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  • Annexe 2 to NMC Circular 07/2007

    Essential Skills Clusters (ESCs) for Pre-registration Nursing Programmes

    This document should be read in association with NMC Circular 07/2007 that provides supporting information.

    The term patient/client is used throughout and includes service users and, where appropriate, significant others (including parents / carers).

    Key:

    Standard (e.g. 3, 4b, 7d, 8f) relates to respective outcomes and proficiencies within the Standards of proficiency for pre-registration nursing education (NMC 2004) See Annexe 3 for codes.

    Code (e.g. 1.1, 1.2, 1.3, 7.1) relates to the Code of professional conduct: standards for conduct, performance and ethics (NMC 2004).

    (*) Items requiring numerical assessment (9, 27, 28, 29, 31, 32, 33, 36, 38)

    Items requiring specific assessment (25 and 42)

    Summative health related numerical assessments are required to test skills identified (*) within the ESCs that encompass baseline assessment and calculations associated with medicines, nutrition, fluids and other areas requiring the use of numbers relevant to the field of practice:

    For entry to the branch, programme providers will use the ESCs to inform the nature and content of the assessment, including whether to assess through simulation. They will determine their own pass mark and number of attempts.

    For entry to the register, programme providers will use the ESCs to inform the nature and content of numerical assessment in the branch programme where a 100% pass mark is required and all assessment must take place in the practice setting. The number of attempts is to be determined by the education provider.

  • Care, Compassion and Communication

    Care, Compassion and Communication Patients/clients can trust a newly registered nurse to:

    For entry to branch For entry to the register

    1 Provide care based on the highest standards, knowledge and competence.

    i. Demonstrates the underpinning values of the NMC Code of professional conduct: standards for conduct, performance and ethics

    ii. Works within limitations of the role and recognises own level of competence.

    iii. Promotes a professional image iv. Shows respect for others v. Is able to engage patients/clients and build

    caring professional relationships vi. Forms appropriate and constructive

    professional relationships with families and other carers

    vii. Uses professional support structures to learn from experience and makes appropriate adjustments

    Standard: 7, 1a, b, c, d, e, f, 2d, 4a, d, 7d, 16d Code: 1.1, 1.2, 1.3, 7.1

    viii. Demonstrates clinical confidence through sound knowledge, skills and understanding relevant to Branch.

    ix. Is self aware and self confident, knows own limitations and is able to take appropriate action

    x. Acts as a role model in promoting a professional image

    xi. Acts as a role model in developing trusting relationships, within professional boundaries

    xii. Recognises and acts to overcome barriers in developing effective relationships with patients/clients

    xiii. Initiates, maintains and closes professional relationships with patients/clients and carers

    xiv. Uses professional support structures to develop self awareness, challenge own prejudices and enable professional relationships, so that care is delivered without compromise

    Standard: 7, A1, 2, 3, 4, 5, 6, C4, K1, P3 Code: 1.2, 1.3, 2.3, 6.1

    Page 2 of 29

  • Care, Compassion and Communication Care, Compassion and Communication Patients/clients can trust a newly registered nurse to:

    For entry to branch For entry to the register

    2 Engage them as partners in care. Should they be unable to meet their own needs then the nurse will ensure that these are addressed in accordance with the known wishes of the patient/client or in their best interests.

    i. Actively involves the patient/client in their assessment and care planning

    ii. Determines patient/client preferences to maximise comfort & dignity

    iii. Actively encourages patient/client to be involved in, and / or ensures they are supported in own care/self care

    iv. Supports patient/client to identify their goals v. Assesses patients/clients level of capability

    for self care vi. Provides care (or makes provisions) for those

    who are unable to maintain own personal care (e.g. mouth care, elimination, bathing, care of skin, cleaning teeth, hair washing, cleaning eyes and cleaning and cutting nails)

    Standard: 7a, b, c, 8f Code: 2.1, 4.1, 4.2

    vii. Is sensitive to patient/client needs, choice and capability and appropriately incorporates this into planned care

    viii. Supports access to independent advocacy ix. Recognises situations and acts appropriately

    when patient/client choice may compromise safety

    x. Uses strategies to manage situations where the patients/clients wishes conflict with planned care

    xi. Acts to ensure that patients/clients who are unable to meet their activities of living have these addressed in a sensitive and dignified manner and a record is kept in relation how these needs are met, e.g. bathing, elimination, care of the skin, nails, hair, eyes, teeth and mouth

    xii. Works confidently, collaboratively and in partnership with patients/clients, their families and other carers to ensure that needs are met in care planning and delivery, including strategies for self care and peer support

    xiii. Helps the patient/client to identify and use their strengths to achieve their goals and aspirations.

