The Nursing Midwifery Council (NMC)
This section brings together key information focused on upholding and maintaining your new role. Completion of your studies shows you have the skills and ability needed to perform the role effectively.
You are at the start of your professional career. A career offering lots of stimulating and exciting opportunities to develop. You will feel job satisfaction in providing excellent quality care to those who need it.
Nursing and midwifery offers you the opportunity of a truly fulfilling career. It is full of enjoyable moments and learning opportunities. But there may be times you feel uncertain and slightly anxious about the role. A solid foundation for your professional role as a registered nurse comes when you know:
- what good practice is
- what you are responsible and accountable for
- what resources are available to support you or know who to ask for help.
(NMC 2018) – Professional standards of practice and behaviour for registered nurses.
(NMC 2019) – Professional standards of practice and behaviour for midwives.
As an newly registered nurse (NRN) you will need to continue to develop your confidence and competence in all areas of your practice. This includes using your clinical judgement and decision-making skills.
The Code (NMC 2018) set out the standards and behaviours required of registered nurses. In relation to clinical judgement and decision making, this includes:
Practise effectively:
- Standard 6. Always practise in line with the best available evidence.
- Standard 11. Be accountable for your decisions to delegate tasks and duties to other people.
Preserve safety:
- Standard 13. Recognise and work within the limits of your competence.
- Standard 19. Be aware of, and reduce as far as possible, any potential for harm associated with your practice.
Promote professionalism and trust:
- Standard 25.1 Identify priorities, manage time, staff and resources effectively, and deal with risk to make sure that the quality of care or service you deliver is maintained and improved, putting the needs of those receiving care or services first.
Building sound clinical judgement, moving from novice to expert, is a long journey. To begin with your aim should be to broaden your knowledge and experience. This will help you make safe informed decisions. Also, to know where to turn when decision-making proves difficult.
The NMC Future Nurse Standards can guide you in your development as a registered nurse.
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Every year, you will need to make a payment to remain on the NMC register. You must pay your annual fee before your retention date, or your registration will lapse. If your registration lapses you will automatically be removed from the register.
It is important you know when this date is—it should correspond with the month your application to the NMC was submitted. You will receive emails from the NMC reminding you of your renewal. Please check these emails are not going into your spam folder. You must also ensure the NMC has your up-to-date details.
Nursing is a continuous journey of learning and development.
Continuing professional development (CPD) is vital to develop and improve your professional practice. It will be shaped by how you respond to situations, your experiences and those around you. CPD can build on your strengths, as well as develop yourself where you have capability gaps. Getting feedback is important so you can reflect on your role and practice as a nurse.
As a registrant you need to revalidate with the NMC every three years. This is to ensure you remain fit to practise throughout your career. It is never too early to start thinking about what you need to do to stay on the NMC register. Revalidation is not simply checking you meet the required practice hours or standards. The aim is to promote CPD throughout the three-year period. You need to be able evidence this learning and development. We recommend you create a portfolio for this. All RCN members have free access to an online portfolio which can support this process.
The NMC set out the requirements for revalidation. It provides detailed guidance and templates for you to record your evidence.
We recommend you look at these documents and resources as soon as possible so you can plan and know how to collect evidence in the years preceding revalidation. This will make your revalidation process much easier when the time comes. Linking your revalidation work to the Future Nurse standards is also a good idea.
The RCN has developed some resources to support you in your revalidation.
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The RCN prides itself on the wealth of high-quality, evidence based CPD resources available to all members through the professional forums, networks, subject areas and clinical topics: https://startingout.rcn.org.uk/Develop https://startingout.rcn.org.uk/Develop/Forums-and-Networks
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RCNi Learning - Enhance your skills and expand your clinical knowledge
RCNi Learning is an interactive online learning resource, featuring more than 180 RCN-accredited learning modules designed to support you with your professional development and help bridge the gap between theory and practice. Try a selection of free modules today at: rcnilearning.com
RCNi Portfolio
Build, track and store your evidence for revalidation and be guided through the process one step at a time with helpful progress alerts.
