Staff focus - RCN support

Publications

The following are selected publications from the RCN and are downloadable from the RCN website. 
Other titles and details of how to obtain hard copies of publicationscan be accessed from the RCN website.

Within each section the following list is arranged firstly by publication date order (most recent first), and then alphabetically by title.

Some of the resources on this page are in PDF format - see how to access PDF files.

Clinical supervision and support

Delegating record keeping and countersigning records: guidance for nursing staff (2012) (PDF 585KB)
This guidance aims to clarify the issues of delegating record keeping and countersigning records for nursing staff and employers. 

Accountability and delegation: what you need to know (2011) ( PDF 1613KB)
This provides the principles of accountability and delegation for nurses, students , health care assistants and assistant practitioners. It aims to encourage staff engaged in the delivery of health care to reflect collaboratively on tasks proposed for delegation, in order to ensure that clients receive safe and effective care from the most appropriate person.

Guidance for mentors of nursing students and midwives: an RCN toolkit (2007) (PDF 194.4KB)
This is the second edition of the toolkit which is designed to assist practitioners in the role of mentoring pre-registration nursing and midwifery students to enable students to get the most out of their practice experience. It may also be of use to those mentoring post-registration students. The toolkit aims to identify key responsibilities, highlight accountability issues in mentoring, and help mentors to ensure compliance with NMC requirements and to optimise the support available to them.

Clinical supervision in the workplace: guidance for occupational health nurses (2002) (PDF 81KB)
Designed as an introduction to clinical supervision, this aims to stimulate ideas and to encourage occupational health (OH) nurses to set up supervision practice in their workplaces.

Employment support

A shift in the right direction: RCN guidance (2012) (PDF 728KB)
The health and safety impacts of shift work are widely recognised. Long hours, fatigue and lack of rest breaks or time to recuperate between shifts are associated with an increased risk of errors. In addition, long-term exposure to shift work, particularly night shifts, has been associated with a whole range of health issues for workers ranging from gastrointestinal problems, cardiovascular problems and an increased susceptibility to minor illnesses such as colds. This publication is primarily aimed at RCN safety representatives to assist them in their work with employers to protect members and patients from the negative impacts of shift working. It is also a useful resource for health care managers or specialist advisers responsible for managing shift systems or supporting the health, safety and wellbeing of health care workers.
A short version is also available at A shift in the right direction: RCN guidance (PDF 678.4KB).

Disability Equality Scheme: ability counts (2007) (PDF 156KB)
This document outlines how the RCN intends to meet the requirements of the Disability Discrimination Act 2005.

Working with care: improving working relationships in health care. Self-assessment tools for health care teams (2006) (PDF 277.3KB)
Working with care is a set of tools designed to encourage health care staff to examine their interactions with colleagues, to enhance the positive interactions and to increase awareness of negative interactions, some of which can amount to bullying and harassment

Bullying and harassment at work: a good practice guide for RCN negotiators and health care managers (2005) (PDF 735.5KB)
Provides guidance based on good practice in dealing with workplace bullying and harassment.

Professional development and education

RCN Competences. Finding, using and managing information: nursing, midwifery, health and social care information literacy competences (2011) (PDF 1.44MB)
This provides an information literacy competence framework to complement the RCN's clinical competence framework and aims to help nurses, midwives, health care assistants and nursing students develop their skills in using information and knowledge and apply this to their practice. The competences are intended to support the individual and the nursing team’s thinking about the information required to inform activities of varying complexity, and they are mapped to the Knowledge and Skills Framework and the Skills for Health competences.
The core clinical competence framework is available at Integrated core career and competence framework for registered nurses (PDF.50MB).

An accompanying RCN Learning Zone area provides help in researching topics in support of day-to-day work or studies. The learning is arranged around the RCN competences for information literacy and looks at some of the issues and activities involved, including using information legally, inclusively and ethically and applying and communicating the results of your information search appropriately. Stories told through a series of case studies using specific searches demonstrate the competences in practice. The stories currently available are about searches undertaken by an infection control link nurse, a student and a health care assistant. You can access this learning area at How trustworthy is your information?

The Knowledge and Skills Framework and appraisal guidance for members and employers outside of the NHS (2009) (PDF 167.7 KB)
This publication will help members who do not work in the NHS prepare for appraisal and PDRs carried out in their workplace. It provides pointers on gathering evidence  in order to maximise professional development opportunities and competencies, and on working towards future appraisals and development reviews.

