Successful Professional Portfolios for Nursing Students

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Suzanne Reed

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    Foreword to the First Edition

    In the increasingly litigious world of healthcare there are important lessons for nurses to learn in order to avoid subsequent court room or NMC disciplinary hearing appearances. Shortcomings in nurses’ record keeping is the second most common category of hearing brought before the nursing and midwifery regulator. This compact new textbook is a timely addition to the nursing literature in offering nursing student readers an opportunity to embark on a journey that will sustain them throughout the whole of their professional lives. The journey alluded to here is the process of keeping and maintaining a professional portfolio.

    In this book, readers are offered tangible, clear and unambiguous instruction on building and maintaining a sustainable professional portfolio. All nursing students are cognisant of the need to ensure that their record keeping is meticulous. They all understand that they have a professional and legal duty to keep records which are clear, intelligible and accurate. Hence, NMC policy is clear in highlighting the importance of nurses making records which are accurate and recorded in a way that ensures the meaning is clear. The discipline of keeping and maintaining a professional portfolio has been highlighted by the NMC as an aid to developing these skills.

    Portfolio keeping as a discipline is advisable as it acts as a concrete focus for reflection in both learning and clinical environments. The evident link between keeping a portfolio and reflection offers the individual student a lifelong approach to dealing with the everyday complexities of life as a nurse in contemporary healthcare settings. The discipline of keeping a professional portfolio has many benefits for the individual embarking on the journey, not least being the ability to recall through the pages of the portfolio events which may have happened years before.

    Each of the seven chapters in this book is designed to depict, through examples, the benefits of keeping a professional portfolio harnessed to reflection. The recording of one's own feelings on how an individual decision was made and how it relates to the personal lived experience of being a nurse is what makes this book so special.

    Linking your own career with the keeping of a portfolio not only makes good sense but is likely to impress future employers, all of whom take portfolio keeping very seriously as the epitome of professional nursing. Suzanne Reed has designed and written a book which I commend to you as an essential acquisition to ensure the viability of your transition from nursing student to registered nurse and beyond.

    Professor Edward Alan Glasper Professor of Nursing The University of Southampton

    About the Author

    Suzanne Reed is an experienced General Manager with many years working at strategic and operational levels in the NHS and independent sector. Senior posts held include Ward Manager in medicine and neurology, Director of Academic Affairs and Associate Dean for the development and assessment of pre- and post-registration nursing and midwifery programmes, Head of Department, and General Manager for clinical quality and multidisciplinary education. Suzanne was an accredited reviewer for the approval of NMC nursing preparation programmes and a managing reviewer for quality monitoring of NMC nursing, midwifery and health-visiting programmes. Currently, Suzanne is a freelance writer and a voluntary carer in the community. Awards include winner of the Sister Dora Silver Medal for clinical practice and a Florence Nightingale Scholarship to study clinical assessment in Canada. Suzanne has been a key speaker at many international and national nursing conferences, and has published many articles in refereed journals as well as a nursing textbook on evidence-based practice.

    Contributor

    Alison Clark is a Lecturer in the School of Nursing, Midwifery and Physiotherapy at the University of Nottingham. She teaches across nursing theory and practice with a specific remit for public health and health promotion, and also teaches health psychology, professional development and mentorship. She has implemented learning sets to support practice-based learning for mentors and students, and has developed practice-led portfolios and web-based resources for mentorship, securing funding from two Centre for Teaching and Learning Excellence sites. Alison continues to work with a local cancer support group to maintain her interest in the psychosocial care of people with cancer and their carers.

    Acknowledgements

    Throughout the time it took to write this book, life went on. I would like to thank my husband who encourages me in everything I do, making it possible for me to maintain focus on the things that matter.

    This book would have been so much less without the abundance of talent and contributions from Alison Clark and students from the University of Nottingham School of Nursing. I would also like to thank Professor Edward Alan Glasper for sharing his knowledge and providing numerous tips. Finally, a big thank you to Richenda Milton-Daws who read my drafts and helped me to say what I wanted to say, fixing my errors and advising on sections that needed rewriting for clarity.

    Suzanne Reed
  • Suggested Programme for Potential Placement Experience for a Student using the Hub and Spoke Model

    How the Hub and Spoke Model Works

    Third-Year Student (Children's Nursing) Neonatal Intensive Care Unit, 27 Weeks
    Weeks 1–2: HUB Low-dependency area

    Orientation to placement area

    Basic care of babies, e.g. temperature monitoring, nappy changing/skin care

    Different feeding methods

    Communication with parents

    Care planning/evaluation

    Weeks 3–4: HUB High-dependency area

    Care of sick/premature babies

    Intensive monitoring

    Communication with parents

    Care planning/evaluation

    Week 5: INSIGHT

    Postnatal wards – prenatal care of mums at high risk of preterm delivery, emotional care after delivery of preterm/sick baby, conditions in mums which may cause premature delivery

    Labour suite – care of women in premature/high-risk labour

    Pregnancy assessment/ultrasound – care in high-risk pregnancy, diagnosis of abnormalities

    Crash bleep team – immediate resuscitation of preterm or sick baby

    Transport team – transfer of sick or premature baby from DGH to intensive care

    Weeks 6–9 HUB

    High-dependency area

    Weeks 10–11: SPOKE Paediatric high-dependency/intensive care units

    Caring for ex-neonatal patients, appreciation of ongoing care needs

    Weeks 12–13: SPOKE Neonatal surgical unit

    Caring for babies with surgical conditions Theatres to observe surgical treatment

