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We discussed how this process would impact on reflecting-in-action and
possibly the culture in her area. Nina was convinced this would place
greater responsibility on nurses who wanted to progress to demonstrate
the higher competencies. She felt many nurses concentrated their learning
around clinical skills and saw learning primarily taking place away from the
bedside while skills such as communication and patient management were
often undervalued or ignored by the nurses.
Nina also found perseverance and resilience were needed including a
sense of when to ―time suggestions for change‖ in her organisation. Her
experiences of change always seemed even slower than she might
anticipate, frustrating her. She felt she had to keep referring issues
upwards because the suggested change seemed stalled somewhere in
the organisation. I had just asked how she decided, based on her
reflections, if there might be an organisational issue requiring her to
instigate a change through the organisation. She told me the following
story.
Nina noticed when she began her education role that the Trust had lots of
different training departments providing the nursing staff with mandatory
training and specialised clinical skills updates. There was a training
department for Health and Safety which worked totally on its own, a
Medical Directorate Department, the Professional Development
Department and all the different Departments that did their own clinical
training courses that nurses might need to access depending on the
individual‘s clinical subject need. Consequently there were at least three
main training managers all working in isolation unaware of the training
provided by each other. A further complication was that Registered Nurses
needed yearly mandatory training updates as stipulated by the Nursing,
Midwifery Council. Nina gave an example of a band 5 nurse (the lowest
grade of staff nurse) and formulated a list of all the clinical skills she would
need to look after the clients on her ward. She worked out the total time
spent on training and all the courses that they‘d need to do, such as:
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