TheRolesandResponsibilitiesoftheRegistered

Nurse by NWOGU OKECHEKWU

Introduction
ThenursingprofessionhasundergonealotofchangessinceFlorenceNightingalefoun
dedthefirstnursingschool162yearsagoandsinceTheCreationoftheNHSin1948.Bef
oretheformationoftheNHSanurse'srolewasverymuchconcernedwithmeetingdoctor
s'demands.Comparingtodoctors,nurseswereperceivedsubservientandratherunskill
ed.Therehavebeenmanyfactorstochangethissuchasaccesstoeducationandcareerde
velopmentopportunities,genderequality,scientificadvancementandpublicreliance
onNHS.Todaynursingisarespectedandlifelongcareerafarmorediverseprofessionth
anithaseverbeenbefore.

RecentChangesandtheirimpactontheRolesandResponsibilitiesoftheRegist
eredNurse

FlorenceNightingaleestablishedtheNightingaleTrainingSchoolforNursesin1860a
tSt.ThomasHospitalinLondontotransformnursingandhealthcare.Itwasthefirstnon
-
religiousinstitutiontoprovideprofessionalnursetraining.Nursingschoolscontinued
formostofthe20thcenturyuntiltheywereclosedinthemid-
1990sandmovedintouniversities.
Aftertheadoptionoftheproject2000inthe1986,nurseeducationmovedintouniversiti
eswhilecontinuingtohaveacloserelationshipwithnursingpractice,largelyintheNH
S(Nursingtimes,2002).Numerouslegislationsandpolicieswereintroducedafter199
0thatimpactedtheregisterednurse'sroles,patientsandthecommunity.TheNHSandC
ommunityCareAct(1990)gavenursesmoreresponsibilityintermsofbusiness,proce
dures,budgetsandmanagement.TheNHSImprovementPlan(2004)outlinedchange
stothecreationofthefoundationtrustsandencouragednursestowardsinnovation.The
HealthandSocialCareAct(2012)replacedprimarycaretruststo move
toclinicalcarecommissions,empoweredpatientsandnursestookmoreleadershipand
specialistrolesinvolvingadministeringmedicationandcareplans,monitoringdiet,tr
ackingprogressorrecordingstatistics.
TheHealthandSocialCareActsetoutMonitor'sroleasthesectorregulatorforhealthca
rewithresponsibilityforregulatingallprovidersofNHS-
fundedservicesinEngland(TheKing'sFund,2022).TheEconomicausterityhashada
greatimpactontheNHScausingbudgetcuts,risingcostsinsuppliesandstocking.The
NHSrelyonpublicfundsthatiswhyexpenditureiscontrolledtobalancethebudget.T
hecovid-
19pandemichashadanextensiveimpactontheNHSputtingpressureonthehealthsys
temthatwasalready
strugglingtomeethighdemands.Socialchangesputpressureonthenurses'practiceas
theyhavechangedtheirpatternsofcareandadaptedtothepatient'sgrowingexpectatio
nsandnursesexpandedanddevelopedskillstomeettherequirements.Thisisbecause
ofpeoplelivinglongerandtheincreasingcostsofchronicallyillpatientsandvulnerab
lecare.Incorporatingtechnologyintohealthcareisverybeneficialforpatientsandnur
ses.Itsupportspatient-
centredcarebyempoweringpatients,enhancespatientmonitoringanddatawhichint
urncaninformpersonalisedcarepathways,givesagreateraccesstohealthcare,expan
dstheknowledgebasefornursesandpatients,increasesefficiencyofcare,reduceserr
orsduetohavingmedicationinformationathand,bystreamlininghandoversandoffe
ringe-prescriptions.
TheModernisationAgencywasfoundedin2001withtheaimtoredesignandexpandth
eskillsandrolesofhealthcareprofessionals.Theprofessionalisationenablednursesto
controltheirpractice.Itallowednursingrolestobematchedwithskillsandcompetencie
swhichhaveimprovedpatientcareandjob
satisfaction.Nursestobeassessedontheircompetency,honesty,problemsolvingabilit
yandcoordinatecare.
TheNMCStandardsforPre-
RegistrationNursingEducation(2010)wouldpreparenursesforarangeofdifferentr
olesincludingleadership.Nursesmustmaintainthesestandardsforcompetencethro
ughouttheircareerstoremainonourregister(NursingandMidwiferyCouncil,2010)
.TheNMCstandardswouldenjointhatnursewouldrespondtochangingneeds,priori
ties,developmentandexpectations.ClinicalCommissioningGroupslaunchedafter
theFrancisReport(2013)specifiedthatstrongerleadershipandopencommunicatio
nsystemwouldcreatesaferhealthcareenvironmentsandimprovepatients'carequali
ty.CCGsreplacedPrimaryCareTruststakingresponsibilityforprimarycareservice
sandsomespecialisedhospitalservices.Inthiswaynurseswouldcarryoutriskassess
mentsandabidebysafetypoliciesasapartofanurse'srole.Nursescanprogresstheircar
eersmovingfromageneralnursetonursespecialist.Thegovernmentlaunchednursin
gdegreeapprenticeshipswhichallowsnursestobecomeaspecialistnurseinavariety
offieldssuchasdermatology,haematology,intensivecareorlong-
termcare.Developmentopportunitiescreatednewnurserolesincludingmanageme
nt,emergencycarepractitionersworkinginA&Edepartments,advancednursepract
itioners,nurseprescribers.
Thoserolesrespondedtoconstantlychangingpatient'sneedsandpopulationchanges
.