    Week 14: INSIGHT Multidisciplinary team

    Family care team – home visits, home oxygen, support of families

    Hearing screeners

    Dietitian – feeding supplementation, PN, importance of nutrition/growth

    Physician – developmental care, assessment of development, positioning/exercises to support development

    Pharmacist – improve medication knowledge

    Baby checks with SHO – development of knowledge of normal and common abnormal findings in babies

    Consultant follow-up clinics – ongoing care/development/support of babies post-discharge

    Neonatal support groups/playgroups – what support is available, how families cope day to day

    Weeks 15–16: SPOKE Children's general medical/general surgical ward

    Immediate ongoing care of babies discharged directly from neonatal to paediatric care with long-term problems

    Readmission of babies/children who have previously required neonatal care

    Week 17: SPOKE Children's development centre

    Specific clinics, e.g. neurodevelopment

    Respite care of children with complex needs, knowledge of difficulties faced by babies discharged from neonatal care in later life

    Weeks 17–18 HUB

    Management – low-dependency area

    Care planning, moving babies towards home

    Parent teaching in preparation for discharge, e.g. bathing, feeding, temperature monitoring, medication administration, spotting illnesses, emergency care/resuscitation

    Discharge planning meetings; liaison with other agencies, e.g. home oxygen, postnatal wards, outpatient clinics, medical staff, community midwife/health visiting teams, GPs, family care team, arranging TTOs/equipment for discharge

    Managing team of other nurses and healthcare assistants to coordinate and prioritise care of all babies in low-dependency area

    Weeks 19–27 HUB

    Management – high-dependency area

    Admission of sick babies, both preterm and full term, expected and unexpected intensive monitoring and treatment methods

    Intensive care strategies, e.g. ventilation, cooling for HIE, blood gas analysis

    Patient assessment and care planning

    Recognising and managing deterioration

    Resuscitation

    Managing and prioritising a workload

    MDT working: doctors, consultants, pharmacists, physios, dietitians, radiologists, surgeons

    Parent support, dealing with anxiety, helping to encourage bonding and involvement of care in the baby

    Staff allocation

    Ward round

    Managing staffing levels

    Liaison with delivery suite, postnatal wards, transport team regarding admissions and available bed spaces

    Arranging transfer to referral (e.g. surgical, cardiac units) or referring (e.g. DGH for continued care after intensive care) centres as appropriate

    Glossary

    Clinical governance

    A system of audit and other checks health services use to check on and improve their services.

    Confidentiality

    Only divulging information that has been given by a patient to the people with whom the patient has agreed the information may be shared and not sharing the information beyond this group. It is a cornerstone of nursing practice.

    Critical thinking

    Questioning one's own and others’ assumptions, addressing gaps in knowledge to achieve aims, challenging illogical or unethical beliefs or practice, evaluating strength of available evidence, and the ability to present a logical, evidence-based argument and defend it when challenged.

    Evidence

    Any kind of information that is used to support reasoning, problem solving, clinical judgement and decision making, including observations, feedback, policy, theory and research.

    Learning style

    A preference for particular ways of learning.

    Mentor

    A registered nurse who has met the requirements of the NMC mentorship standard and is responsible and accountable for facilitating learning and assessing competence of students in a practice setting.

    Nursing

    Promoting health, prevention of or recovery from illness or injury, adaptation to disability, or dignity in facing death in patient-centred care by applying bio-psychosocial-spiritual knowledge, skills and ethical values to safe, effective judgement, decisions and evidence-based practice.

    Ongoing achievement record (OAR)

    A document that provides evidence of the progression in practice of nursing students and demonstrates their achievements to successive placement mentors as they move from placement to placement and year to year.

    Personal development plan (PDP)

    A framework and plan of action drawn up by students and qualified nurses identifying their own strengths and weaknesses, and including plans for building on the former and addressing the latter by additional learning. The PDP, which will be closely linked to the professional portfolio, will also outline some goals for a future path.

    Preceptorship

    A period of practical experience, or ‘training on the job’ in which the student nurse is supervised by an expert in the field.

    Reflection

    Considering and reviewing thinking, actions and circumstances to develop new ideas.

    Reflection-in-action

    Knowing what to do in order to make a difference within a given situation.

    Reflection-on-action

    Examining some of those ‘in the moment’ decisions for the possibility of other choices and ways of acting, and how these insights might shape and develop future practice.

    Reflective practice

    Considering and reviewing the interplay between theory, practice and new ideas.

    References

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    Bradshaw A. , and Merriman C. ( 2008 ) Nursing competence 10 years on: fit for practice and purpose yet? Journal of Clinical Nursing, 17(10): 12639.
    Clark A.C. ( 2010a ) How to compile a professional portfolio of practice 1: aims and learning outcomes. Nursing Times, 106(41): 1214.
    Clark A.C. ( 2010b ) How to compile a professional portfolio of practice 2: structure and building evidence. Nursing Times, 106(42): 1418.
    Clark D. ( 2008 ) Honey and Mumford's Learning Styles Questionnaire. Available at: www.nwlink.com/∼-donclark/hrd/styles/honey_mumford.html (accessed February 2015).
    Department of Health (DH) ( 2001 ) What is a Portfolio? London: HMSO.
    Department of Health (DH) ( 2012 ) Compassion in Practice. London: HMSO.
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