More than 300,000 qualified nurses are employed in the NHS which makes nursing the single largest workforce in the service. They are crucially important to the delivery of high quality patient care and to ensuring patients, and their families, have positive experiences of their care. Given the key role they play, it is perhaps obvious to note how vital it is that the right people are recruited into nursing.
Recruitment and selection
Significant effort goes into the recruitment and selection of student nurses prior to them entering pre-registration nursing programmes. In their role as the regulatory body and in order to protect the public, the Nursing and Midwifery Council (NMC) set standards for this recruitment and selection process against which universities are measured on a yearly basis. These standards include academic criteria as well as evidence of ‘good health’ and ‘good character’. With respect to academic criteria, the NMC sets minimum academic entry criteria that all students of nursing must meet. These minimum academic criteria are based on years of schooling and requirements of literacy and numeracy. However, individual universities normally set their own additional entry academic criteria over and above these minimum standards.
In addition to academic entry criteria, applicants also have to declare good health and good character. The NMC’s Guidance on Good Health and Good Character for Education Institutions, published in 2010, states that ‘good health is necessary to undertake practice as a nurse or midwife. Good health means that a person must be capable of safe and effective practice without supervision’. The NMC also require applicants to provide evidence of their good character. But what is actually meant by this? The NMC’s Guidance publication also states that ‘good character is important and is central to the code in that nurses must be honest and trustworthy. Good character is based on an individual’s conduct, behaviour and attitude. It also takes account of any convictions, cautions and pending charges that are likely to be incompatible with professional registration’. With respect to the latter, all potential nursing students are screened through the Disclosure and Barring Scheme. But the issues of conduct, behaviour and attitudes are perhaps a little more difficult to ascertain.
Good character debate
There is some disagreement in academic circles about whether the components of what constitutes good character, for example values, attitudes, virtues and beliefs, are innate in a person or whether they can be taught. In other words, is good character an example of nature or nurture? This debate creates challenges in judging the nature of good character in student nurses by posing the question of whether values can be taught or whether they should be sought during the recruitment and selection process.
So until this debate is resolved, universities work carefully with their partner healthcare organisations, such as local hospital trusts, to ensure their recruitment and selection processes assure the good character of their nursing students. Current or past service users and carers are also involved in the selection process, either in designing the recruitment and selection process itself, or in selection interviews or in providing feedback to candidates. Candidates’ application forms are assessed for evidence of not only meeting the set academic criteria but also whether they have previous caring experience. Such experience gives an indication that candidates have an informed view of the realities of contemporary nursing. If invited for interview, each applicant is assessed for evidence of compassion and caring attitudes and questioned as to why they want to join the nursing profession, what they understand the role of the nurse to be, and why they have chosen a particular field of nursing.
Recent high profile examples of failings in nursing care have brought to the fore concerns about ensuring nurses are recruited for their compassionate and empathetic values. The key stakeholders involved in pre-registration nursing education – universities, healthcare organisations and regulatory bodies – need to continue to seek out ways to ensure that an appropriate value base is sought in student nurses, and that they are recruited, then nurtured and continually supported in their quest to deliver compassionate and safe care for their patients.
- Nursing and Midwifery Council (2010) Guidance on Good Health and Good Character for Education Institutions, London, NMC.