TheRoleoftheNursingandMidwiferyCouncilinRelationtoNursingPractic
e

TheNursingandMidwiferyCouncilistheregulatorofnursesandmidwivesintheUnit
edKingdomanditsmissionistoprotectthepublicasrequiredbytheNursingandMidwi
feryOrder(2001).NursesmustbeabletomeetallNMCrequirementswhentheyqualif
yandthenmaintaintheirknowledgeandskills(NursingandMidwiferyCouncil,2010
).NMCsetsstandardsofeducation,training,conductandperformancefornursesand
midwivestodeliverhighqualitycareandovertheperiodoftheircareers,ensuresthatth
eyholdskillsandknowledgeuptodate,keeptheNMC'sprofessionalstandards.TheN
MChasaveryclearprocesstoinvestigatenursesandmidwiveswhofallshortofitsstan
dards.ThenewqualifiednursesmustmeettheNMC'seligibilitycriteriatotakethetesto
fcompetence.Afterconfirmationofeligibilityapplicantsregisterandpaytotakethete
stwithPearsonVUE.Professionaldutyofcandourstatesnursehasresponsibilitytobe
openandhonestwithpatientsincaseanythingiswrongwiththeirtreatment.Theircom
municationsmustalwaysbesafe,effective,compassionateandrespectful99(Nursin
gandMidwiferyCouncil,2010).Registerednursesmustrevalidatetheirregistratione
verythreeyearswithaconfirmationtheyarefittocontinuepractice.Highstandardsne
edtobemadetorevalidateincluding450practicehoursand35hoursofCPD,fivepiece
sofpractice-
relatedfeedback,fivewrittenreflectiveaccounts,areflectivediscussionwithNMCre
gistrant,ahealthandcharacterdeclaration,professionalindemnityandinsuranceand
confirmationthatrequirementshavebeenmet.Guidesareregularlypublishedbythe
NMCtomakesureallregistrantsarekeptuptodateandareremindedoftheircommitme
nttotheNMCcode.

