Statement of Indirect Supervision of Students Date Prepared Dave Reviewed Reviewer Name Date of Next Review May 2004 March 2006 March 2008 March 2010 August 2013 April 2016 Jenny Temple Adele Kane March 2012 August 2015 SPECIFIC NOTE FOR FILE Addendum: Added for commencement of academic year 05/06 March 2010: New NMC Guidance added to page 1 Contact details ~ phone number changed page 3 NAME OF REVIEWER
Indirect Supervision of Students Statement (Relating to Healthcare students including Pre-registration Nurses) 1 Introduction The following paper has been prepared using as a basis the Nursing and Midwifery Council (NMC) document Standards to support learning and assessment in practice published in July 2008. In this it sets out the following guidance for mentors: Page 31: Guidance At all times students must be directly or indirectly supervised in the practice setting. The mentor s responsibility is to plan and coordinate the student s whole learning experience, determining the amount of direct supervision required by the mentor, and what experience may be through indirect supervision (student working independently). Some experience may be supervised by others (other professionals, mentors or practice teachers). The named mentor is accountable for their decisions to let the student work independently or with others. 1.1 This statement provides guidance on the supervision of healthcare students in practice environments for the purpose of placement learning. In the case of nursing students, it is a professional requirement that they are assessed in practice by a registered nurse and they are required to be under the supervision (directly or indirectly) of a registered nurse or other professional health or social care worker at all times when allocated to practice environments. 1.2 Direct supervision is particularly important for inexperienced students in their 1 st and 2 nd year of study, and should apply equally to 3 rd year students especially when the student is being challenged with new clinical experiences and learning opportunities for the acquisition of professional skills. 1.3 This statement should be read and interpreted in the context of the local policy position regarding Lone Workers in the host organisation. This local policy takes precedence in the practice environment and should be adhered to at all times. The guidance provided here relates to nursing students during their allocation to a relevant practice area and should be interpreted in the context and content of the local Service Provider Lone Worker policy. 1.4 The purpose of this statement is to clarify the PQDD s advice to assist allocation decisions and the on-going management of those situations where a nursing student, in agreement with their mentor, is perusing a learning opportunity where indirect or tripartite supervision will apply. Placement learning situations that result in the indirect supervision of the student for a period of time should be prior planned events and should not occur outside of a prior risk assessment. The NMC requires that as a minimum, whilst giving direct care in the practice setting at least 40% of a student s time must be spent being supervised (directly or indirectly) by a mentor/practice teacher.
1.5 A prior risk assessment ensures consideration of any risk to the student, patient/client, organisation, other workers, agencies or the environment can be anticipated, accommodated for, managed and any appropriate risk reduction strategies put into place, including personal safety guidance for the student in the event of unforeseen circumstances developing. 1.6 The general principles of this statement apply in all settings where nursing students are allocated to practice, but is of particular relevance to home care settings where the service is taken into private environments inclusive of other people s homes or residences and to situations where the student is alongside workers providing emergency service care delivery outside of the hospital environment. This statement applies to all four of the current Nursing Branches. 2 Guidance to Mentors and Managers 2.1 Indirect supervision or lone working in the pursuit of professional learning cannot take place without the full consent of the student. If in doubt about the value of the planned experience to the student s professional development, mentors or managers are advised to discuss the proposal with the Programme Leader for the specific branch of nursing the student is following or the Placement Development Team Leads (PDT) for the Trust in which the student is on placement. 2.2 As in all practice placements students are under supervision of a qualified member of staff at all times. But the NMC permit supervision by non-mentoring nursing professionals. This can be direct or indirect and the level of supervision is determined by: The student s stage of education within their programme of study The student s capability/previous experience The type and nature of the skills being developed Qualified staff s knowledge of the client and situation and potential risks involved 2.3 In order to develop the skills required of a qualified nurse, the student must be an active participant in care. However, unaccompanied visits with or to clients should only be undertaken after careful consideration of the following factors: Clients are either well known to the service providers and are an established service user or supervised care is being delivered in an emergency situation. There needs to be evidence that a risk assessment is in place and on-going assessment of individuals are evaluated and updated accordingly. A risk assessment should include the suitability of accompanied/unaccompanied visits by students, environmental, psychological, social and physical circumstances surrounding the visit including historical information, risk posed and interventions to manage the risks identified. Any formal risk assessment should be recorded in accordance with the normal practice for record keeping. It is for the professional with responsibility for supervising the student in practice to consider this as part of the risk assessment and to satisfy themselves that the student is able to both deliver and contribute to care of the client in a way that maintains the ongoing safety, comfort and wellbeing of all interested parties. The visits/care activity form part of the normal pattern of care for that client as identified by the professional.
