With COVID-19 presenting unique challenges, RCN Head of Legal (Regulatory) Roz Hooper explains how the RCN’s legal team is supporting members during the pandemic
Temporary changes at the NMC
Nursing staff living in and working through a pandemic need to be aware of the legal impact of their actions more than ever before.
From the outset, the legal implications were clear. Huge changes to the Nursing and Midwifery Council (NMC) register were rushed through, and in the space of just a few weeks, a temporary register was established, which allowed 14,000 former nurses to practise under temporary regulations.
The boost to the nursing workforce was welcome. Without doubt, their timely contribution made an invaluable impact on the availability of nursing provision that was delivered when it was needed most.
From a legal point of view, they joined with fewer constraints than other registrants. Some returners are in our retired membership category, which under normal circumstances would mean they didn’t pay for workplace support. We recognised they now need this and acted quickly to provide this on the retired rate. We also extended this offer to those who weren’t previously members.
The NMC has prioritised issues clearly during the pandemic and has made changes to take the pressure off frontline staff. We were consulted on the decision to temporarily delay revalidation, which we supported.
The NMC has confirmed it will take into account the extraordinary circumstances nurses are working in if they’re referred for issues such as accountability and delegation.
It’s also made the decision not to tell people if they’ve been referred unless it’s absolutely necessary. We agree that this is the humane thing to do as some of these referrals won’t be investigated for some time so there’s no benefit to having this hanging over anyone right now.
Nursing staff are having to make difficult decisions in extraordinary circumstances
At the moment, nursing staff are having to make difficult decisions in extraordinary circumstances, including those staff who have been redeployed and aren’t even working in their usual areas.
That’s why it’s so important to make sure your record-keeping and documentation is as accurate as possible. Nobody is going to succeed in criticising you if you made a decision that can be justified. Ensure you have a record of what you did and why you did it.
However, it’s important, of course, to remember that record keeping can be affected by the pressure nursing staff are working under. The RCN is on your side. We understand the pressures nursing staff are under and will continue to fight your corner.
Inadequate PPE
At one point there was a difference between what personal protective equipment (PPE) Public Health England and the World Health Organization were recommending.
This was confusing and frightening for many nursing staff. Those in care homes, in particular, were facing huge decisions.They were scared. If they didn’t have the right PPE, they rightly asked us what they should do.
The NMC Code asks nurses to take their safety, that of the public, and the treatment of patients into account, but this didn’t answer all the questions in these unusual circumstances.
We said, ultimately – as a last resort – you can refuse to treat if you found yourselves without the recommended PPE, which attracted some controversy in the press. The NMC then ratified this advice.
While most nursing support workers are not regulated by the NMC, the same principles apply to members in this category of membership.
If you’re accepting tasks, ensure you feel safe and comfortable in doing so. People need to understand why you came to that decision.
Ultimately, we’ll assist you whatever you choose to do. We support members without judgement. However, my best advice is to make sure you can justify your own decision-making.
While you’re making more unusual decisions in far from usual circumstances, remember you are the professional, you make good decisions. Ensure you can explain them.
Social media
The heightened emotion in these times can make people more unguarded, especially in their social media communications, but the usual rules apply.
Be careful and be aware that others may react in unpredictable ways, especially when using online communications. The NMC has specific social media guidance and it would perhaps be advisable to refer to this at this time.
The public are more aware than ever of nursing roles and the NMC has received some referrals relating to social media use.
Our advice is to tread cautiously if you say you’re a nurse, remain calm and avoid arguments with others. Whistle-blowers should use an organisation’s policy rather than social media to raise concerns.
Continued legal support
The RCN’s legal support for members has continued uninterrupted. We’re co-operating with the NMC who are running virtual hearings for interim orders and are making these as user-friendly as possible. Some cases are not yet being investigated by the NMC – they have put some on hold.
There has been and will still be much for us to consider; employment issues, furlough, redeployment, returning to “the new normal”, shielding, childcare provision, the impact on pay, and terms and conditions all have legal consequences.
It’s likely that members will be involved in inquests related to COVID-19 and we will be here to support them. We’re also considering how to prepare for a possible national enquiry on the pandemic and how we support the families of members who have died or have been injured.
Further information
- For more information about what the NMC has put in place during the pandemic, visit the NMC's website.
- If you need support or advice on legal issues, or any of the issues mentioned in this story, contact RCN Direct in the first instance for advice.