TheImplicationsoftheCodeonNursingPracticeandTheRoleoftheRegiste
redNurse

TheNursingandMidwiferyCouncilcodespecifiesthedutiesandresponsibilitiesofnu
rsesinpracticeanddemonstratesactionsandattitudesthatneedtobecarriedouttoachie
vehighstandardpatientcare.ThevaluesandprinciplessetoutintheCodecanbeapplied
inarangeofdifferentpracticesettings,buttheyarenotnegotiableordiscretionary(NM
C,2018).Nursesareobligedtoupholdthestandardsinthecode.Iftheyfailtocomplythe
NMCcanactandinseriouscasesremovethemfromregister.Thecontinuingdevelopm
entandtherequirementtorevalidatemakenursestopayattentiontoaccountabilityand
clinicalgovernance.Nursesarefullyresponsiblefortheiractionsthereforetheymustp
erformwithinprofessionalstandards.Incasetheyfallshortconcernsmustberaised.Th
ismighthappenespeciallythatnursesoftenworkunderpressureandareaffectedbyma
nyfactorssuchaslimitationsofresourcesorstaffdeliveringpoorcare.iftheyfindanyiss
uesaffectingdutyofcare,theycanreportitanddiscussitdirectlywiththeemployerorth
eunion.ClinicalgovernanceisthesystemwhereNHSisaccountableforthecontinuity
ofimprovementofthequalityofitsservicesandsafeguardinghighstandardsofcare.Nu
rseleadersfollowclinicalgovernancetomakesurepatientsareprovidedwithhighqual
ityofcare.
Nursesmonitortheirworkusingauditstoevaluate,assessandimprovepatientscare.Au
ditmeasurescurrentpracticeagainstadefinedstandard.Auditshowswhethernursesco
mplywithstandardsandinthiswayhealthcareprovidersareinformedaboutthequality
ofcaredeliveredandknowwhichareasrequireimprovementandwhichdon't.Nursesar
eadvocatesforpatientsautonomyinthehealthcareenvironment.Theyprovidepatient
swithinformationconcerningtreatments,possiblerisks,alternativesandbenefitsande
ncouragethemtobeinvolvedindecisionmakingbeforeapatientwillsignaninformedc
onsent.Patientscanalsouseanindependentbodythatwillhelpwiththewholeprocess.
TheNationalInstituteforHealthandCareExcellenceprovidesnationalguidanceanda
dvicetoimprovehealthandsocialcare(Gov.uk,2019).TheNICEimprovesoutcomeso
fpeopleusingpublichealthandsocialservicesbyproducingevidence-
basedguidanceandadvicefornursesandotherhealthcareprofessionals,developingqu
alitystandardsandperformancemetricforpublichealthcareprovidersandprovidingar
angeofinformationservicesformanagers,commissionersandpractitioners.
TheNMCpublicationComplaintsagainstnursesstatesthatnursesarefittoperformdut
yandpatientscantrustthemintermsofhealthandwellbeinghowevertheNMCwillact
whenthenurseposesarisktothepatients,ortheyperformancewoulddamagethepublic
sconfidenceinthenursingprofession.Allegationsagainstnursesincludelackofcomp
etence,misconduct,seriousillhealthandbadcharacter.

TheNeedforEffectiveCommunicationinaMultidisciplinaryHeal
thcareSetting
Multidisciplinaryteams(MDTs)formthemechanismtoorganiseandcoordinatehealt
handcareservicestorespondtotheneedsofpatientsthatrequirecomplexcare.Inamulti
disciplinaryteamdoctors,nursesandhealthprofessionalsfromdiversespecialtieswor
ktogether,communicateandshareresources.Theymakethemostcomprehensiveasse
ssmentofanindividual'sneedsandtofollowitupwithaplanoftreatmenttoprovideholist
ic,person-
centredandcoordinatedcareandsupport.Nursesspendmostofthedutyinteractingwit
hpatients,thereforeitisimportanttheycommunicateinasafe,effective,compassionat
eandrespectfulway.Theymustcommunicateeffectivelyusingawiderangeofstrategi
esandinterventionsincludingtheeffectiveuseofcommunicationtechnologies(NMC
,2015).Whenhealthcareprofessionalsworktogetherthepossibilityoferrorsisreduce
dandpatientsafetyrises.Sharinginformationcontributestowardsgoodteamworkand
decisionmaking,informationshouldbeexchangedclearlyandaccurately.Stressfulsit
uationsanddifferentcharactersmaycausemisunderstandingsandclashessogoodco
mmunicationisthekeytodiscusstheissuesandstaycalm.Effectivelisteningandcom
municationhaveapositiveimpactonarelationshipbetweenhealthcareproviderandpa
tientandfosteringimprovedpatientunderstanding,connectiontotreatmentplansandi
ncreasedpatientsatisfaction.Patientcentredcoordinationcare,sharedcareprotocols,
clinicalcarepathwaysandguidelinesareusedbyhealthcareteamincludingnursestoin
tensifycommunicationwithinmultidisciplinaryteam.Personcentredcoordinatedcar
eisdeliveredwithinmultidisciplinaryteambyhealthcareprofessionalswhoworkcoll
aborativelywiththepatientandthefamilyandtreatingthemasequalpartnersinplannin
g,developingandmonitoringcaretomeettheirneeds.
Communicationinrelationtonursingisinterpersonal,ithelpsthehealthcareprofessio
nalsconveycompassionandsupportforpatients. Nursesmaketheircareandsafetythe
mainconcernandmakesurethattheirdignityispreserved,andtheirneedsarerecognise
d,assessedandrespondedto(NMC,2015).Nursesshouldbeawareofculturalawarene
ssofpatientscomingfromdifferentbackgroundsbecausethismayaffectthewaysofco
mmunicatingwiththosepatients.

