Supervision whilst on placement will vary depending upon the context, competency and activities being carried out by the apprentice nurse and will be ongoing and appropriate for the experience, level of competency and confidence. Supervision will either be Direct or Indirect/Remote. The differences are explained as:
The Nursing Apprentice must be in the line of sight of the supervisor who is present to observe tasks and activities and can intervene immediately if required. Direct supervision should be maintained until the nursing associate apprentice is assessed as being safe to leave alone to undertake directed activities.
Indirect /remote supervision
This is appropriate where there is reliance on processes to provide guidance and support without the supervisor being present. This requires nursing apprentice to:
(1) Have had appropriate training
(2) Have been assessed as competent to perform the task safely and effectively without direct supervision (competence – knowledge, skills, attitudes and ability to practice)
(3) Know their limitations
(4) Know when and how to seek advice from the supervisor
Phased sign-off may be appropriate in staged movement from direct to indirect supervision.
While retaining accountability, Registered Nurses may hand over responsibility to Nursing Associate Apprentices for specific tasks or areas of work that are within their competence and confidence.
Registered Nurses may also assign specific tasks or areas of work (within their competence and responsibility) to Nursing Associate Apprentices.
Who can supervise?
A suitably prepared health or care professional trained to support students in practice that meets Nursing & Midwifery Council (NMC) requirements. For example an approved supporting Learning in Practice Course (NMC 2008) or an approved Practice Supervisor (PS) Course. This may also be a registered Allied Healthcare Professional. Each student nurse will be allocated a separate Practice Assessor and a Practice Supervisor in each of their placements.
Who can assess the apprentice nurse?
The Practice Assessor must be a registered nurse. For RNDA apprentices the Practice Assessor must be a nurse registered in the same field of practice in which the student is studying. TNA apprentices can be practice assessed by a registered nurse or a registered nursing associate. These nurses must have experience of supervising students and should have under gone specific Practice Assessor Course NMC approved training (NMC 2018).
Students can expect that whilst on placement they will have:
- Support from a named and allocated Practice Assessor / Supervisor / Educator with constructive feedback at regular intervals.
- A local induction in your clinical area within the first 24hrs
- A planned work/shift pattern for the duration of the placement
- Supernumerary status throughout their placements that supports quality learning experiences
- A quality learning environment with a culture that encourages learning in practice
- Practice experiences with effective learning and a successful placement
- An audited clinical area to ensure a quality learning environment
- Support from the Clinical Education Team
At the end of the apprentice nurse training programme they will all undertake practice supervisor training which will enable them to support learners as soon as they qualify and feel confident to do so. It is an NMC (2018) requirement that the registered nurse will:
9 Share your skills, knowledge and experience for the benefit of people receiving care and your colleagues
To achieve this, you must:
9.1 provide honest, accurate and constructive feedback to colleagues
9.2 gather and reflect on feedback from a variety of sources, using it to improve your practice and performance
9.3 deal with differences of professional opinion with colleagues by discussion and informed debate, respecting their views and opinions and behaving in a professional way at all times
9.4 support students’ and colleagues’ learning to help them develop their professional competence and confidence