Partnerships in Foundation; nurse education culture and subsequent HEI experience.

2. Partnerships in Foundation; nurse education culture and subsequent HEI experience. NEPNET 2006 Vancouver; Debra Teasdale

3. Predominately provided ‘free at point of access’ via National Health Service. 1990’s Technological advances Resource limitations NHS Plan for NHS evolution. Results; Centralisation of services Changes in roles More staff required Increase in training numbers but immediate solutions required. Healthcare in UK

4. Overseas Nurses in the UK

5. Migration Previously transient Now long term + residence Independent travellers ie via agency / refugees + spouse/ siblings, Financial support for family in home country. RCN 2003 Ethical recruitment HCP depletion from communities with greater needs (ICN 2001) Source countries limited eg EU, India, Philippines, … Targets to ‘hard to recruit areas’ in NHS (DoH 2006) Local Impact – Malayalam nurses in NICU Changing population

6. Preparation for UK Healthcare NMC ‘Requirements’ (prior to Sept 06) Entry into UK - Sponsored/recruited by agencies (+ refugees). • Registered with NMC, work as HCA requirements complete. • IELT test (pass @ 6.5) • Completed NMC determined period of supervised practice in placement to achieve competencies. • Attended programme of study to assist adaptation into UK health system – provided by local employer or agency. No assessment of academic prowess /culture

7. Preparation for Academia • Career progression dependant on ‘Specialist’ ability - qualifications located in HEI. • Good local collaboration with NICU’s + HEI allowed pathway of progression for ON. • Step 1 - Non-accredited academic development course in HEI to ‘equip’ Malayalam nurses with study skills. • Step 2 (Optional) Evidence Based Practice Module (L2) • Step 3 - Specialist Modules (L2)

8. In Practice Hard working Willing Reliable Excellent work ethic Good level of practical skills Valued by colleagues In academia - Nuance / understanding Written expression unclear. Essay vs exams Poor/absent rationale Reticence to seek tutorial support. Devalue own cultural experiences Not just local problem… The impact….observations

9. Gods own country +’ves Education, Womens Literacy, Healthcare, IMR, MMR, -’ves Jobless, Poverty, Alcoholism, Domestic Violence, Suicide, Crime Kerala, South India

10. The local community

11. The Malayalam Student Nurse • Age • Accommodation • Educational Background • Course • Cost

12. Nurse Education Culture • Groups size • Teaching style • Culture of respect. • Resource Access / Use. • Assessment strategy • Multiple roles of tutors.

13. Practice environment • Practice intertwined with academic delivery • Established work ethic • Clear hierarchy persists, Dr’s order, nurse performs • Patient compliant within Healthcare system. • Resources limited

14. Prior Nurse education Indian English Reliance on Examinations Lack of resources limits knowledge Hierarchical education and healthcare culture. Respect and compliance. Problems in UK HEI Understanding / Nuance /expression unclear Poor essay skills Challenge and supporting rationale Reticence to seek tutorial support. Devalue own cultural experiences Potential Links

15. Resulting Local Action • CPD revalidation in 2005 • Fed information into development team. • Disseminated to Practice areas to highlight issues. • Interim Development of Accredited Academic Development Module (ADM) which ‘travels’ the process of the academic essay’, encourages discussion and sharing of experiences. • Maintained Specialist Neonatal Courses at L2 and L3.

16. 2 pathways EU Non EU nurses Non EU Nurse; Pass IELT 6.5 (? 7 ) Register with NMC for competency mapping to determine length of supervised practice in placement area. HEI Responsibilities (NMC 2005) 1. Quality assured supervised Practice Placement 2. Compulsory overseas nursing programme 20 protected study days + optional assessment L2 20 credits 3. Sign off competency and good character. Jan 06→ NMC ON’ Programme

17. Positives Placement Quality & Mentoring quality standardised Exploitation of ON reduced [cost, access] Content similar to previous ie Employer specifics for adaptation to UK healthcare Optional Assignment allows accreditation. Negatives No cultural context No ‘academic development’ of study skills beyond that normally offered. 1st Cohort - Unlikely to opt for assessment Proposal that ADM no longer required flawed - module required concurrently with ONP programme ONP Module in HEI

18. They deserve success…

19. References • Department of Health (1999a) Guidance on International Nursing Recruitment. DoH: London • Department of Health (1999b) Making a difference; Strengthening the nursing, midwifery and health visiting contribution to health and healthcare. DoH; London • Department of Health (2006) Countries with recruitment agreements. Available online @ http://ww.dh.gov.uk/PolicyAndGuidance/HumanResourcesAndTraining/MoreStaff/ Accessed 17/03/06 • International Council of Nurses (2001) Position Statement; Ethical Nurse Recruitment. ICN.Available online @ http://www.icn.ch/psrecruit01.htm Accessed 23.03.06 • Royal College of Nursing (2004) The future nurse: trends and predictions for the nurse workforce. RCN. London • Nursing and Midwifery Council (2005) Overseas Nursing Programme for UK Registration’ NMC;London.