Students in practice or work-placed learning must be supported to learn and practise safely. In order to have the student at the centre of learning, we specify that students must have some form of supported or protected learning time.
Pre-registration nursing and midwifery
For pre-registration student nurses and midwives, including those studying for their degree by way of an apprenticeship, this means that all students must be considered ‘supernumerary’ when it comes to their practice learning, which we define as follows:
Supernumerary: students in practice or work placed learning must be supported to learn without being counted as part of the staffing required for safe and effective care in that setting. For apprentices, this includes practice placements within their place of employment; this does not apply when they are working in their substantive role. Placements should enable students to learn to provide safe and effective care, not merely to observe; students can and should add real value to care. The contribution students make will increase over time as they gain proficiency and they will continue to benefit from ongoing guidance and feedback. Once a student has demonstrated that they are proficient, they should be able to fulfil tasks without direct oversight. The level of supervision a student needs is based on the professional judgement of their supervisors, taking into account any associated risks and the students’ knowledge, proficiency and confidence.
Please also see our guidance on running nursing degree apprenticeships, which includes guidance on supernumerary status for practice learning and making time available for academic learning [add link].
Pre-registration nursing associates
We do not require all nursing associate students to be supernumerary while learning in practice but some will be, whilst other students must have ‘protected learning time’. The decision about how this is provided is for AEIs and their practice learning partners to make in line with the options set out in the programme standards for nursing associates [add link].
Post-registration programmes
As students on post-registration programmes are already on our register, they are not regarded as ‘supernumerary’ when undertaking practice learning as part of their education and training on post-registration programmes. However, they should have ‘protected learning time’ in line with the standards relevant to the programmes they are studying. ‘Protected learning time’ is time spent in a health, care or other setting during which students are learning and are supported to learn. Post-registration students must be supervised during protected learning time. The level of supervision required is a matter of professional judgement and will depend on the competence and confidence of the student, and the risks associated with the care intervention being delivered in order that people remain safe at all times.
Protected learning time – post-registration/prescribing
We are often asked what is meant by protected learning time for post-registration programmes – if someone is already an employed registered professional, what protected learning time might need to be provided for them by their employer?
One example might be where a post-registration student takes some non-clinical time to explore some records relating to people in their care in depth in order to inform a person’s care or a case study.
Another example may be where a prescribing student takes some non-clinical time to research from patient records and academic findings the known side effects of particular medicines and treatments to help inform their future prescribing practice or spends time with a pharmacist to learn more about their role in the prescribing process.
There would be many other examples and we would encourage students and educators alike to be innovative and creative in making use of protected learning time to enhance the learning experience. Students in particular should feel empowered to direct their own learning and put forward suggestions as to what learning opportunities they may wish to explore during protected learning time.
Protected learning time – student nursing associates
Protected learning time can be an issue for student nursing associates who are carrying out their practice learning in a setting where they are already employed. For student nursing associates who may work and learn in the same practice environment, careful consideration and planning is essential to balance their professional role with their learning activities.
When they are learning as a student nursing associate rather than working in their regular employment role, this should be respected, and their learning prioritised, in terms of how to apply the new knowledge and skills they are learning to become a registered nursing associate rather than continuing to carry out functions more appropriate to their employment role.
We are aware that to help with this, many sites operate a policy whereby student nursing associates will wear different uniforms and identity badges on the days when they are on practice learning experience from the days when they are working in their current role. This makes it clear that they are there as a student rather than as an employee, and that they should be regarded accordingly by people who use services, members of the public, colleagues, managers and those supervising their learning.
Case study – post-registration student on a prescribing programme
Context - Courtney is a registered nurse who is currently undertaking an NMC approved V300 independent/supplementary prescribing programme at her local university.
Courtney is on the third consecutive shift with the same practice supervisor, who works in a different area from that where Courtney usually practises, and he notes that Courtney has been late for each of her shifts. He decides to talk to her about this as she has always appeared to have a committed and enthusiastic approach to her work and studies.
The practice supervisor discusses and expresses his concern for her wellbeing and the potential impact it could have on her practice and programme outcomes. Courtney confides that it has been difficult to get protected learning time due to being very busy at work. There has been limited access to the necessary practice learning opportunities and the chance to apply the knowledge she has learned. She describes learning a great deal at university but has been unable to embed this newly acquired knowledge and skills into practice.
Courtney had discussed her concerns with her personal tutor who suggested she speak to the nominated person for that practice area. Courtney acknowledged that she had yet to do this, as she had an awareness that there is a lot of staff sickness and she didn’t want to let the team down.
The practice supervisor thanked Courtney for her honesty as he had usually found her to be friendly, efficient and proactive, yet recently had noticed she was not her usual self. It turned out that Courtney felt conflicted as she didn’t want to put her own learning needs before the more immediate needs of the team.
The practice supervisor set up a three-way meeting with himself, the practice assessor (based on another ward) and Courtney. Initially this felt uncomfortable for Courtney, although this changed when her practice assessor gave her constructive feedback from her other practice supervisors, this included the community pharmacist who had been impressed with her knowledge and her comprehensive understanding of polypharmacy, pharmacokinetics and pharmacodynamics.
During this meeting they were able to develop a clear action plan for Courtney and her practice supervisors to work together.
This included:
- Update the action plan and outline the outstanding competencies that Courtney needs to meet
- The actions required for Courtney to feel empowered and take the responsibility to be proactive in her learning
- Similarly, for the nominated person to work with Courtney to support her with protected learning time and the ensure that the right resources are available
- Practice supervisors to make Courtney aware of the support and learning opportunities available to enable independent learning
- Courtney’s practice assessor to periodically observe her in order to confirm achievements and to give her constructive feedback on her progress.
- The academic assessor to be kept informed of the updated action plan
- A review date for the action plan and the next three-way meeting.
