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Practice supervision and assessment in nursing
Practice supervision and assessment in nursing

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5.1 Concerns with a student’s performance

There are times when a students’ performance can become a concern and usually falls into one of two categories:

Conduct: Lack of professionalism (poor behaviour).

Proficiency: The learners’ ability to demonstrate the required level of knowledge and skill related to their practice.

(NES, 2020b)

Conduct

Professionalism can mean different things to different people although it is generally seen as being essential to good care (NMC, 2018f). A single definition for what it means in nursing and midwifery is difficult to establish. This multifactorial concept was taken up by the NMC (2018f) when it published its enabling professionalism framework.

Activity 22

Note down some behaviours that you consider a student nurse could display if their conduct (behaviour) was not at an acceptable standard.

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Discussion

There is no definitive list of unacceptable behaviours. This is because context as well as the behaviour itself need to be considered. However, here are some attributes you may have thought of:

  • Wearing uniform incorrectly or wearing of inappropriate clothing where a uniform is not worn
  • Taking shortcuts; not following policies and procedures
  • Showing disrespect, confrontational
  • Offensive language
  • Poor hygiene
  • Lack of motivation/interest
  • Late on duty/frequently absent
  • Unfounded stress/anxiety which affects work performance
  • Untrustworthy
  • Blurring of personal and/or professional boundaries
  • Lack of theoretical knowledge
  • Inconsistency of clinical performance
  • Blames others for identified failings

Proficiency

This is having the skills and knowledge to competently carry out an activity to the required standard. The NMC (2018c) detail the requirements of the proficiencies that a student nurse needs to obtain before being eligible to join the NMC register. The role of the Practice Assessor and Academic Assessor is to ensure that the student nurse is able to demonstrate they have the requisite skills and knowledge required for their stage/level of practice.

Activity 23

In assessing a student nurse in practice note down the types of performance issues that would be of concern to you.

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Discussion

There is no definitive list of however it will be clear that the student is not able to deliver care to an acceptable standard. Here are some indicators that you may have considered:

  • Poor/unsafe practice
  • Inability to manage the care needs of a service user
  • Poor time management
  • Inefficient organisation of workload
  • Weak/incompetent clinical performance
  • Unable to accept and respond positively when given developmental feedback from others
  • Deficient communication skills either/or written and verbal
  • Failures such as maintaining contemporaneous records, handing over important information to relevant others
  • Failure to develop skills and competencies identified at review meetings
  • Avoid working with Practice Assessor