Buildingatrustwithpatientisveryimportant.Nursescanachievethisbylisteningactiv
elyandtakingconcernsandcomplaintsseriously.Alotdependsonhowtheinformation
issharedandalevelofpatient'sconfidenceinahealthcareprofessionalcompetenceand
expertise.TheMDTteamscommunicatingeffectivelyenhancepatientsafety,cutdow
nonmedicalerrors,improveclinicalperformance,easepatientsconcernabouttreatme
ntsandprocedures,lowerhealthcarecostsandraiseefficiency.
TheEffectivenessoftheMultidisciplinaryApproachinaHealthcareSetting
Nursesplayacontributoryroleinthemultidisciplinaryteamapproachtopatientcare.T
heymustcommunicateeffectively,shareskills,knowledgeandexperienceandnursen
eedsgoodcoordinationtomakesureeffectiveoutcomes.Coordinatingtasksrequiresn
ursesandotherhealthcareprofessionalstofollowpoliciesandprocedures.Membersof
MDTteamfollowagreedguidancetoprovideregularinformationandhelp.Keysucces
sfactorsthatmakemultidisciplinaryteamsuccessfulincludesharedgoalsandobjectiv
es,culturecollaborationandshareddecisionmaking,accesstopatientdataandshareinf
ormationtechnology,everyoneinvolvedworksandcooperatestoachievethesamegoa
l,mutualteamsupport,effectivenessisreviewedandevaluatedwithinagreedframewo
rk,coordinatortakesaccountabilityforactionstobecompletedwithinfixedtimeframe.
TheNursingprocessisascientificmethodusedbynursestoensurethequalityofpatient
care(Nursingprocess.org,2019).Thisapproachcanbebrokendownintofivestages:
Assessmentisthefirststepwherecriticalthinkingskillsanddatacollectiona
reinvolved
Nursingdiagnosisformulationbyemployingclinicaljudgementhelpstoplanan
dimplementpatientcare
Duringplanningprocessgoalsandoutcomesareformulatedthatimpactpatie
ntcare
Implementationisthecarryingoutofnursinginterventionoutlinedintheca
replan
Evaluationisthefinalstepimportanttoapositivepatientoutcome.Healthcarepro
vidersreassessandevaluateswhetherthedesiredoutcomehasbeenmet.

