Principles of Regulation for Registered Nurses in Scotland

Nursing is among the most crucial profession in the healthcare sector, primarily because their responsibility revolves around providing care to patients of every kind. Nurses serve as clinicians, leaders, providers, educators, among other responsibilities which are in the realm of patient care provision (“Become a nurse”, n.d.). Therefore, principles governing this practice, from acquired professional education to code of ethics, should be strictly enforced to ensure quality care and patient satisfaction. This essay outlines the principles of regulation for registered nurses in Scotland, beginning with educational and registration requirements, then the code of conduct governing nursing as a practice, and finally, ethical behaviours upheld.

Professional Education and Registration Requirements

To be a registered nurse, one requires, at least, a nursing degree and to be a member of the Nursing and Midwifery Council (NMC) through registration. Additionally, students undertaking their nursing degree have an option to choose between the four major areas of patient care which are learning disability, mental health, children, and adults. The practice also necessitates for higher level of decision making as well as technical competence, which are all developed during nursing placements in real life health care settings. Different nurse training institutions dictate their own academic requirements, but there are some behavioural-related qualifications common in any nursing school. For instance, the institution has the right to check an aspiring student’s police record or past criminal convictions to determine certain things. In addition, a student has to prove numeracy and literacy, among other factors that are important for nursing.

As previously stated, training requires a student to select their scope of study among learning disability, mental health, children, and adults. Adult nursing requires working with patients who are above 18 years and can either be in hospitals, seniors’ facilities, individual homes, among other care settings. Later after qualification, the nurse can undertake other special courses, specifying in adult care provision areas like opening a practice, critical care, emergencies, cancer care, among others. Children nursing, on the other hand, defines care and education provision to patients under 19 years and their parents or guardians respectively, specializing in distinct settings like adolescent units and children care. Special nurse training is required for children because they react differently to diseases than adults (”Become a nurse,” n.d.).

Nurses who specialize in the learning disability section help individuals with the same problem to live a fulfilled and independent life. Finally, mental health nursing involves providing care to people in specialist hospitals or at home, suffering from similar issues. Just like in the other areas of specialization, nurses require specific training for issue like communication and personal care in mental health nursing. Such may then take further courses to work in areas like substance abuse, child and adult mental health, rehabilitation, among others (”Become a nurse,” n.d.) Akin to the nursing profession, other health providers like doctors specify their areas of study and have to meet minimum requirements to be accepted as a student and considered as a professional upon completion of studies. Most health professionals also choose to specialize in a particular field such as surgery, paediatrics, orthopaedics, among others.  

Nursing registration to the Scotland’s NMC requires that a nurse has completed their bachelor’s education and has practiced in different health care settings for a specific amount of time. In addition, the training nurse has to have read, understood, and willing to perform all nursing duties as well as, follow the code of conduct as outlined by the NMC. After every three years, nurses in Scotland have to renew their registration licences, in a process known as revalidation. This ensures that the nurses are still fit as a healthcare provider, helping reinforce public protection and quality patient care (”Revalidation,” n.d.). Requirements for revalidation vary slightly with those of first-time registration, but are all geared towards patient satisfaction and quality care. In Scotland, revalidation requires an already registered nurse to have practiced for three years after registration or prior revalidation, be of sound character and health, acquire practice feedback, among others (”Revalidation,” n.d.).

Code of Conduct

Similar to every profession, nursing in Scotland is governed by a code of conduct that is geared towards providing the best possible care, while also putting the patient at the fore front. Nurses who are looking to register with the NMC and those already in practice are required to uphold the code. The code is in line with the contemporary world, reflecting the shifting expectations and roles of nurses (NMC, 2015). The code is revised regularly to keep up with the changes in healthcare provision, such as advanced technology, and is meant to reinforce the nursing professionalism. Nurses who fail to comply with the code may have their practice questioned, and possible revocation of their licenses. The code is based on four primary objectives, all meant to benefit both the patient, nurse, and employer.

The first primary theme of the nursing code in Scotland is to prioritize people. This translates to putting the people who require nursing care at the forefront, being considerate of their needs by according them with respect and dignity. This also includes listening and attending to patient needs including psychological, emotional, and physical. Additionally, the code requires nurses to respect patients’ right to confidentiality and privacy (NMC, 2015). The second primary aim of the code is to practice effectively. This includes applying the best evidence-based care, treatment or intervention, communicating effectively with both the patient and fellow nurses, and cooperating with workmates who can either be in a similar or different profession. In the spirit of collaboration, the code requires nurses to share skills and knowledge with colleagues for the benefit of patients. Practicing effectively also means that a nurse is protected by an indemnity or insurance offered in Scotland (NMC, 2015).

