Sign-Off Nurse Mentor Information Pack Supporting the transition to Sign-Off Mentor status
Contents Page 1. Introduction to Nurse Mentorship 2. Flow chart showing detailed transition from Nurse Mentor to Sign-Off 3. NMC Criteria for Nurse Mentor status 4. NMC Criteria for Sign-Off 5. Specific responsibilities of a Sign-Off mentor 6. Maintaining Mentorship 7. Support for Sign-Off Mentors 8. Resources 9. Useful Contact Details 10. References 11. Appendix 1 Mentor Database Information Update Form 12. Appendix 2 - Signing off practice proficiency: Evidence Sheet
1 Introduction to Nurse Mentorship This Information Pack has been developed by the Learning Environment Team, Southern Health NHS Foundation Trust, to support individual registrants during the transition from nurse Mentor to Sign-Off Mentor status. It explains the Nursing and Midwifery Council (NMC) criteria for each role and provides the documentation required to formally record evidence of the Mentors development throughout the transition. The NMC recognise the vital role that clinical Mentors provide in the learning and development of student nurses and state in the NMC Code of Conduct (NMC, 2008a) that, as a registered nurse you must facilitate students and others to develop their competence. The definition of a Mentor is a registrant who, following successful completion of an NMC approved Mentor preparation programme, has achieved the knowledge, skills and competence required to meet the defined outcomes to support learning and assessment in practice of student nurses. (NMC, 2008b) It should be noted that competence as a Mentor can only be achieved through the individual s personal development in conjunction with a mentorship qualification. 1.1 Standards to Support Learning and Assessment in Practice The NMC has developed Standards to Support Learning and Assessment in Practice (NMC, 2008b) to ensure that all pre-registration nursing students are assessed by Mentors in practise who are knowledgeable, up to date, and who can confirm that students are safe practitioners at the time of registration, to ensure public protection. The Standards to prepare nurse Mentors determine the structure and content of mentorship programmes followed by a developmental framework, which defines and describes the knowledge and skills all Mentors and Sign-Off Mentors need to apply in practice when they support and assess students undertaking NMC approved programmes leading to registration or a recordable qualification on the NMC Register. The Standards place the responsibility on the Sign-Off Mentor to assure the NMC that the pre-registration students are capable of safe and effective practice at the end of a programme and suitable at point of entry to the Register for their practice. Therefore any learner undertaking an NMC approved programme requires a Sign-Off Mentor on their final consolidation placement. Best practice would include the expertise of a Sign- Off Mentor at each progression point, which is at the end of each year of training, although realistically it is recognised that this is not always possible. The NMC recognise registrants who successfully completed a Mentor preparation programme previously approved by one of the National Boards between April 2002 and September 2007, e.g. ENB 998, as being the first Sign- Off Mentors to be entered onto local Mentor Registers. From September 2007 anyone working towards becoming a Sign-Off Mentor has to be supervised signing off students on a NMC approved course on three separate occasions. The local interpretation of the NMC Standards (NMC, 2008a) is that two of these supervised sign-offs can be on the same student at both the interim and final assessment. Best practice would be that the third sign-off is on a final placement, but this is not mandatory. N.B. Having received feedback about the difficulty in finding sufficient opportunities in practice to supervise signing off, the NMC Professional Practice and Registration Committee have agreed that, in future, University NMC approved mentor preparation courses may choose to incorporate one or two supervised sign-offs within the course, through simulation or role play, ensuring the final supervision for signing off proficiency is on an actual student undertaking an NMC approved programme.