Students do not alter the plan of care. There is immediate feedback after the visit/care activity between the student and the professional that includes completion of any formal documentation associated with the visit/care activity. The entry should be witnessed and countersigned by the supervising professional. All visits/care activities are to promote the student s placement learning. The student is made aware that she/he can terminate involvement in that visit/care activity if circumstances change or they feel unsafe. The student understands the local procedures for Clinical Incident Reporting. See Plymouth University s Sudden or Untoward Incidents policy. 2.4 The student must be given prior access to lone worker policies for the placement organisation and be made aware of any health and safety requirements that apply in this setting. The student must be given the opportunity to seek clarification or practice under supervision any safety or nursing or other intervention techniques that may be required. The student must adhere to the local policy when undertaking a visit and let their supervisor know when they are going and when they plan to return. 2.5 Students who choose to use motorised transport whilst allocated for home care experience must ensure that they have arranged business cover through their Motor Insurance Company. 2.6 Managers or mentors with responsibility for supervising and sanctioning a student s indirectly supervised learning experience involving a motorised journey to a client are advised to satisfy themselves that the student has made this amendment to their motor insurance policy. If the student cannot evidence business cover for their vehicle, the indirectly supervised placement learning cannot take place. 2.7 Any indirectly supervised learning experience that involves lone working must involve the full agreement of the student. The student s wishes must be respected and any withdrawal must not inform any part of their summative outcome. 2.8 The registered practitioner supervising the student remains accountable for any delegation of client care/work load. Academic Placement Lead (CPT) Practice Quality Development Division.
Glossary of Terms: Direct Supervision Indirect Supervision Lone Worker Supervision Tripartite Supervision This relates to supervision undertaken alongside the learner during an episode of care provision/placement learning activity This relates to supervision undertaken when the mentor/supervisor and the learner are in the same building/ward/unit but the mentor is not directly working alongside the learner. The mentor is however; physically available to the learner should it be necessary. This relates to supervision that takes place when the learner is accompanying a mentor/supervisor in community settings and when the learner is visiting patients/clients in their own homes with the mentor/supervisor unavailable physically but contactable by telephone for support This relates to supervision that takes place at a distance by a professional other than the learners named mentor/supervisor for a set period of time or involves the mentor themselves being supervised/ assessed Addendum: This statement can be used as a basis for supporting and supervising students allocated to the emergency services for the purpose of placement experience. Where the principle supervising professional is not a nurse, a link mentor with an appropriate nursing qualification will need to be identified prior to the student commencing their practice allocation. This may be a nurse based in A& E, a Practice Educator, the student s personal tutor or the allocated Link Lecturer. This professional will be the named person responsible for undertaking and signing the student s summative assessment with the active involvement of the supervising emergency service professional.
MEETING SCHEDULE FOR TRIPARTITE ASSESSMENT OF HEALTHCARE STUDENTS Student Name: Tripartite Assessor Name: Meeting Notes Date Signed: Student Signed: Nurse Assessor 1: Initial Interview 2: Learning Contract Interview 3: Formative Mid-point Interview 4: Summative Assessment Interview