Holisticnursingfocusesonhealinganindividualasthewholeperson.Holistichealing
addressestheinterconnectednessofthemind,body,spirit,social/
cultural,emotions,relationships,contextandenvironment(NursingTheory,2016).
Theaspectscombinetocreatethepatientinordertohealthepatient.Thenursethenlook
satallaspectsandtheireffectonthepatient'shealth.Nursesutilizeownexperiencetobet
hefoundationoftheircare,integratethepatient'sexperiencesandvaluestotreatthepers
onratherthanillness.
Nursesusearangeoftoolstoprovideevidence-
basedandsafeapproachestocare.GoodexamplesareABCDE(airway,breathing,circ
ulation,disabilityandexposure),whichisacomprehensiveandsystematicassessmen
tofapatient'sphysiology,BMI(bodymassindex)tomeasurebodyfatbasedontheweig
htinrelationtotheheightorFLACC(face,legs,activity,cry,consolability),abehaviou
ralpainassessmenttooltouseonpaediatricandnon-verbalpatients.
Multidisciplinarycareincludesalllevelsprofessionalsfromthetreatmentpyramid.
Eachmemberoftheteamisaccountableforthetreatmentinwhichtheyexpertise.Inter
msofevaluationofthemultidisciplinaryteamsthebenefitsandlimitationsmustbetak
enintoconsideration.Theadvantagesincludebetteraccesstohealthinformation,im
provedoutcomes,treatmentandqualityofcare,patientenhancedsatisfaction,shorte
nedperiodfromdiagnosistotreatment,probabilitytoreceivecareaccordingtoclinic
alguidelinesandpsychosocialsupport.Healthprofessionals'benefitfrombetterpati
entoutcomes,bettercarecoordination,reducedduplicationofservices,streamlinedt
reatmentpathwaysandeducationalopportunities.Amongthelimitationstherearela
ckoftrust,incorrectfacts,misunderstandingofresponsibilities,notclearpositiondes
criptions,conflictedgoalsandobjectives,limitedteammembersparticipationindeci
sionmaking,inabilitytoacceptchangeandinabilitytoleadership,inadequateactionp
lans.

Conclusion

Nursingprofessionhasbeenevolvingformanyyears.Asmedicinehasprogressedsoth
erolesandresponsibilitiesofregisterednurse.Nursesworkacrossmultipledisciplines
includingserviceusersandfamilies.TheNMCisthebodythatprovidesguidanceandfr
ameworkfornursesthroughouttheircareersmakingsureprofessionalstandardsareob
served.Nursesconstantlyimprovetheirskillsandcompetenciesmaintaininghighstan
dardsofpatientcareandsupport.Nursesareattheheartofthehealthcaresystemandposs
essuniquequalitiestocarrythemissiondespitethechangingchallengestheymustface.

References

Ardl.org.uk(2020).SeniorParalegal-NursingandMidwiferyCouncil.[online]
AssociationofRegulatory&DisciplinaryLawyers.Availableat:https://
www.ardl.org.uk/senior-paralegal-nursing-and-midwifery-council/

AppexCareers(2020).ClinicalGovernanceinPrestonUK.[online]ApexCarers
Availableat:https://www.apexcarers.co.uk/clients/clinical -governance/.

CordisBright(2018).Whatarethekeyfactorsforsuccessfulmultidisciplinaryteamworking
?[online]Availableat: https://www.cordisbright.co.uk/admin/resources/05-hsc-
evidence-reviews-multidisciplinary-team-working.pdf.

Epearl(2021a).TheRolesandResponsibilitiesoftheRegisteredNurse.
[online]scch.epearl.co.uk.Availableat:https://
scch.epearl.co.uk//vle/_store/scorm/1629986036-the-roles-and-responsibilities-of-
the-registered-nurse-scorm2004-2glkh3jr/scormcontent/index.html#/lessons/
XI9Dm2x4DwD2.

Epearl(2021b).TheRolesandResponsibilitiesoftheRegisteredNurse.[online]
scch.epearl.co.uk.Availableat:
https://scch.epearl.co.uk//vle/_store/scorm/1629986036-the-roleand-
responsibilities-of-the-registered-nurse-scorm2004-
glkh3jr/scormcontent/index.html#/lessons/DAqR7-
FFzH9BOLjP1OrsLukzsKOd42ad.
Epearl(2021c).TheRolesandResponsibilitiesoftheRegisteredNurse.
[online]scch.epearl.co.uk.Availableat:https://
scch.epearl.co.uk//vle/_store/scorm/1629986036-the-roles-and-responsibilities-
of-the-registered-nurse-scorm2004-2glkh3jr/scormcontent/
index.html#/lessons/YqXTvdtA1Hk_P3tlG_4s4rfx1x9Tkc7

GOV.UK(2019).NationalInstituteforHealthandCareExcellence.[online]
GOV.UK.Availableat:
https://www.gov.uk/government/organisations/national-institute-for-clinical-
excellence.

NICE(2013).Whatwedo|About|NICE.[online]NICE.Availableat:
https://www.nice.org.uk/about/what-we-do.