The impact and effectiveness of interprofessional education in primary care: an RCN literature review (2007) (PDF 387KB )
This review of inter-professional education (IPE) was commissioned by the RCN Primary Care Educators Forum. It involved an in-depth literature review to identify reports on the impact and effectiveness of IPE in primary care. The literature was analysed to identify common themes and best practice. The findings are summarised and a series of recommendations are made.

A joint statement on continuing professional development for health and social care practitioners (2007) (PDF 520KB)
This is a position statement has been issued by the RCN in collaboration with other  professional bodies "in recognition of the fact that continuing professional development is fundamental to the development of all health and social care practitioners, and to the enhancement of quality patient/client care within uni- and multi-professional teams".

Discussing and preparing evidence at your first personal development review: guidance for RCN members on the NHS Knowledge and Skills Framework (2006) (PDF 306KB)
This guidance is intended to help nurses make the most of their first personal development review (PDR). It suggest the kinds of evidence that can be gathered in relation to the NHS Knowledge and Skills Framework (KSF) outline for a post, and how this evidence can be recorded. The document emphasises the need to use this guidance alongside the NHS KSF and the Development Review Process Handbook.

Workplace resources for practice development (2007)
This is a paper-based collection of practical tools and guidance on practice development designed to help you evaluate your own practice and the evidence you use in decision-making. Copies of this can be ordered directly from RCND Publications publications@rcn.org.uk. The resource is available in CD format (publication code: 003534, £20) or paper format (publication code 003533, £60).

Role development

Becoming and being a nurse consultant (2012) (PDF 2.2MB)
This study examines the developing role of nurse consultants. It explores how these nurses can further improve their practice, and that of their colleagues, in order to benefit patient care and build on the patient experience, and how organisations can take maximum advantage of the expertise and influence that these nurses have in bringing about change at both a strategic and day-to-day level. The study also involved aspiring nurse consultants to see how they could be more fully prepared to take on such critical role.

Community nursing: transforming health care (2011) (PDF 776.5KB)
During the last decade there has been a significant investment in hospital services with a corresponding increase in the number of hospital nurses and doctors, while the number of both district nurses and health visitors has fallen and the university based programmes for these disciplines have been drastically reduced. Community services remain less visible despite the extent of work undertaken by community nurses and the range of roles covered. An earlier RCN publication Pillars of the community offers a set of principles to help ensure the development of high quality community nursing services.This publication provides case studies "to inform, inspire and persuade people to scrutinise their current community nursing services and identify how they can be both expanded and enhanced". The case studies illustrate work in mental health, long-term conditions, end-of-life care, with vulnerable young mothers, developing custodial nursing, and supporting families with autism.

Making the business case for ward sisters/team leader to be supervisory to practice (2011)(PDF 2.2 MB)
This work builds on the recommendation from the 2009 RCN publication Breaking down barriers, driving up standards, which recognised the importance of shaping and strengthening the pivotal role of the ward sister. It includes a definition and description of what the attributes of the supervisory model are and the potential impact of implementing a supervisory model. The publication aims to be a practical resource which can help directors of nursing highlight how cost effective the change to supervisory practice for ward sisters/team leaders can be.  Appendices provide a template and accompanying guidance for presenting a business case.

RCN’s UK position on health visiting in the early years (2011) (PDF 324KB)
In August 2010 the RCN published 'Pillars of the community: the RCN UK position on the development of the registered nursing workforce in the community'. This position statement builds on that document describing in more detail what this might mean for the future of health visiting in the early years across the UK.  It looks at the important role that health visitors play in the lives of children and families and in improving public health in a challenging time for the NHS. The position statement sets out core values to guide the development of health visiting across the UK. Case studies are included showing exemplars of innovative practice.

Pillars of the community: the RCN’s UK position on the development of the registered nursing workforce in the community (2010) (PDF 310KB)
This 'sets out the core conditions that the Royal College of Nursing believes must be satisfied for community services to thrive as care is increasingly delivered closer to home and health services work to become more efficient at a time of significant financial challenge'. It is intended the document be used by the RCN and its members for lobbying purposes. The document describes the health and social care context for each of the four UK countries. The core conditions are then grouped into eight statements which 'must be applied in their entirety to nursing in the community developments taking place across the UK for reforms to be successful'. See also the related comments at community nursing.

A sustainable future: the RCN vision for community nursing in Scotland (2009) (PDF 180KB)
In this publication RCN Scotland presents a vision for a sustainable future for community nursing which is based on consultation with members and other key stakeholders. The vision is underpinned by a National Framework for Community Nursing in Scotland which ensures that the core values and job profiles of community nursing retain national currency but allow for local flexibility, and recommends two fields one working with children, young people and families and the other focusing on the needs of adults and older adults.