2 Simplified Process for Mentor Transition to Sign-Off Registered nurse After 1 year clinical experience, eligible for NMC approved mentorship module Having passed the module, enter Trust s mentor database and work towards becoming a Sign-Off Mentor Be observed signing off proficiency three times and enter database as Sign-Off Mentor 2.1 Flow chart showing detailed transition from Nurse Mentor to Sign-Off Existing Mentors Check qualification is recognised by the NMC Choose mode/academic level and then attend approved mentor module (e.g., taught, mixed mode, elearning NO YES Complete and pass the module then Be supervised signing-off student proficiency on at least 3 occasions by an existing Sign-Off Mentor Complete LEaD Verification Enter the database as a Sign- Off Mentor once the criteria have been achieved. For placement 6 only: Mentors must be on the same part of the register and working in the same field of practice as the student A Sign-Off Mentor is then expected to:- mentor at least 2 students every 3 years Attend annual face to face updates
3 NMC Criteria for Mentor status The NMC Criteria for Mentor status is that a registrant:- Has read and understood the NMC Standards (NMC, 2008b) to support Learning and Assessment in Practice (NMC, 2008a). Has a working knowledge of current programme requirements, practice assessment strategies, and relevant changes in education and practice. Has developed their knowledge, skills and competence beyond registration (i.e. been registered for at least one year). Has successfully completed an NMC approved Mentor preparation programme (or a comparable programme accredited by an Approved Educational Institution as meeting the NMC Mentor requirements). Has the ability to select, support, and assess a range of learning opportunities in their area of practice for students undertaking NMC approved programmes. Must be able to support learning in a multi-professional environment selecting and supporting a range of learning opportunities for students from other professions. Must be able to make judgements about competence/proficiency of NMC students and be accountable for such decisions. Should have the ability to contribute to the assessment of other professionals under the supervision of an experienced assessor from that profession. Must be able to support other nurses in meeting Continued Professional Development needs in accordance with the NMC Code (NMC, 2008a) Must be entered onto a local Mentor Register (Mentor Database) using the Mentor Database Information Update Form (see Appendix 1). Must participate in annual face to face updating. Must participate in Triennial Review Is expected to mentor at least 2 students within a 3 year period. This does not necessarily require the Mentor to be the named Mentor but to have had an input in the assessment of competence of students even if for a few days at a time. It is the Mentor s responsibility to ensure that, whilst giving direct care in the practice setting, at least 40% of the students time is spent being supervised (directly or indirectly) by a Mentor or Practice Teacher. It is an NMC requirement that Mentors seek advice and support from a Sign-Off Mentor or Practice Teacher as well as academics from the University when dealing with failing students.
4 NMC Criteria for Sign-Off Mentor status A Sign -Off Mentor is an experienced Mentor who has met all the NMC Criteria for Mentor status. There are no other formal courses that have to be undertaken to become a Sign-Off Mentor. In addition you need to:- Have been supervised on at least three occasions for signing off a student nurse s proficiency at a progression point by an existing Sign-Off Mentor or Practice Teacher. It is possible for two of these sign-offs to be with the same student (at the Interim and Final Review of a placement). Ideally one sign-off should be at the end of a final placement, but this is not essential. The three sign offs should be documented on the:- Signing off practice proficiency: Evidence Sheet (Appendix 2), for your own records. Once you have achieved your Sign-Off status and you feel competent in your ability to sign off students you will need to update the local Mentor Register by completing a Mentor Sign off Status Confirmation Verification via your LEaD training record You also need to:- Be a registered nurse with the NMC on the same part or sub part of the Register and working in the same field of practice as the programme the student has undertaken and intends to register or for a qualification that is recordable on the NMC Register. Have clinical currency and capability in the field of practice in which the student is being assessed. Have a good working knowledge of current programme requirements, practice assessment documentation, strategies and relevant changes in education and practice for the student they are assessing. Have a good understanding of the NMC programme and registration requirements and their contribution as a sign off mentor to the achievement of these requirements. An in-depth understanding of their accountability to the NMC for the decision they make to pass or fail a student when assessing proficiency requirements at the end of a programme. To maintain Sign- Off status you need to be involved in mentoring at least two students within each three year period. This does not necessarily require the Mentor to be the named Mentor but to have had an input in the assessment of students even if for a few days at a time. Keep sufficient records to support and justify their decisions on whether a student is competent, adhering to confidentiality at all times. Ensure that when a student is in their final placement that at least 40% of the student s time is supervised (directly or indirectly) by a Mentor or Practice Teacher and that in addition one hour a week protected time is spent with a Sign-Off Mentor. This allocated hour is to ensure students have effective feedback on their performance so that the ultimate decision on their proficiency is not unexpected and ensure comprehensive records are kept of the student s performance in their final placement. N.B. Having received feedback about the difficulty in finding sufficient opportunities in practice to supervise signing off, the NMC Professional Practice and Registration Committee have agreed that, in future, University NMC approved mentor preparation courses may choose to incorporate one or two supervised sign-offs within the course, through simulation or role play, ensuring the final supervision for signing off proficiency is on an actual student undertaking an NMC approved programme.