NMC(2018).TheCodeProfessionalStandardsofPracticeandBehaviourfor
NursesandMidwivesNursingandMidwiferyCouncil.[online]Nursingand
MidwiferyCouncil,NursingandMidwiferyCouncil,p.6.Availableat:
https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-
code.pdf.

NursingandMidwiferyCouncil(2010).Standardsforcompetenceforregistered
nurses.[online]Availableat:
https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-
standards-for-competence-for-registered-
nurses.pdf#:~:text=Standards%20for%20pre-registration%20nurse%20

NursingandMidwiferyCouncil(2010).StandardsforPre-registrationnursing
education2010.[online]Availableat:
https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-
standards-for-pre-registration-nursing-education.pdf.

Nursingnotes(2017).A-ZGuideofClinicalAssessmentToolsforNurses.
[online]NursingNotes.Availableat:
https://nursingnotes.co.uk/resources/guide-nursing-
assessments/#.YjNnJ4_P1PY

NursingTheory(2016).HolisticNursing-NursingTheory.[online]Nursing
Theory.Availableat:https://nursing-theory.org/theories-and-models/holistic-
nursing.php.

Nursingprocess.org(2019).NursingProcessSteps.[online]Nursingprocess.org.
Availableat:https://www.nursingprocess.org/Nursing-Process-Steps.html.
PublicHealthEngland(2016).Clinicalgovernance.
[online]GOV.UK.Availableat:https://
www.gov.uk/government/publications/newborn-hearing-screening-programme-
nhsp-operational-guidance/4-clinical-governance.

Randstad(2019).Careerpathsavailabletonursingprofessionals.|Randstad
UK.[online]www.randstad.co.uk.Availableat:
https://www.randstad.co.uk/career-advice/career-guidance/career-paths-
available-to-nursing-professionals/#:~:text=Nursing%20roles%20come%20in
%20many%20forms%20and%20in

ResearchGate(2022).Figure2.2:Illustrationshowingthenursingprocess
(Illustrationby...
[online]ResearchGate.Availableat:https://www.researchgate.net/figure/Illustration-
showing-the-nursing-
process-Illustration-by-author_fig4_45635377.

TheNursingandMidwiferyCouncil(2022).Whathappenswhenwereceiveaconcern
orcomplaint.
[online]www.nmc.org.uk.Availableat:https://www.nmc.org.uk/concerns-nurses-
midwives/support-for-patients-families-and-public/what-happens-when-we-
receive-a-concern-or-complaint/.

Toney-Butler,T.J.andThayer,J.M.(2021).NursingProcess.[online]Nih.gov.
Availableat:https://www.ncbi.nlm.nih.gov/books/NBK499937/.

Webmedy(2022).ImportanceofMultidisciplinaryCare.[online]Webmedy.
Availableat:https://www.webmedy.com/blog/importance-of-
multidisciplinary-care/.

Brown,T.,Yu,M.andEtherington,J.(2020).AreListeningandInterpersonal
CommunicationSkillsPredictiveofProfessionalisminUndergraduate
OccupationalTherapyStudents?HealthProfessionsEducation,6(2).

Contributor,N.T.(2002).MakingaDifference:theimplicationsfornurse
education.[online]NursingTimes.Availableat:
https://www.nursingtimes.net/roles/nurse-educators/making-a-difference-
the-implications-for-nurse-education-14-05-2002/.

Davies,N.(2019).Digitalnurses:TakingtheNHSintothe21stcentury.[online]
www.independentnurse.co.uk.Availableat:
https://www.independentnurse.co.uk/professional-article/digital-nurses-
taking-the-nhs-into-the-21st-century/222608/.

epearl(2021).TheRolesandResponsibilitiesoftheRegisteredNurse.[online]
scch.epearl.co.uk.Availableat:
https://scch.epearl.co.uk//vle/_store/scorm/1629986036-the-roles-and-
responsibilities-of-the-registered-nurse-scorm2004-2-
glkh3jr/scormcontent/index.html

Fitzpatrick,L.(2018).Theimportanceofcommunicationandprofessional
valuesrelatingtonursingpractice.