Breaking down barriers, driving up standards. The role of the ward sister and charge nurse (PDF 884.5KB) (2009)
Ward sisters and charge nurses have many roles, but their responsibility is clear – to oversee patient care on a ward. This Royal College of Nursing report looks at how the role of ward sisters and charge nurses  is working across different types of hospital trusts in England, including mental health, children and adult wards. The importance of the ward sister and charge nurse role applies universally, and where the role is supervisory, patient care benefits. The report findings highlight that work urgently needs to done to strengthen and support the role for the delivery of high-quality nursing.

RCN competencies - Advanced nurse practitioners: an RCN guide to the advanced nurse practitioner role, competencies and programme accreditation (2008) (PDF 1.5MB)
Increasing numbers of nurse practitioners are now working in secondary and tertiary care and within specialties. The term advanced nurse practitioner (ANP) is increasingly being used in the UK to acknowledge the advanced level of the role, the scope of practice and its associated competencies. This revised publication includes a definition of the ANP role, presents the RCN's revised domains and competencies for ANPs in the UK, and the standards which collaborating higher education institutions must meet for their ANP educational programmes to receive RCN accreditation. 

Maxi nurses: nurses working in advanced and extended roles promoting or developing patient-centred healthcare (2005) (PDF 1.1MB)
This presents nine case studies of nurses working in advanced and extended roles and is a companion publication to the report of an extensive survey undertaken by the RCN.

Interpreting accountability: An ethnographic study of practice nurses, accountability and multidisciplinary team decision-making in the context of clinical governance (2004) ( PDF 645KB)
This ethnographic study used interviews, vignettes and participant observation to explore how accountability was understood within one team of clinicians working in a general practice, following the introduction of clinical governance.

Defining nursing (2003) (PDF 1.0MB)
This publication which incorporates the results of wide consultation and participation by RCN members and others, provides a definition of nursing that can be used in developing policy and legislation, determining skill-mix, and resource management.
A summary leaflet (PDF 199.9KB) is also available.

Staffing and recruitment

Mandatory nurse staffing levels (2012) (PDF 408.6KB)
This policy briefing provides background to the RCN position on mandatory staffing levels providing an overview of the evidence around nurse staffing levels, and the guidance available on levels in different fields of nursing. It also includes an overview of the experiences of other countries who have introduced mandatory nurse-to-patient ratios.

Overstretched. Under-resourced.The UK nursing labour market review 2012 (PDF 1.1MB)
This report highlights the impact of financial pressures on the current and future NHS nursing workforce. It is submitted to the NHS Pay Body Review as part of the RCN’s Evidence to the NHS pay review body 2013-14. It also provides an overview of different systems of workforce planning in place across the four UK countries and highlights the very real risk of nursing under-supply due to developments in workforce planning.

Safe staffing for older people’s wards: an RCN toolkit (PDF 4.8MB)
This provides a simple, practical way to explore nursing staff levels on older people’s wards, or wards where the large majority of patients are older people, and to determine whether they meet the RCN recommendations for safe care. It is based on the RCN recommendations in Safe staffing for older people’s wards: summary guidance and recommendations. The toolkit can be used to support a review of staffing on hospital wards where older people are cared for. It can also be used to help address any associated leadership and workforce issues and provides guidance on developing an action plan that will identify how, and to whom, actions should be addressed.
Safe staffing for older people’s wards calculator (2012) (PDF 8.95KB). The calculator appears as the appendix in the toolkit as well as  this standalone version.

Safe staffing for older people's wards: RCN summary guidance and recommendations (2012) (PDF 1013KB)
This draws on the further evidence gathered through a survey of nurses who work on older people’s wards, nurse focus groups, a panel of expert nurses across the UK, stakeholder consultation and literature review, and sets out a threshold of staffing levels below which care becomes compromised on older people's wards. It provides guidance and recommendations for the provision of good quality compassionate and safe nursing care for older people in hospital, and identifies what is needed to meet the expectations of patients, nurses and the public, both now and in the future.

The community nursing workforce in England (2012) (PDF 473.4KB)
In this briefing, data from the NHS Information Centre is used to analyse community nursing workforce trends in the last decade, to expose the precarious current status of the community workforce. In addition a survey of RCN nurses working in the community was conducted in April 2012 in order to explore the impact this understaffing has on patients and the delivery of health services. The survey involved 2,219 nurses and also highlighted how current pressures on the social services' budgets are impacting on nursing services and patient care.

