In a previous article Gaynor Morrison and Sharon Bunford introduced Safeguarding supervision in midwifery. They take the discussion further, exploring developing competency of safeguarding during preceptorship.
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This article aims to highlight three main identified tiers of provision of Safeguarding within an Acute NHS Trust to promote cohesion and aid learning for preceptee midwives:
- Statutory on-line and lecture style learning at levels 2 and 3 as set by the local Safeguarding Partnership and NHS Foundation Trust. (RCN Intercollegiate document, 2019)
- Case study review through the means of Safeguarding Supervision (Wonnacott, 2015).
- Competency Document: Shadowing the Safeguarding Midwifery team as part of a preceptee programme to gain support, resources, liaison and guidance (West, Baily and Williams, 2020).
We have explored Supervision in our previous article (Morrison and Bunford, 2023) and for this article we will explain the rationale for providing a competency document as part of a preceptee’s orientation package within an acute Trust.
The preceptee midwife is allocated from 2 hours to ½ a day in the programme to work alongside the Safeguarding team for work-based learning (WBL) and at the end of this be able to have ‘signed-off’ their competencies set by the team and Clinical Practice Development Team. During peak recruitment times (October – November for newly qualified midwives) group sessions can be facilitated rather than multiple one-to-one sessions for individuals. Vygotsky’s theory (1978) validates this experiential style of learning and believed that people learn from ‘most knowledgeable others’ (MKO) – in this case the Safeguarding team specialists. The process of learning from others is known as the Zone of Proximal Development (ZPD). The ZPD takes the preceptee from knowledge they are struggling to grasp independently to independent learning via the MKO who supports them and provides additional learning experiences.
Most days start with a handover and daily ward round in the in-patient areas including antenatal and post-natal wards, delivery suite and Special Care Baby Unit (SCBU). Hughes and Quinn (2013) state that a great deal can be learnt on a clinical round which can help gain insight into the role of the safeguarding midwife and spark conversations and discussion. This view is supported by Kirk-Batty (2017) who recommends that shadowing the team can have huge impact in understanding processes and procedures and help to build the essential skills when working with vulnerable families. The Safeguarding midwife must facilitate this session and accommodate the preceptees’ goals for achieving and consider their needs (Jarvis and Parker, 2005). They must be able to create a meaningful learning environment whilst managing their daily work-load and challenges. According to Hughes and Quinn (2013) they suggest that a facilitator moves away from being the ‘teacher’ to become a ‘conveyor of information or a learning resource’. The safeguarding midwifery team are specialists in the field of safeguarding for unborn and new-born babies and have an acquired level of expertise needed to provide this facilitation for learners to learn (MKO). However, using Rogers (2004) humanist approach to facilitation rather than teaching, the team need to provide a supportive environment conducive for the preceptee midwife to access and be flexible in their approaches for the learners to achieve their own learning goals (Orey, 2002). Rogers (2004) argues that expertise and authority should change to one of facilitation where the learner can reach their own conclusions and solutions and identified three elements which he headed as Congruence, Empathy and Respect. Hall (2003) argues that the facilitator must understand their own emotional responses to be able to facilitate the students’ experiential learning and developing their own emotional intelligence is integral to being effective.
The NMC (2020; p10) endorse that the preceptee needs to be empowered to work in partnership in their induction programme and be afforded the opportunity to feedback, influence content, be able to feed-forward and reflect throughout, not only to meet their own needs but also for the organisation to adapt and grow. Ensuring that SMARTER feedback is collated from the preceptee elevates the learner’s voice and makes them central to its design (Bates, 2019; NMC, 2020).
The preceptee competency document promotes working together and ensures that there is an organisational culture conducive of supporting new and existing staff, recognising and building on prior knowledge and promoting their competency and safety. The RePair project (HEE, 2015) promotes the spread of best practice initiatives for staff retention to be optimised and whilst it can be argued that its primary focus was on the undergraduate programme it also encompasses the transition to the clinical area once qualified. Commitment from the healthcare provider to provide robust measures for supporting the preceptee crossing the ‘flaky bridge’ into autonomous practice, invests and promotes retention and a safe workforce.
For an electronic copy of the preceptee competency document please email : Sharonbunford@nhs.net.
Gaynor Morrison MSc, BSc (hons) : Specialist Midwife in Safeguarding and Lecturer at Surrey University.
Sharon Bunford MSc, BSc (hons) : Named Midwife for Safeguarding. Royal Surrey County Hospital NHS trust
References:
Bates, B (2019) Learning Theories Simplified. Second Edition. Sage. London.
Hall, C (2003) The Emotional Development Curriculum In Hornby, G; Hall, C and Hall, G (eds) Counselling Pupils in Schools. Routledge Falmer. London pp55-68.
HEE.sharepoint.com (2015) RePAIR Reducing Pre-registration Attrition and Improving Retention Report. Health Education England. Accessed 7.3.22
Hughes, S and Quinn, F (2013) Quinn’s principles and practice of nurse education. 6th Edition. Cengage Learning. Hampshire, UK. p21.
Jarvis, P and Parker S (2005) Human Learning. A holistic approach. Routledge, Oxon. p166.
Kirk-Batty, L (2017) Safeguarding Children. The Practicing Midwife. Vol 20 Issue 2 pp 16-20.
NMC (2020) Principles for preceptorship. London. www.nmc.org.uk accessed 07.03.22
Orey M (2002) One year of Online Blended Learning: ‘Lessons Learned’. Paper presented at the Annual Meeting of the Eastern Educational Research Association, Sarasota, Florida In J Ireland, S Martindale, N Johnson, D Adams, W Eboh, E Mowatt (2009) British Journal of Nursing. Vol 18 No 2 pp 124-130.
RCN (2019) Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff. Fourth edition: Intercollegiate Document. London. p27.
Rogers, C (2004) On Becoming a Person. London. Constable.
Vygotsky, L.S (1978) Mind in Society. Cambridge. MA Harvard University Press.
West, M; Bailey, S and Williams, E (2020) The Courage of Compassion. The Kings Fund.
Wonnacott, J (2015) Developing and Supporting Effective Staff Supervision. In Trac Pavilion Publishing and Media LTD. London.