History.com(2018).FlorenceNightingale.
[online]HISTORY.Availableat:https://www.history.com/topics/womens-
history/florence-nightingale-1.

Hughes,C.(2018).MultidisciplinaryTeamworkEnsuresBetterHealthcare
Outcomes.[online]Td.org.Availableat:
https://www.td.org/insights/multidisciplinary-teamwork-ensures-better-
healthcare-outcomes.

Johnson,P.,Emmerson,C.,Miller,H.,Phillips,D.,Stoye,G.,Delestre,I.,Stockton,I.
,Ogden,K.,Joyce,R.,Adam,S.,Waters,T.,Warner,M.andZaranko,B.
(2021).AninitialresponsetothePrimeMinister’sannouncementonhealth,socialca
reandNationalInsurance.
[online]ifs.org.uk.Availableat:https://ifs.org.uk/publications/15597.

KeypathEducation(2020).RecentChangesinNursingPractice&Education|
GlobalHealthEducation.
[online]globalhealtheducation.com.Availableat:https://
globalhealtheducation.com/article/recent-changes-nursing-practice-
education#:~:text=%20Recent%20Changes%20In%20The%20Nursing
%20Practice%20.

McKee,R.(2017).Fearsfor<easierlanguagetests=forforeign-bornNHS
nurses.[online]Dailystar.co.uk.Availableat:
https://www.dailystar.co.uk/news/latest-news/nhs-crisis-nurses-eu-workers-
17028147

ResearchGate(2015).Figure1:Thefourprinciplesofperson-centredcare1.
[online]ResearchGate.Availableat:https://www.researchgate.net/figure/The-
four-principles-of-person-centred-care-1_fig1_289928318.

SocialCareInstituteforExcellence(2018).Multidisciplinaryteams-
Activitiestoachieveintegratedcare.
[online]SocialCareInstituteforExcellence(SCIE).Availableat:https://
www.scie.org.uk/integrated-care/research-
practice/activities/multidisciplinary-teams.

TheHealthFoundation(2004).<TheNHSimprovementplan:puttingpeopleat
theheartofpublicservices=whitepaper.[online]PolicyNavigator.Availableat:
https://navigator.health.org.uk/theme/nhs-improvement-plan-putting-people-
heart-public-services-white-paper.

TheKing’sFund(2015).TheKing’sFund.[online]TheKing9sFund.Availableat:
https://www.kingsfund.org.uk/projects/new-nhs.

UniversityofStAugustine(2020).Theimportanceofeffectivecommunication
innursing.
[online]UniversityofSt.AugustineforHealthSciences.Availableat:https://
www.usa.edu/blog/communication-in-nursing/.

www.healthcentre.org.uk.(2022).ThechangingroleofnurseswithintheNHS.
[online]Availableat:https://www.healthcentre.org.uk/news-archives/the-
changing-role-of-nurses-within-the-nhs.html.

50NursingQuotestoInspireandBrightenYourDay.
[online]NurseBuff.Availableat:https://www.nursebuff.com/nursing-quotes-2/.
Bibliography

ardl.org.uk(2020).SeniorParalegal-NursingandMidwiferyCouncil.[online]
AssociationofRegulatory&DisciplinaryLawyers.Availableat:
https://www.ardl.org.uk/senior-paralegal-nursing-and-midwifery-council/

AppexCareers(2020).ClinicalGovernanceinPrestonUK.[online]ApexCarers.

Availableat:https://www.apexcarers.co.uk/clients/clinical -governance/.

CordisBright(2018).Whatarethekeyfactorsforsuccessfulmultidisciplinaryteam
working?[online]Availableat:https://www.cordisbright.co.uk/admin/
resources/05-hsc-evidence-reviews-multidisciplinary-team-working.pdf.