The nursing team: common goals, different roles (2012) (PDF 79.5KB)
 The nursing team has developed considerably over recent years and become more complex as new roles such as assistant practitioners (APs) have been created. This briefing aims to assist health care assistants (HCAs), APs, registered nurses, colleagues, patients and the public to understand how the team functions and works together.

Position statement on the education and training of health care assistants (HCAs) (2012) (PDF 1.2MB)
Health care assistants (HCAs) are a valued and integral part of the nursing team, who should be supported to develop their knowledge and skills required to deliver competent and compassionate patient-centred care. The RCN recognises the need for a flexible workforce with the appropriate competences which can respond to the changing requirements of the health and social care sector. This position statement provides commissioners, education providers and employers with guidance on best practice in relation to the training and education of HCAs in the UK working at levels 2-3 of the Skills for Health Career Framework (2008).

A decisive decade – mapping the future NHS workforce (2011) (PDF 741KB)
This interim report is taken from the forthcoming Royal College of Nursing Labour Market Review (LMR) 2011. This looks at the challenges facing nursing and the nursing workforce across the UK in 2011. In order to shed some light on the current and future status of NHS nursing, it examines eight possible scenarios of the supply of NHS nurses in England over the next ten years. It found that in the worst case scenario, 28 per cent of the nursing workforce (99,000 out of a current workforce of 352,104 registered nurses) could be lost during the next 10 years.

Guidance on safe nurse staffing levels in the UK (2010)
This document sets it in the context of the current quality and productivity programmes and initiatives in the four UK countries. The report sets out the range of different factors that influence the total demand for staff, including the economic context and quality and productivity initiatives. It then highlights the variety of methods for planning or reviewing staff. There are chapters on: why nurse staffing matters; current staffing levels/skill mix; planning nurse staffing. In the conclusion the RCN has identified key staffing indicators which can usefully be monitored by providers, commissioners/purchasers, and regulators. An appendix also sets out some recommended staffing minimums in the UK. A further appendix describes different staff planning tools, their key features, advantages and disadvantages.
There is also a shorter paper that summarises the RCN policy position in relation to safe staffing levels – see: RCN policy position: evidence-based nurse staffing levels.

International and European nurse recruitment. RCN guidance for nurses, health care assistants, health care employers and RCN officers (2010) (PDF 2.4MB)
This guidance sets out the key considerations and RCN principles for ensuring the ethical recruitment and employment of nurses internationally, and from across the EEA (European Economic Area) and Switzerland. It is aimed at nurses and health care assistants who may want to work in the UK, as well as potential employers. This publication includes advice on good recruitment and employment practice, information on the regulation of nurses in the UK, support available for nurses, and details of useful contacts and resources.

Taking the pulse of NHS Scotland: A report from the Royal College of Nursing on the finance and workforce pressures facing NHS Boards (2010) (PDF 473.74KB)
The work done for this report  by the RCN arose from concerns about the impact of the tightening of public sector spending on the nursing workforce, and whether in trying to meet financial pressures NHS boards in Scotland were reducing the nursing and midwifery workforce. Findings showed variation in quality and quantity of information supplied and on the budgeting and workforce planning processes used. The report presents an overview of the financial issues and processes and the workforce context and issues. Overall the work done has increased understanding of the financial and workforce issues faced by NHS boards which “will help the RCN play its part in the evidence-based, mature and creative debate required in the coming months about the challenges facing the NHS”.

NHS Knowledge and Skills Framework outlines for nursing posts: RCN guidance for nurses and managers in creating KSF outlines in the NHS (2005) (PDF 138KB)
This guidance provides broad information about how to develop NHS Knowledge and Skills Framework outlines for nursing posts in the NHS, and will help RCN members and their managers select KSF 'dimensions' that might be appropriate for different roles and at different stages in a nurse's career. It should be read in conjunction with the NHS KSF Handbook.

Defining staffing levels for children's and young people's services (2003) (PDF 2.3MB)
This document follows on from the 1999 RCN publication 'Skill-mix and staffing in children's wards and departments'. It provides further information and specific guidance on staffing levels based on the outcome of a Delphi study undertaken by the RCN's Paediatric Nurse Managers Forum during 2002. The guidance relates to neonatal and paediatric intensive care services, as well as the average general children's ward.

RCN briefings

Policy and International Department briefings on a wide range of issues affecting nurses and nursing.