Document Title: ROLES & RESPONSIBILITIES OF TRUST

PRE-REGISTRANT NURSES & MIDWIVES

Document Reference/Register no: 15006 Version 2.1

Number:

Document type: (Policy/ Guideline/ Guideline To be Nursing Staff

SOP) followed by:
(Target Staff)

Ratification Issue Date: 14th January 2019 Review 13th January 2022
(Date document is uploaded onto the Date:
intranet)

Developed in response to: CQC Standards

NMC Code of Conduct
Contributes to HSC Act 2008 (Regulated Activities) Regulations 2014(Part
3); and CQC Regulations 2009 (Part 4)
CQC Fundamental Standards of Quality and Safety: 17, 19
Issuing Division/Directorate: Corporate Nursing

Author/Contact: (Asset Administrator) Deborah Cobie, Nurse Recruitment Lead

Hospital Sites:  MEHT

(tick appropriate box/es to indicate □ BTUH
status of policy review i.e. joint/ □ SUH
independent)
Consultation: (Refer to page 2)

Approval Group / Committee(s): n/a Date: n/a

Professionally Approved by: (Asset Maggie Bayley, Interim Director Date: 7th January 2019
Owner) of Nursing

Ratification Group(s): Documents Ratification Approval Date: 9th January 2019

Group Chair’s Action

Executive and Clinical Directors Date: January 2019 Distribution Intranet and
(Communication of minutes from Method: Website
Document Ratification Group
 Roles & Responsibilities of Trust Pre-Registrant Nurses /15006/2.1

Consulted With: Post/ Approval Committee/ Group: Date:

Daniel Spooner Deputy Director of Nursing 22nd November 2018
Jill Lambeth Induction Facilitator
Jude Horscraft Practice Development Midwife
Associate Directors of Nursing
Ward Sisters

Related Trust Policies (to be read in Injectable Medicines Policy 09060

conjunction with) Controlled Drug Policy 08083
Recruitment Policies (various)
Management of mentorship for nurses and midwives in
practice 07067
Dress Code/Uniform Policy 04041

Document Review History:

Version Authored/Reviewer: Summary of amendments/ Issue Date:
No: Record documents superseded by:
0.1WD Angela Wade 24 Mar 2015
1.0 Angela Wade 28 April 2015
2.0 Deborah Cobie Full revision 14th January 2019
2.1 Deborah Cobie & Sue Amendment to points 3.7, 4.4, 4.6, 4.7, 5.2 29 April 2020
Poole and 9.2.2 & removal of points 4.8 and 11.1

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Index

1. Purpose

2. Scope

3. Uniform

4. Non-EU overseas nurses

5. EU Overseas Nurses

6. UK Educated Nurses

7. UK Educated Midwives

8. NMC registration confirmed

9. Responsibilities

10. Breaches of Policy

11. Audit and Monitoring

12. Communication and Implementation

13. Equality Impact Assessment

14. References

15. Appendix

Appendix 1 – Equality Impact Assessment Form

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1.0 Purpose
1.1 To guide and promote a clear, consistent approach to roles and responsibilities of the
substantive pre-registered nurse whilst awaiting NMC PIN (Personal identification
number) registration.
1.2 To promote safe practice, mentorship and support for pre-registration nurses; both
those from overseas and those who have completed UK based nurse education.
1.3 To provide guidance regarding scope of practice, level of competence and
accountability required by the Trust.

2.0 Scope
2.1 This guideline applies to:
 Pre-registered nurses employed on a Trust contract under supervised practice
whilst awaiting NMC PIN registration.
 All clinical staff involved in the supervision, mentorship and management of the
pre-registered nurse.

3.0 Uniform
3.1 As pre-registration nurses it is important that uniform and badge identification clearly
identifies the role undertaken. Therefore, for Overseas nurses, both EU and Non EU,
name badges and MEHT security badges should state the role of Pre-
registration nurse.
3.2 For Non EU nurses, the nurses’ uniform should be that of a Band 4 associate
practitioner: blue stripes with red trim.

3.3 For EU nurses and UK Educated nurses, the nurses’ uniform should be that of a
HCSW: blue stripes with white trim.
3.4 On receipt of NMC PIN registration, a band 5 staff nurse uniform should be requested
as per the uniform policy.
3.5 Badges should be updated under the ward sister/change nurse authorisation.

3.6 Pre-registration nurse should adhere to the Dress Code/Uniform Policy Register No.
0404.

3.7 Uniforms are only to be used for official duties inside or outside the hospital. Staff may
travel directly to or from work in uniform provided it is covered completely with a full
length coat at all times. In exceptional circumstances the Trust may call for staff to
only wear their uniforms in the clinical area and not to travel to and from work in their
uniforms.