epearl(2021a).TheRolesandResponsibilitiesoftheRegisteredNurse.[online]
scch.epearl.co.uk.Availableat:
https://scch.epearl.co.uk//vle/_store/scorm/1629986036-the-roles-and-
responsibilities-of-the-registered-nurse-scorm2004-2-
glkh3jr/scormcontent/index.html#/lessons/XI9Dm2x4DwD2

epearl(2021b).TheRolesandResponsibilitiesoftheRegisteredNurse.[online]
scch.epearl.co.uk.Availableat:
https://scch.epearl.co.uk//vle/_store/scorm/1629986036-the-roles-and-
responsibilities-of-the-registered-nurse-scorm2004-2-
glkh3jr/scormcontent/index.html#/lessons/DAqR7-
FFzH9BOLjP1OrsLukzsKOd42ad

epearl(2021c).TheRolesandResponsibilitiesoftheRegisteredNurse.[online]
scch.epearl.co.uk.Availableat:https://
scch.epearl.co.uk//vle/_store/scorm/1629986036-the-roles-and-
responsibilities-of-the-registered-nurse-scorm2004-2-
glkh3jr/scormcontent/index.html#/lessons/YqXTvdtA1Hk_-
P3tlG_4s4rfx1x9Tkc7

GOV.UK(2019).NationalInstituteforHealthandCareExcellence.[online]
GOV.UK.Availableat:https://www.gov.uk/government/organisations/national-
institute-for-clinical-excellence.
NICE(2013).Whatwedo|About|NICE.[online]NICE.Availableat:
https://www.nice.org.uk/about/what-we-do.

NMC(2018).TheCodeProfessionalStandardsofPracticeandBehaviourforNurses
andMidwivesNursingandMidwiferyCouncil.
[online]NursingandMidwiferyCouncil,NursingandMidwiferyCouncil,p.6.Availa
bleat:https://www.nmc.org.uk/globalassets/sitedocuments/nmc-
publications/nmc-code.pdf.

NursingandMidwiferyCouncil(2010).Standardsforcompetenceforregisterednurse
s.
[online]Availableat:https://
www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-

standards-for-competence-for-registered-
nurses.pdf#:~:text=Standards%20for%20pre-registration%20nurse%20

NursingandMidwiferyCouncil(2010).StandardsforPre-registrationnursing
education2010.[online]Availableat:
https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-
standards-for-pre-registration-nursing-education.pdf.

Nursingnotes(2017).A-ZGuideofClinicalAssessmentToolsforNurses.
[online]NursingNotes.Availableat:https://
nursingnotes.co.uk/resources/guide-nursing-
assessments/#.YjNnJ4_P1PY

NursingTheory(2016).HolisticNursing-NursingTheory.[online]Nursing
Theory.Availableat:https://nursing-theory.org/theories-and-models/holistic-
nursing.php.

Nursingprocess.org(2019).NursingProcessSteps.[online]Nursingprocess.org.
Availableat:https://www.nursingprocess.org/Nursing-Process-Steps.html.

PublicHealthEngland(2016).Clinicalgovernance.[online]GOV.UK.Available
at:https://www.gov.uk/government/publications/newborn-hearing-screening-
programme-nhsp-operational-guidance/4-clinical-governance.
Randstad(2019).Careerpathsavailabletonursingprofessionals.|Randstad
UK.[online]www.randstad.co.uk.Availableat:
https://www.randstad.co.uk/career-advice/career-guidance/career-paths-
available-to-nursingprofessionals/#:~:text=Nursing%20roles%20come%20in
%20many%20forms%2
0and%20in

ResearchGate(2022).Figure2.2:Illustrationshowingthenursingprocess(Illu
strationby...
[online]ResearchGate.Availableat:https://
www.researchgate.net/figure/Illustration-showing-the-nursing-process-
Illustration-by-author_fig4_45635377.

TheNursingandMidwiferyCouncil(2022).Whathappenswhenwereceivea
concernorcomplaint.
[online]www.nmc.org.uk.Availableat:https://www.nmc.org.uk/concerns-nurses-
midwives/support-for-patients-families-and-public/what-happens-when-we-
receive-a-concern-or-complaint/.

Toney-Butler,T.J.andThayer,J.M.(2021).NursingProcess.[online]Nih.gov.
Availableat:https://www.ncbi.nlm.nih.gov/books/NBK499937/.

Webmedy(2022).ImportanceofMultidisciplinaryCare.[online]Webmedy.
Availableat:https://www.webmedy.com/blog/importance-of-
multidisciplinary-care/.