    Standard: C3, D1, E1, G1, 2, 3, Code: 2.1, 3.1, 3.2, 4.4

    Page 3 of 29

  • Care, Compassion and Communication Care, Compassion and Communication Patients/clients can trust a newly registered nurse to:

    For entry to branch For entry to the register

    3 Treat them with dignity and respect them as individuals.

    i. Takes a person-centred approach to care. ii. Demonstrates respect for diversity and

    individual patient/client preference, regardless of personal view

    iii. Applies the concept of dignity iv. Delivers care with dignity making appropriate

    use of the environment, self, skills and attitude

    v. Identifies factors that influence and maintain patient/client dignity

    vi. Acts in a way that demonstrates respect for others promoting and valuing differences

    Standard: 3, 4b, 7d, 8f, 9 Code: 2.2, 2.3, 2.4

    vii. Acts professionally to ensure that personal judgements, prejudices, values, attitudes and beliefs do not compromise the care provided

    viii. Is proactive in promoting and maintaining dignity

    ix. Challenges situations/others when patient/client dignity may be compromised

    x. Uses appropriate strategies to encourage and promote patient/client choice

    Standard: C4, E3, J1 Code: 1.4, 2.1, 2.2

    Page 4 of 29

  • Care, Compassion and Communication Care, Compassion and Communication Patients/clients can trust a newly registered nurse to:

    For entry to branch For entry to the register

    4 Care for them in an environment and manner that is culturally competent and free from discrimination, harassment and exploitation.

    i. Demonstrates an understanding of how culture, religion, spiritual beliefs, gender and sexuality can impact on illness and disability.

    ii. Respects peoples rights iii. Adopts a principled approach to care

    underpinned by the NMC Code of professional conduct: standards for conduct, performance and ethics.

    Standard: 1e, 2d, e, 3a, 9

    Code: 2.3, 2.4, 2.5, 3.1, 3.2

    iv. Delivers care that is culturally competent and free from discrimination, harassment and exploitation.

    v. Upholds patients/clients legal rights and speaks out when these are at risk of being compromised

    vi. Takes into account differing cultural traditions, beliefs, UK legal frameworks and professional ethics when planning care

    vii. Is proactive in promoting care environments that are culturally sensitive and free from discrimination, harassment and exploitation.

    viii. Manages challenging situations effectively

    Standard: B1, 4, C1, 2, 3, 4, K2, 3, 4

    Code: 2.1, 2.2, 3.2, 8.1

    Page 5 of 29

  • Care, Compassion and Communication Care, Compassion and Communication Patients/clients can trust a newly registered nurse to:

    For entry to branch For entry to the register

    5 Provide care that is delivered in a warm, sensitive and compassionate way.

    i. Is attentive and acts with kindness and sensitivity

    ii. Takes into account a patients/clients physical and emotional responses when carrying out care

    iii. Delivers care in a manner that is interpreted by the patient/client as warm, sensitive, kind and compassionate

    iv. Delivers care that addresses both physical and emotional needs and preferences

    v. Evaluates ways in which own interactions affect relationships to ensure that they do not impact inappropriately on others

    Standard: 3b, c, 4b, d Code: 1.4, 2.3, 7.1

    vi. Anticipates how the patient/client might feel in a given situation and responds with kindness and empathy to provide physical and emotional comfort

    vii. Makes appropriate use of touch viii. Listens to, watches for, and responds to verbal

    and non verbal cues ix. Delivers care that recognises need and provides

    both practical and emotional support x. Has insight into own values and how these may

    impact on patient/client interactions xi. Recognises circumstances that trigger personal

    negative responses and takes action to prevent this compromising of care.

    xii. Recognises