4.0 Non-EU Overseas Nurses

4.1 Until these nurses have completed and passed the NMC Test of Competency Part 2:
the objective structured clinical examination (OSCE) and this has been submitted to

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the NMC for application PIN registration, they are to be supernumerary for 100% of
their time. The OSCE ensures the nurse meets the NMC Future nurse: Standards of
proficiency for registered nurses

4.2 If the nurse started their application to the NMC prior to 6 th April 2017, they will have
up to two attempts to achieve their OSCE. If the nurse started their application
on or after 6th April 2017, they will have up to three attempts.

4.3 The first OSCE must be taken within 3 months, and the OSCE must be achieved
within 8 months of commencement of employment with the Trust.

4.4 If the nurse is unsuccessful in their first attempt, they must wait a minimum of 10
days before their second attempt. For those with three attempts, if the nurse is
unsuccessful in their second attempt, they must wait a minimum of ten days from the
date of their second attempt before they can take their third attempt

4.5 Failure to achieve their OSCE within 8 months will result in the nurse being
repatriated to their home country, and will be unable to return to the UK as a nurse
awaiting NMC Pin for 12 months.
4.6 Their supernumerary status will support the required learning in OSCE preparation,
both in a classroom environment and clinical practice. A minimum of 40% of their
working time will be spent with their allocated supervisor who is a competent
Registered Nurse, and the subsequent 60% of their time with a competent Registered
Nurse.
4.7 Non-EU overseas pre-registered nurses can

 Administer oral medication under direct supervision of RN throughout the process

(countersigned on drug chart by RN);
 Prepare and administer subcutaneous/intramuscular injections under direct
supervision of RN throughout the process (countersigned on drug chart by RN;)
 Be the second check for non-IV controlled drugs (the RN must administer the drug
 Observe only as a 3rd member, the preparation and administration of IV
medication `including IV fluid infusions;
 Can perform cannulation and venpuncture once deemed competent.
4.8 As Non EU pre-registered nurses enter their employment at the level of a third year
student nurse, the extended roles of cannulation and venepuncture would not be an
expected role undertaken by a pre-registration 3rd year student and therefore not
supported by trust policies for injectable medicines.

4.9 At point of commencement in the Trust, the non-EU overseas nurse will be provided
with the band 5 generic competency book to complete.

4.10 At the point they pass their OSCE, the non-EU overseas nurse can
continue their employment following the guidance for EU overseas nurses.

4.11 On receipt of their PIN registration, they will have a 2-week supernumerary period
working 80% of their shifts with their mentor.

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5.0 EU Overseas Nurses

5.1 Until their PIN is received, these nurses should work 40% as supernumerary to
support learning in clinical practice and the remaining 60% as HCSW.
5.2 They should be assigned a competent RN as a supervisor; this supervisor is not
required to be ‘live’ on the Trust’s mentorship register, as in this instance the
mentorship function is to support competence and role development, and not for the
purposes of university sign off.
5.3 EU overseas pre-registered nurses can:

 administer oral medication under direct supervision of RN throughout the process

(countersigned on drug chart by RN)
 prepare and administer subcutaneous/intramuscular injections under direct
supervision of RN throughout the process (countersigned on drug chart by RN)
 be the second check for non-IV controlled drugs (the RN must administer the drug)
 Observe only as a 3rd member, the preparation and administration of IV
medication including IV fluid infusions

5.4 The EU overseas nurses can undertake the extended roles of cannulation and
venepuncture; this would follow attendance on the theoretical study day followed by
supervised practice in the clinical area and competency sign off. As the EU overseas
nurse will be fulfilling aspects of the role of an HCSW whilst awaiting their PIN
registration, this extended skill is supported by the Injectable Medicines Policy 09060
section 5.15 guidance for HCSW (Health Care Support Worker) Band 3 administering
and 2ml NaCl- flush on insertion of cannula. Completion of all band 5 generic
competencies prior to attendance is not a requirement.

5.5 On receipt of their PIN registration, they will have a 2-week supernumerary period
working 80% of their shifts with their mentor.

6.0 UK Educated Nurses

6.1 Until these nurses have received their NMC PIN registration they will work as an
HCSW 100% of their clinical practice.