5 Specific responsibilities of a Sign Off Mentor The Sign-Off Mentor, who has met the NMC additional criteria for assessing proficiency, is responsible and accountable for making the final sign-off in practice-confirming that the student has successfully completed all practice requirements (NMC, 2008b). This refers to pre-registration students in final placements. Only a registered nurse, who is on the same part or sub part of the NMC Register and working in the same field of practice as the Programme the student has undertaken and intends to register with the NMC, may sign off a nursing student. It is the Sign-Off Mentor s responsibility to be able to provide evidence that they meet the NMC criteria of Mentor preparation, proficiency, and confirm their own competence to be a Sign-Off Mentor. They should be annotated on the local Mentor Register as a Sign-Off Mentor by completing the Mentor Sign-Off Status Verification Confirmation via LEaD. The Sign-Off Mentor is responsible and accountable to the NMC for making a final judgment of competence which is the requirement for entry to the NMC Register. The evidence of competence must show that the student has achieved the required standards of proficiency for safe and effective practice at the end of the programme and confirms that the required proficiencies for entry to the Register have been achieved. (NMC, 2008b) When signing-off at the end of a programme the Sign-Off Mentor is responsible for reviewing the evidence of previous practice assessment documentation to assess proficiency for entry to the Register, confirm that the student has successfully completed all practice requirements and ensure that any concerns raised earlier in the programme have been appropriately addressed and resolved. Any outstanding concerns must be identified and raised immediately with education staff from the Health Education Institutions. The NMC Standards (NMC, 2008b) expect Sign-Off Mentors to be granted protected time to reflect, give feedback, and keep records of a student s achievement in their final period of practice learning. They suggest that this should be the equivalent of an hour per week, per student, in addition to the NMC requirement that 40% of the student s time to be supervised by a Mentor (directly or indirectly). Once a student nurse has been entered onto the NMC Register they are accountable for their own actions. If this registered nurse is consequently involved in Fitness to Practice case the Sign-Off Mentor of this student is unlikely to face a formal proceeding unless there is evidence that the Sign- Off Mentor did not have the appropriate mentorship qualifications, competence or authorisation, or that they had been reckless in their decision-making. The NMC expects Sign-Off Mentors and Practice Teachers to support other Mentors who are faced with failing a student. If a Sign-Off Mentor is supervising a Mentor signing off proficiency of a student nurse, the Sign -Off Mentor should countersign that the proficiency has been achieved by the student. Sign-Off Mentors are expected to be aware of when and how to seek support to assist them in their role to ensure validity and reliability of judgements made when assessing challenging circumstances. Long-arm Sign Off A Sign-Off Mentor must be registered on the same part or sub-part of the Register as the student they assess at their final assessment of proficiency and be in the same field of practice (NMC, 2008b). Taking this into account, a scenario that frequently occurs is when a Child student nurse is allocated to a Health Visiting Team which does not have a Sign-Off Mentor on the Child part of the Register. In this situation a suitable Sign-Off Mentor from a different practice area may work closely with the named Mentor, to sign off that student. This is known as a long-arm Sign-Off. There are other situations where named Mentors who are not Sign-Off Mentors may be allocated a final placement student, either due to placement problems, or where the named Mentor is working towards becoming a Sign-Off Mentor. In both these situations a Sign-Off Mentor, possibly a long-arm Sign- Off, can oversee and countersign the signing off by the named Mentor.
