51, pp. 1-13.

Bowers, S. (2015). Bowers Reflective Model. The Journal of New Writing in Health and Social Care, vol. 1, no. 2, pp. 31-37.

Department of Health. (2012). Safeguarding Adults: The Role of Health Service Practitioners. [Online] available at: < https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215714/dh_125233.pdf> (Accessed 1 Dec. 2016).

Gordon S. & Nelson S. (2005) An end to angels. American Journal of Nursing, vol. 105, no. 5, pp. 62–69

Hoeve Y., Jansen G. & Roodbol P. (2013) The nursing profession: public image, self-concept and professional identity. A discussion paper.  Journal of Advanced Nursing, pp. 1-15.

Kemmer L.F. & Silva M.J.P. (2007) Nurses’ visibility according to the perceptions of the communication professionals. Rev latinoam Enfermagem vol. 15, no.2, pp. 191–198.

McCance, T., McCormack, B., & Dewing, J. 2011. An Exploration of Person-Centredness in Practice. The Online Journal of Issues in Nursing, 16(2). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782329/# (Accessed 15/10/2016).

McCormack, B. 2003. A Conceptual Framework for Person-Centred Practice with Older People. International Journal of Nursing Practice, 9(3), pp. 202-209.

Nursing and Midwifery Council. (2008). Competencies for entry to the register: Adult Nursing. [Online] available at: < http://www.ed.ac.uk/files/imports/fileManager/8%20-%20Competencies%20for%20entry%20to%20the%20register%20Adult%20Nursing.pdf> (Accessed 1 Dec. 2016).

Nursing and Midwifery Council. (2010). Standards for pre-registration nursing education. [Online] available at: < http://www.bcu.ac.uk/cmsproxyimage?path=/_media/docs/standards%20for%20pre-registration%20education.pdf> (Accessed 1 Dec. 2016).

Nursing and Midwifery Council. (2015). The Code Professional standards of practice and behaviour for nurses and midwives. [Online] available at: < https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf> (Accessed 1 Dec. 2016).

Valdez, A. M. (2008) Transitioning from novice to competent: What can we learn from the literature about graduate nurses in the emergency setting? Journal of Emergency Nursing, vol. 34, no.5, pp. 435-440.


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