6.2 At point of commencement in the Trust, the nurse will be provided with the band 5
generic competency book to complete.
6.3 Whilst awaiting their PIN they will be assigned a mentor to support them through the
first six months preceptorship period. They will also receive the preceptorship pack to
support this process.
6.4 On receipt of their PIN registration, they will have a 2-week supernumerary period
working 80% of their shifts with their mentor.

7.0 UK Educated Midwives

7.1 Until these Midwives have received their NMC PIN registration they may work as an
MCA 100% of their clinical practice.

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7.2 At point of commencement with the Trust, a newly qualified Midwife will commence at
band 5 on the preceptorship program and will be provided with the Preceptorship
Handbook and a named ‘Buddy’ Midwife to support them. The Midwives
preceptorship is a twelve month period where by they are supported in practice by the
Practice Development Midwife and maternity team.

7.3 On receipt of the NMC PIN Midwives will commence their maternity preceptorship
rotation program including a two week supernumerary period

8.0 NMC Registration Confirmed

8.1 On receipt of NMC PIN registration, all newly registered nurses will commence on the
Trust’s Preceptorship programme and complete the taught and competency based
elements in the first 6 months of registered practice.

9.0 Responsibilities
9.1. Site Director of Nursing
The Site Director of Nursing is responsible for ensuring that systems are in place to
ensure the safe and effective delivery of care for all patients.

9.2 Ward senior sister/charge nurse

9.2.1 The ward sister is accountable for the line management and assessment all members
of the ward teams performance objectively through, Knowledge Skills Framework
competency and personal development planning.
9.2.2 The ward sister must assign the appropriate supervisor for the overseas nurse and
ensure that Health Roster supports the supernumerary and supervisor matched shifts
required to meet the guide set out in this policy.

9.3 Registered Nurses (and other Healthcare Professionals, as appropriate)

should offer a welcoming learning environment that supports the development of
competent member of their team, should work collaboratively and understand the
roles and responsibilities of the team members.

9.4 Lead Nurse/Ward Sister

The Lead Nurse/Ward Sister must ensure that compliance with this policy is achieved
through a regular monitoring programme agreed within their directorate.

10.0 Breaches of Policy

Any non-compliance with this policy must be immediately notified to the line
manager and reported on Datix in accordance with the Incident Policy.

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11.0 Audit and Monitoring

11.1 The corporate nursing team will keep a central register of “Overseas Nurses’ Mentors”
and monitor compliance with meeting the agreed working patterns set out in this
policy and report compliance at the Overseas Nurse Recruitment meeting held bi-
monthly and chaired by Associate Chief Nurse.

11.2 The Ward Sisters/Charge Nurses will monitor compliance with the specific clinical
practice responsibilities set out in the policy. Namely, the monitoring of competent
practice that relates to competency sign off and safe drug administration. Compliance
will be monitored through existing staff personal development plans.

12.0 Communication & Implementation

 The author will email the policy to nursing team leaders to share.
 It will be uploaded to the intranet and website.
 It will be included in the welcome information given to the overseas nurses when
commencing employment in the organisation.

13.0 Equality Impact Assessment

(Refer to Appendix 1)

14.0 References

NMC (05.2018) Future nurse: Standards of proficiency for registered nurses

NMC (09.2018) Registering as a nurse or midwife in the UK information for applicants

trained outside the European Union (EU) or European Economic Area (EEA)

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Appendix 1: Preliminary Equality Analysis

This assessment relates to: 15006 Roles & Responsibilities of Pre-Registrant Nurses & Midwives

A change in a service to patients A change to an existing policy X A change to the way staff work

A new policy Something else

(please give details)
Questions Answers
1. What are you proposing to change? 3.1,3.2,3.3
Section 4.0
Addition of 5.5
Addition of 7.0
Update of role title 8.1

2. Why are you making this change? Clarification of 3.1,3.2,3.3

(What will the change achieve?) Section 4.0 To reflect change in NMC registration assessment for registration
5.5 To advise on induction following receipt of NMC Pin
7.0 Inclusion of UK educated Midwives
9.1 Reflect change in role title
3. Who benefits from this change and how? All pre-registered nurses
4. Is anyone likely to suffer any negative impact No
as a result of this change? If no, please record
reasons here and sign and date this assessment.
If yes, please complete a full EIA.
5. a) Will you be undertaking any consultation as Yes: Site Director and Deputy Director of Nursing
part of this change? Associate Directors of Nursing
b) If so, with whom? Lead Nurses
Ward Managers and ward sisters
Trust Induction Facilitator
Preliminary analysis completed by:
Name Deborah Cobie Job Title Nurse Recruitment Lead Date 22.11.18