As a professional, you are personally accountable for actions and omissions in your practice and must always be able to justify your decisions (NMC, 2008a) 6 Maintaining Mentorship 6.1 Continuing Professional Development Mentors should take the opportunity to formally discuss and record their mentorship development at PDR / Appraisals and 1:1 s with their line manager to identify any developmental needs. 6.2 The Triennial Review The NMC Standards (NMC, 2008b) require all Mentors to have their performance, as a Mentor, reviewed with their manager once every three years to verify that they have maintained their mentorship skills, knowledge, and competence to remain on the local Mentor Database. As part of this review the NMC Triennial Review Verification is completed to confirm that the Mentor has:- Mentored at least two students within the 3 year period. Participated in annual updating throughout the last 3 years including attendance at face to face mentor update sessions. Mapped on-going development in the role as Mentor against the current NMC mentor/practice teacher standards The Verification is accessed via LEaD training records 6.3 Face to Face Mentor Updates NMC Standards (NMC, 2008b) require a face to face update every year which has to be recorded on the local Mentor Register. Mentor Updates are run throughout the year and are held at venues across Southern Health NHS Foundation Trust. The Mentor Updates are publicised and booked via the LEaD website and is the individual Mentors responsibility to book and attend. The Attendance Sheet must be signed in order to verify attendance and update the LEaD training record and local Mentor Database. The course is designed to:- Inform Mentors of any changes within the NMC approved programmes. Give the opportunity to discuss the implications of changes to NMC requirements. Give the opportunity to reflect on experiences of mentoring by meeting with other Mentors to explore issues and challenges when assessing competence and fitness for safe and effective practice. Map on-going developments in the Mentor /Practice Teacher role against the current NMC Standards Inform and update Mentors and practice teachers of changes in student assessment and documentation. Staff who can evidence that they have undertaken face to face updates separately to the Mentor Updates provided by the Trust must inform the Learning Environment Team so that details can be recorded on the local Mentor Register. 6.4 Mentor Register The Learning Environment Team (LET) maintains the local Mentor Database which the NMC regularly access for auditing purposes. If you have any queries on your own mentorship record please the team by email or by telephone:- 02380 475746.
Please note that the LET also regularly contact Mentors to validate the information held on the database to fill any gaps in the records. When completing any of the forms provided by the LET it is essential that the information requested is completed in full as it is this information that is audited by the NMC. 7 Support for Sign-Off Mentors Mentors and Sign-Off Mentors are advised to adopt a team approach with other members of their team, where possible, when making assessment decisions of student performance and competence. Concerns and worries about students should always be shared primarily with the student s personal Academic Tutor/ Practice Academic Coordinator Teacher or Link tutor from their University. Advice and support can also be requested from the Learning Environment Lead. Mentor Updates booked via LEaD provide important information on mentoring and need to be attended annually to fulfil NMC requirements. Many placement areas have an identified lead for student issues (i.e.; practice education facilitator, learning environment manager, and lead nurses for education), find out if your area has someone with this role. Concerns regarding placement areas should be raised with the Learning Environment Team who aims to support Mentors and students in practice by enhancing the capacity and quality of the learning environment for all Healthcare learners within Southern Health NHS Foundation Trust.