Third, the code necessitates for safety preservation when providing care to patients. This can be upheld by nurses knowing their scope of competence and only practicing on that realm. As a nurse in Scotland, the code also requires that one helps in emergency cases, even in a setting that is outside of their practice because patients are considered as first priority. In cases where the care required is beyond their competence, nurses are required to ask for support immediately in order to alleviate patient suffering (NMC, 2015). The newly launched Scottish Patient Safety Program (SPSP) by Scotland’s National Health Service (NHS) is an extension of this objective. The program seeks to ensure that reliability and safety is preserved by healthcare providers, to reduce individual harm (”Scottish Patient Safety Program,” n.d.). This program was as a result of a multidisciplinary collaboration, with a primary aim of reducing mortality rates across the nation. By 2011, the program had realized a 5% decrease in in-hospital mortality rates, as well as ”infection rates for certain hospital-associated infections that have been cut by more than half.” (Haraden & Leitch, 2011). Later in 2013, Scotland’s NHS responsible for quality strategy extended this program to include primary care, making the country the first to offer coordinated care and programs, globally (Houston & Bowie, 2015). Finally, the code aims at promoting both trust and professionalism in the nursing field. This entails performing one’s outlined duties and responsibilities to their entirety and in a manner that depicts professionalism. In case of a complaint against their services, nurses are required to respond professionally, ensuring that this does not interfere with quality of their care (NMC, 2015).

Ethical Behaviours and Professional Boundaries

Besides the code of conduct, nurses in Scotland are also required to observe certain ethics and practice within particular professional boundaries. Just like in other health professions principles of practice for ethical behaviours are reinforced to, mainly, protect the patient. Nurses are constantly faced with dilemmas that require making decisions based on morals and ethical guidelines of the practice. Behavioural ethics are, therefore, stipulated to ensure that each nurse is accountable for their own practice. Nursing professional ethics in Scotland, and almost anywhere in the world, entails responsibilities, duties, rights, and values whose primary aim is patient protection and to serve as a guideline for nurses as they provide care (Kangasniemi, Pakkanen & Korhonen, 2014). One of the most important ethical behaviour is confidentiality (Ulrich et al., 2010). The registered nurse has a duty to keep all the discussions and results of diagnosis between them and their patients confidential unless otherwise. This cements the nurse-client relationships, building trust and professionalism. Ethical behaviour in nursing also requires the nurse to have their patient’s signed consent before performing any procedure on them. This protects patient rights as well as, the nurse who, otherwise, breaches the code of ethics if operating without consent. It also upholds the issue of patient autonomy which advocates for the patient’s ability to make such decisions on their own, after learning both the benefits and possible ramifications for a particular medical procedure. Another ethical behaviour required of nurses is to serve care that is in the interest of a patient (NMC, 2015). However, this ethical provision has a wide scope and can sometimes be confusing, especially when the same advocates for patient consent.

Conclusion

Every profession has its stipulated principles and regulations of practice. Registered nurses in Scotland are required to achieve a minimum education level of Bachelor’s in Nursing (BN) and to complete a specified period of placement practice in real-life care before being acknowledged by the NMC. Nursing students can specialize in one of the four areas namely children, adult, mental health, and learning disability. Each of these areas can be categorised for nurses who wish to be specific about their practice. After registration, nurses are required to revalidate their licenses and overall practice every three years to ensure that they are still fit, as they were during first registration to treat and offer care to patients. In real life patient care, the NMC has an outlined code of conducts that explains expected parameters and ethical behaviours to be observed. The code has four primary objectives, which are promoting trust and professionalism, patient safety preservation, effective practice, and prioritizing people, which in this case are patients. Additionally, there are some ethical guidelines such as upholding confidentiality and seeking patient’s consent during care provision, which serve as a framework of governance.

References

Become a nurse. N.d. Royal College of Nursing. Retrieved from https://www.rcn.org.uk/professional-development/become-a-nurse

Haraden, C. and Leitch, J., 2011. Scotland’s successful national approach to improving patient safety in acute care. Health Affairs, 30(4), pp.755-763.

Houston, N. and Bowie, P., 2015. The Scottish patient safety programme in primary care: context, interventions and early outcomes. Scottish medical journal, 60(4), pp.192-195.

Kangasniemi, M., Pakkanen, P. and Korhonen, A., 2015. Professional ethics in nursing: an integrative review. Journal of advanced nursing, 71(8), pp.1744-1757.

Nursing and Midwifery Council. 2015. The Code: Professional standards of practice and behaviour for nurses and midwives.

Revalidation. n.d. Royal College of Nursing. Retrieved from https://www.rcn.org.uk/professional-development/revalidation

Scottish Patient Safety Program. N.d. Healthcare Improvement Scotland. Retrieved from http://www.scottishpatientsafetyprogramme.scot.nhs.uk/

Ulrich, C.M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M. and Grady, C., 2010. Everyday ethics: ethical issues and stress in nursing practice. Journal of advanced nursing, 66(11), pp.2510-2519.