Fertility competences – an update

Published: 05 January 2012

Val Peddie reports on the latest guidance aims.

Fertility nursing is highly specialised, and has been subject to dramatic change and rapid development over the last 10 years. Indeed, there has been a paradigm shift in increased clinical responsibility and clinical skills, no doubt as a result of the European Working Time Directive (EWTD) and reduction of medical staff hours (NHS, 2009). However, the RCN recognises that specialist and advanced nursing practice convey benefits, such as continuity of care and a holistic approach to practice (RCN, 2010).

Background documents

In 2002, the RCN Accreditation Unit accredited nurse practitioner programmes and published ‘Advanced nurse practitioners: an RCN guide to the advanced nurse practitioner role, competencies and programme accreditation’. Whilst draft recommendations from the Prime Minister’s Commission on the future of nursing and midwifery called on the Nursing & Midwifery Council (NMC) to take urgent steps to address public safety concerns over nurses’ roles, specialist nurses were required to provide evidence of their competence to the NMC (Manley, 2007; Gainsbury, 2010).

NHS Scotland first sought clarification and support of advanced nursing practice through the ‘Framework for developing nursing roles’ (2005), which led to the launch of ‘Modernising Nursing Careers’ (2006), and subsequently ‘The Advanced Nursing Practice Toolkit’ (2010); a useful resource for enhancing the understanding of clinical application of advanced nurse practitioners (ANP).

Clarifying our role

Yet many challenges exist in the context of role clarification: proliferation of job titles; conflicting educational requirements; qualifications; scope of practice and fragmentation/variability in standards and quality of educational programmes (Schober and Affara, 2006; Daly and Carnwell, 2003). Fertility nurses frequently work autonomously and form an integral part of the multidisciplinary team, yet no formal or nationally recognised framework or training pathway exists.

The RCN Fertility Nurses Group (FNG) – now the Midwifery and Fertility Nurses Forum (MFNF) – recognised that members should have the competence, experience and appropriate educational training to facilitate and support role extension, thus support clinical practice. Whilst fertility nurses might view role extension as ‘advanced nursing practice’, the literature concurs that such a role should be supported by appropriate academic study (NMC, 2010; Daly and Carnwell, 2003). A survey previously carried out by the RCN FNG (2000) focused on the pursuit of a ‘Principles of best practice project’ in the form of a National Competency Framework Programme. Roach (1992) defined competence as: “the state of having the knowledge, judgement, skills, energy, experience and motivation required to respond adequately to one’s professional responsibilities”.

Guidance aims...

The RCN Competences – Specialist Competences for Fertility Nurses was published in 2007 and now updated, its aim being to provide a changing context of accountability and evidence on which to base national guidance on clinical care as well as the building blocks for:
1. assessing individual competency and training needs (continuing professional development)
2. planning career pathways
3. developing comprehensive induction programmes for new members of staff
4. developing a framework for development of nursing portfolios.

Having the knowledge, skills, experience and motivation to do the job is situated at the heart of the Competency Framework and has provided fertility nurse specialists with a benchmark – or standard – for the delivery of clinical care (Peddie et al., 2011).

 There are certainly different ways in which nurse might demonstrate evidence of competency – nevertheless, nurse competencies should be a key tool in the process (Hinchliff and Rogers, 2008) of progressing from ‘novice to expert’, thus mapping the way for standardisation of training and regulation of advanced nursing practice.

Please contact on v.peddie@abdn.ac.uk.