Resources This information pack has been compiled from the following documents and websites, which you may also find useful: University on-line Resources for Mentors University of Southampton http://www.southampton.ac.uk/alps/nursing/ University of Surrey http://www.surrey.ac.uk/healthandsocialcarecurrent_students/index.htm University of Bournemouth http://www.bournemouth.ac.uk/practiceassessor University of Hertfordshire Professional Bodies The Nursing and Midwifery Council Standards to Support Learning and Assessment in Practice The Nursing and Midwifery Council The Nursing and Midwifery Council Sign-Off Mentor circular http://www.nmc-uk.org/ Royal College of Nursing Guidance for mentors of nursing students and midwifes: an RCN toolkit www.rcn.org.uk/data/assets/pdf_file/0008/78677/002797.pdf Southern Health Resources Southern Health Foundation Trust Learning Environment Team Leadership, Education and Development Mentor updates NMC Mentorship Resource Pack http://www.southernhealth.nhs.uk/staff/ http://www.herts.ac.uk/courses/schools-of-study/health-and-socialwork/health-mentoring/home.cfm http://www.nmc-uk.org/documents/nmc-publications/nmc-standards-tosupport-learning-assessment.pdf http://www.nmcuk.org/documents/circulars/2010circulars/nmccircular05_2010.pdf http://www.southernhealth.nhs.uk/career/lead/student-and-mentorsupport/ http://www.southernhealth.nhs.uk/career/lead/student-and-mentorsupport/
Useful Contact Details University of Southampton Main Reception 023 80 597979 Bournemouth University University of Surrey University of Hertfordshire Learning Environment Team ( LET ) 023 8047 5746 Rm 33, Tom Rudd Unit Moorgreen Hospital West End Southampton HANTS SO30 3JB First point of contact is the Academic Tutor for student. Contact details are found on the front page of students Assessment of Practice Document. Other contacts:- Practice Academic Coordinator for area Learning Environment Team Megan Lloyd Megan Lloyd University Practice Learning Advisor Bournemouth University B411, Bournemouth House Tel: 01202 962563 Mobile: 07545420732 mlloyd@bournemouth.ac.uk Julia Boon Practice Liaison Teacher E-mail: j.m.boon@surrey.ac.uk PLTLocality3and3a@surrey.ac.uk Maggie Jones Lecturer Practitioner E-mail: m.m.jones@herts.ac.uk 07715 811461 Anne Prout - Learning Environment Lead Mental Health Liz Dickinson - Learning Environment Lead Learning Disabilities Hannah Connell - Learning Environment Lead Integrated Community Services Di Taylor- Administrator Supportinglearners@southernhealth.nhs.uk
References a) The Nursing and Midwifery Council. (2008) The Code- standards on conduct, performance and ethics for nurses and midwives. London Midwives b) The Nursing and Midwifery Council. (2008) 2 nd Edition. Standards to support learning and assessment in practice. London Further Reading NMC Standards to Support Learning and Assessment in Practice http://www.nmc-uk.org/documents/nmc-publications/nmc-standards-to-support-learning-assessment.pdf Aston, L. Hallam,P. (2011) Sucessful mentorship in Nursing. Learning Matters:Exeter Sharples, K. (2011) 2 nd Edition. Successful Practice learning for Nursing Students. Learning Matters:Exeter Gray, M.A.and Donaldson, J.(2009) Exploring issues in the use of Grading in Practice:Literature review Edinburgh Napier University
Appendix 1 Mentor Database Information Update Form Mentor Database Information Update This form is designed to ensure the Learning Environment Team hold current and valid information on the Trust s Mentorship Database as required by the NMC Full name Place of work Job title Mentorship qualification in full (name of course and course code) Date attained Do you hold Sign Off mentor status? Have you been involved with mentoring 2 students within the last 3 years? Signature: Date: Please print name in full as it appears on NMC Professional Register: Learning Environment Leads: Anne Prout (Anne.Prout@southernhealth.nhs.uk), Hannah Connell (Hannah.connell@southernhealth.nhs.uk), Liz Dickinson (liz.dickinson@southernhealth.nhs.uk) Please send a copy of this form to Di Taylor, Learning Environment Team Database Co-ordinator, Learning Environment Team, Room 33, Tom Rudd Unit, Moorgreen Hospital, Botley Road, Southampton, SO30 3JB. Telephone 02380 475746
Appendix 2 Signing-Off practice proficiency: Evidence Sheet (Student at Progression point or Final Placement) Date Student Supervising Sign-off Mentor Student Name: Comments: Cohort: Placement: Allocation dates from: to: Signature: Print name: Date Student Supervising Sign-off Mentor Student Name: Comments: Cohort: Placement: Allocation dates from: to: Signature: Print name: Date Student Supervising Sign-off Mentor Student Name: Comments: Cohort: Placement: Allocation dates from: to: Signature: Print name:
Author: Ruth Latham-Warde (Practice Facilitator in Secondment Role), Learning Environment Team, Tatchbury Mount Date Issued: February 2013 Date of Review: February 2014 Version 2 - updated by Di Taylor 29 th March 2016 Version 3 - updated by Anthea Groves 27th March 2017 Version 4 update by Liz Dickinson 13 th June 2017 END OF DOCUMENT