5.3 Failing to fail
The role of a Practice Assessors/Academic Assessors is not only to support the development of the student nurse in clinical practice, but also to safeguard the public from incompetent nurses by preventing a failing student nurse becoming an NMC registrant (Bachmann et al., 2019). Unfortunately, there are times when a student nurse does not meet the proficiency standards required and the student needs to be failed. This is an unenviable situation for an assessor, as needing to fail a student nurse is not a pleasant situation. Hughes et al. (2016) in their systematic literature review found that registrants found failing a student nurse to be a difficult and emotional process for both student and assessor. Hughes et al. go on to say that from their work it was recognised that failing a student can provoke strong emotional responses in assessors such as self-doubt, guilt, failure of themselves as an assessor. Assessors also felt that the act of failing a student was against the ‘caring’ nature of belonging to the nursing profession. Alongside this, assessors were cognisant of the personal responses they may get back from the student having made this decision as well as the consequences for the student personally as a result of this failure outcome. As a result of these emotions, failing a student was sometimes avoided. No matter how emotional the situation failing the student when it is right to do so cannot be ignored. ‘Failing to fail’ (Duffy, 2003) a student nurse who does not display satisfactory clinical performance in itself has personal and professional ramifications for the Practice Assessor/Academic Assessor.
Activity 24
What do you think are the personal and professional consequences of giving a first-year student nurse the benefit of the doubt and making the decision not to fail them when they need to be failed?
Discussion
Not failing a first stage student nurse has ramifications even though it may at face value may not seem to be too much of an issue as there will be more opportunities for the student to ‘catch up’ later. However not failing a first-year student when they needed to have been failed leaves a problem for others to pick up. If this situation of failing to achieve the required standards of performance continues through subsequent placements until the student is in the final stage of their training leaves this final Practice Assessor with a huge issue; fail the student and they do not join the NMC register or let an incompetent individual join the register.
For the student they may feel that they have done well and can overestimate their skill level. If subsequently their practice is questioned and corrected by a subsequent assessor, it can come as a huge shock to the student and it is not unknown for the student to react to this with indignation and even outrage, making it harder for the new assessor to maintain the ‘moral courage’ to fail them, so allowing the student pass and thus the cycle repeats itself (Hughes et al., 2019).
The process of supporting students can be made a lot easier with an open and honest dialogue with the student throughout their placement. All supported of course, with good contemporaneous record keeping of the interactions. Not failing a failing student nurse has significant implications for the individual student and assessor involved, as well as for nursing profession and patient safety. Hughes et al. (2016) say in their paper that ‘assessors have an obligation to the profession and to the public, to care for the well-being of patients by ensuring student nurses are safe and competent to practise’. So, failing to fail an incompetent student nurse is not an option.