The process of becoming a fully-fledged nurse involves numerous steps. One of those steps is being placed within a medical institution and to have one’s competences recorded on a Professional Assessment Document (PAD). The assessment is done based on the guidelines provided by the Nursing and Midwifery Council in the U.K. This organization has prescribed four main domains to be used in determining the progress and suitability of a practicing nurse to become a fully-fledged nurse (Gopee 2015).Nurses in all fields have to pass through this step. The assessment is meant to measure the level of competency that a nurse has in four main domains. These domains are communication and interpersonal skills; professional values; leadership, management and team working; as well as nursing practice and decision making. There is a certain threshold that nurses should meet to pass through and become professional nurses. The threshold is left to the discretion of the mentors that the nurses are assigned to during their placement (Morton-Cooperand Palmer2000). This paper will be assessing a case study involving a learner whose competencies across the four domains leave a lot to be desired. The assessment of how the learner has met or failed to meet the requirements is hoped to lead to conclusive evidence on the connection between evidence-based practice and theory.

Background

The paper is based on the case of Sandra Lobe. She is a mature learner who has already completed two years of placement. It is reported that even though she has passed the minimum threshold for the first and second year of placement, she has struggled to meet the threshold in some areas within the four domains. Her PAD reports that she has not been able to fully demonstrate the level of practice needed from her undergraduate program. In her second year, it is noted that she is not confident executing tasks using her clinical skills. She also appears to be disorganized. Nonetheless, there are some positive remarks on her PAD such as excellent interpersonal skills and willingness to help. She also has excellent verbal communication skills. Sandra Lobe will be the basis of discussion in the subsequent sections based on her PAD and NMC’s four domains.

Identification of Case Study Learner’s Needs

The case study learner, in this case, was Lobe. One of the most effective ways of identifying her learning needs is by assessing her weaknesses during her placement. From her PAD, it was indicated that she struggledin several key areas. For instance, it was reported that she has not been able to fully demonstrate the level of practice needed from her undergraduate program. This implies that she needs to re-read some of the concepts from her undergraduate notes to become a competent nurse. This is especially so in the areas that connect to evidence-based practice (Quinn and Hughes2013).These are areas that cannot be taught by the mentorsand require extra effort from the learner.

Another learning needs that Lobe exhibited was improving her confidence level to perform tasks expected of her. This need was noted in her second year. Her PAD indicated that she is not confident executing tasks using her clinical skills. As well, she showed utter disorganization which undermines her consistency and quality of service. In this regard, she needed to improve her organizational skills and build from there (Nowell et al. 2015). With impeccable organizational skills, confidence will thrive.

These misgivings noted about Sandra indicate that she has not mastered the two main NMC domains. These are leadership, management, and team working and nursing practice and decision making. She needs to pay close attention to these two domains to make a competent and all-rounded nurse. This way, she will meet the threshold for each domain and go on to become a reliable and fully-fledged nurse. It is important for her to understand the essence of each skill she has been taught in her undergraduate program to make herfully prepared for the demands of the nursing profession (Nowell et al. 2017a). From this discussion, the identification of learners’ needs as far as the NMC domains are concerned is best achieved by assessing specific areas where a learner shows weakness and tracing that skill back to the four domains.

Professional Accountability of the Mentor

Mentors play an important role when it comes to the assessment of learners. They are expected to offer an objective take on learner’s capabilities and application of gained knowledge (Nowell et al.2017b). Their remarks carry a lot of weight as far as determining the future of a nurse is concerned. As such, the mentors have to carefully assess the performance of the placement nurses to identify any weaknesses. The remarks should not be influenced by personal emotions but should be an objective assessment of the learner. As such, the professional accountability of the mentors is two-fold. The mentors should offer equal opportunities to all learners regardless of gender, race or background. Secondly, they should offer a professional assessmentof the learner bereft of any personal emotions or conflicts.

The mentor is expected to give opportunities to the learners to exercises their knowledge. This implies that the learners need to be offered tasks that are within their knowledge or competencies. This is despite the risk that might be implied to the patient or the hospital itself. The mentor should assume the role of a supervisor without hindering the ability of the learner to perform tasks based on their understanding(Gopee 2015). In the case of Lobe, the second year’s mentor was careful to ensure that she was accessed learning opportunities so that her skill level could be accurately determined.

Mentors are human beings with emotions. Due to different reasons, the mentors may become emotionally invested in the learner, either positive or negatively. Regardless of the nature of emotions invested, the mentors are expected to exhibit professional assessment on the learners. Professional accountability also means that the mentor should offer both positive and negative remarks on the learner’s PAD. It should not be a predominantly negative or positive assessment as each learner has their strengths and weaknesses(Morton-Cooper and Palmer 2000). These are the accountability and responsibility aspects of mentors to their learners.

Determination of Competence

The determination of competence is different from determining the learning needs of a nurse in placement. Competence is determined by assessing how a learner connects theory to evidence-based practice. In the nursing profession, competencies are achieved when a connection is made between theory and evidence-based practice. In the current case involving Sandra Lobe, there were clear signs of strong competencies and lack of adequate competencies in some areas.

Lobe lacked strong competencies in nursing practice and decision making mainly because her PAD reported that she was slowing in some of her assigned tasks. It means that she was taking too long to make pertinent decisions to the tasks assigned to her. In her training, she was also trained to quicken herself as nursing requires quick hands. A second wasted or a second too long can mean the difference between life and death as reported by Quinn and Hughes (2013) as well, nurses who undertake their tasks as fast as humanly possible tend to learn faster on the job according to a survey done in the same report by Nowell et al. (2015).Therefore, Lobe lacked the competency to use what she was taught and apply it appropriately.

