Last week I attended an extremely positive event in Winchester, Hampshire. This was a "how was it for you" review of a pilot where practice nurses had undergone Appraisals using an adapted version of the doctors medical appraisal model. The appraisers had training and they then appraised other nurses, often external to their practice.
The event was extremely positive (and not just because they found the use of the FourteenFish toolkit easy to use!) but the overwhelming theme was how useful they felt having 2 hours of time to sit down with another nurse external to their organisation. This was extremely useful to share learning and useful everyday tips (both for appraisees and appraisers) but they also spoke of the feeling of being valued as an individual and professional that this provided. Several of the nurses were able to relate stories of how the process had had a directly positive effect on patient care.
What about nurse appraisals and revalidation?
The NMC draft guidance versions consistently mentioned appraisal but appraisal is hardly mentioned in the final guidance. A similar model to the appraisal process for doctors, with protected time and trained appraisers, would have significant cost implications if the NMC was to require this for nurse Revalidation and perhaps this was a factor in the change in guidance. Regardless many nurses will still have annual appraisals. At FourteenFish we are often asked how do these count towards revalidation.
The answer really depends on the structure and content of the appraisal itself. The appraisals in the pilot described above were a learner led process with the focus on reflection of the past year and planning development for the year ahead. The portfolio of the learner was reviewed with another NMC registered nurse. This would provide the ideal situation to sign the reflective discussion form if the appraiser was willing. As they were external to the nurse's organisation they most likely wouldn't be able to sign the confirmation form.
However, many nurses when they are talking about their annual appraisal are often referring to a performance review. This may be with another nurse, more senior to themselves, or a manager within their organisation. This should then provide a opportunity for signing the confirmation form and if the colleague conducting the appraisal is a registered nurse they may also be able to complete the reflective discussion form. This performance review appraisal may result in the nurse getting some feedback on their work which can then be documented and used in the feedback section for revalidation. If this is then further reflected on there may be material for a reflective account.
We are passionate about appraisals. I hope this blog is useful in providing both an insight as to why we are passionate about them but also useful ideas on how appraisals in nurses can be used for their revalidation.
We have worked hard to make our Nurse Revalidation dashboard easy to use but also informative and there is more detailed guidance on the site, including both a nutshell guide to revalidation and a more detailed talk from a practice nurse - both worth a look.
Dr Duncan Walling