Sandra depicted strong competencies in the domain of interpersonal skills and communication. Her PAD reported that she was a cordial person with excellent verbal communication skills. As such, it shows that she was able to internalize what she was taught in class as far as the communication and team working domain is concerned. Nowell et al. (2017a) report that nurses with excellent interpersonal skills and communication make work completion rates in hospitals much higher than those without. As such, Lobe’s future prospect as a nurse is positive which means that whichever hospital, she will work in will be gaining a lot from her mastery of this particular domain.

Support Needed by Learner

The learning nurses during placement have various learning needs. To achieve competencies in their areas of weaknesses, they need support. In particular, the weaknesses reported in Sandra’s PAD can be dealt with provided she is accorded support. The nature of support accorded to her will determine the kind of nurse she will become. She might become a less competitive nurse if she receives too much support. Too much support entails the mentor offering themselves to carry out all the tasks that the learner faces difficulties in completing. It is important that the learner is allowed to do things on their own to enable them to learn. As Nowell et al. (2017b) report, there should a balance in the nature and level of support offered to the nurses. It is extremely important that the nurses are taught to acquire independence and not to depend on others or their assigned mentors too much.

Further, the learners have to ensure that they are well aware of the role that their mentors play. This awareness will prevent cases where the placement nurses seek help on things that they should not be seeking help. There are things that the nurses are expected to be aware of as a bare minimum and should not seek help from their mentors. For instance, it was noted that Sandra was struggling to connect theory or what she learned in her undergraduate course with evidence-based practice. This is something that the mentor could not offer support as it would contradict the entire purpose of placement. She is supposed to find a way to apply what she has learned in practice(Gopee 2015). Therefore, support as much as it is needed by the learners needs to be well balanced and justified.

Overall, learners need support. Sandra needed support to fully understand what was expected of her. Her mentors were instrumental in ensuring that she understood her role andaccessed opportunities to apply what she had been taught. This level of support was offered at a distance to ensure that she was not hindered in any way. This is the kind of professionalsupportthat learners need in this sort of situations in the nursing profession(Morton-Cooper and Palmer 2000).

Barriers to Overcome

There are three main barriers that Sandra needed to overcome with the support offered by her mentors. These barriers were: lack of confidence, slowness when performing tasks and poor knowledge translation to skill. These three barriers have the power to limit her capacity to become an excellent nurse(Morton-Cooper and Palmer 2000).With the support offered by the mentors, Sandra could overcome these challenges as outlined below.

On the first barrier involving lack of confidence, Sandra stands a chance to improve her confidence levels. This can be done by allowing her to take on challenging tasks and setting individual goals. With the help of the mentor, she could set daily goals based on the opportunities she receives. In addition, she could also ask for challenging tasks from her mentor to boost her confidence(Gopee 2015).These support actions should be mildly applied to avoid overcompensating.

In the second challenge of being slow when completing a task, Sandra can be supported in teaching her to mind time. Her mentor can show her how best to manage time in completing certain tasks to make sure that she does not delay and cause further inconveniences at the hospital. Such support includes taking her to observe how her mentor addresses and deals with complex tasks at the shortest time possible(Quinn and Hughes 2013). This will give her the push she needs to improve her quickness.

The third barrier was poor knowledge translation to skill. To overcome this challenge, she needs to ensure that she completely understands the knowledge requirements of her role and in her every task. This will make it easier for her to translate this knowledge into skill. To do this, it might require her to either refresh her memories with notes on different nurse-related functions or to add on to her knowledge on how various tasks are done in practice. Through this method, she will be able to address the poor linking of evidence-based practice with theory. Further, the determination of competence is different from determining the learning needs of a nurse in placement(Gopee 2015). Competence is determined by assessing how a learner connects theory to evidence-based practice.

Conclusion

In conclusion, this paper addressed the challenges and assessment done on learning nurses in placement using a case study. The assessment was done based on NMC’s four domains. Through these domains, it was identified that one of the most effective ways of identifying learning needs is by assessing the weaknesses during placement. Specifically, these misgivings noted about Sandra indicate that she has not mastered the two main NMC domains. These are leadership, management, and team working and nursing practice and decision making. Mentors play an important role when it comes to the assessment of learners. They are expected to offer an objective take on learner’s capabilities and application of gained knowledge.The mentors should offer equal opportunities to all learners regardless of gender, race or background. Secondly, they should offer a professional assessment of the learner bereft of any personal emotions or conflicts. There are three main barriers that Sandra needed to overcome with the support offered by her mentors. These barriers were: lack of confidence, slowness when performing tasks and poor knowledge translation to skill. With the support offered by the mentors, Sandra could overcome these challenges.

Reference List

Gopee, N., 2015. Mentoring and supervision in healthcare. Sage.

Morton-Cooper, A. and Palmer, A., 2000. Mentoring, preceptorship and clinical supervision. Nurse Education Today, 20, pp.418-421.

Nowell, L., Norris, J.M., Mrklas, K. and White, D.E., 2017b. A literature review of mentorship programs in academic nursing. Journal of Professional Nursing, 33(5), pp.334-344.

Nowell, L., White, D.E., Benzies, K. and Rosenau, P., 2017a. Exploring mentorship programs and components in nursing academia: A qualitative study. Journal of Nursing Education and Practice, 7(9), pp.42-53.

Nowell, L., White, D.E., Mrklas, K. and Norris, J.M., 2015. Mentorship in nursing academia: a systematic review protocol. Systematic reviews, 4(1), p.16.

Quinn, F., & Hughes, S. 2013. Quinn’s Principles and Practice of Nurse Education (5th edn) Nelson Thornes.

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