RCNi Decision Support - Make evidence-based decisions with confidence when assessing and treating patients
With over 100 topics to choose from, the UK’s first and only decision support tool for nurses helps to guide your thinking and supports you in delivering safe and effective patient care that meets the UK’s best practice guidelines. For more information and to subscribe, please visit: rcnidecisionsupport.com
There is a wealth of research that supports the importance of preceptorship for NRNs. This period of preceptorship can:
- improve confidence
- increase job satisfaction
- offer a sense of feeling valued and respected by your employing organisation
- build a commitment to the organisation’s corporate strategy and objectives.
We know the transition from student to registered nurse can be a particularly stressful period and that having the right support and guidance can make a huge difference to your wellbeing. A recent project shows there needs to be a greater focus on creating cultures where people can flourish (Smail, 2024). Where it feels safe enough to ask questions, raise concerns, make mistakes, and learn. This is key for supporting newly registered staff, retention and to the quality of care provided.
Findings from the research have highlighted the key stressors. It also identifies support and learning that NRNs need to successfully transition.
These are:
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Preparation for practice It is vital to fully understand and be prepared for the job that you have been appointed to. You will find out more information about the role from:
It should also be made clear what to expect during your initial induction, preceptorship period and the support and learning provided. The reality of practice The shift in responsibilities and accountabilities, that comes with becoming a registered nurse, cannot be fully experienced until you start your first post. It will all ‘feel’ different, compared to your experience as a student. Key areas where you will feel different include:
Developing clinical practice You have the knowledge, skills and competency to provide safe and effective care to a range of patients within your field of practice. The patients you are giving care to in your first post may have additional care needs, require specialist interventions and decisions about their care that you may not have experienced before. Developing professional relationships It is likely that you will be a permanent registered nurse within the care team. This will feel very different to your previous experience as a student. You will need to use your communication skills, understanding and skills of team work, and your interpersonal skills to establish yourself as a respected member of team. Developing relationships with patients and families As a student you will have gained skills and developed effective approaches to building relationships with patients and their families. You will have experienced and witnessed some difficult and challenging situations, where experienced nurses and health professionals have effectively communicated and managed in these circumstances. Breaking bad news is a good example of this, whether it is likely to have a brief or long-term impact on the patient or their family. Observing and learning from experienced nurses and health professionals is very different to finding the words and the confidence to do this effectively and compassionately yourself. Seek support as needed, especially if this is new to you. Continue to learn from those around you too. |
This all may seem daunting as you take those first steps into your professional role, but there is growing understanding of the importance of preceptorship across all four UK countries. Most will have policies, guidelines and frameworks in place to follow.
Good practice in the voluntary, independent and private sector promotes the importance of support for NRNs. If you are working in any of those sectors, or for an NHS organisation with no formal preceptorship provision, you should ensure that you have discussed preceptorship and what you would expect in terms of support and guidance before starting your first post. You could use The Code (NMC, 2018) to help you explore this with a prospective employer, using the specific requirements outlined in paragraph nine (practise effectively) and paragraph 13 (preserve safety) to help focus your discussion.
In 2023, the RCN definition of nursing was updated to reflect the change and increased complexity that the nursing profession has seen over the last two decades. This revised definition describes nursing as “a safety critical profession founded on four pillars: clinical practice, education, research, and leadership.” Highlighting nursing as the largest safety critical profession in health and social care and that the nursing team is diverse including the nursing support workforce.
The principles of nursing are applicable to all of the nursing workforce. They describe what everyone, from nursing staff to people and populations, can expect from nursing to deliver safe and effective nursing care. They cover the aspects of behaviour, attitude and approach that underpin good care, and they are mapped to and complement the NMC Code (for registrants).
For more detailed descriptions and an expanded definition read our 'Definition and principles of nursing'.
There can be a time gap between completing your studies and the NMC confirming you as a registered nurse. Until your nurse registration is secured you may be employed as a nursing support worker (NSW) if you are not already employed in this capacity.
You will have achieved the capabilities and competencies to be registered nurse. But until you receive your NMC registration, you are not a registered nurse, and you are not employed as one. As a result, your duty of care is that of an NSW.
All members of the nursing team are personally accountable for their actions. As an NSW, you will have a job description. This provides clear information about the roles and responsibilities of the post. You should receive details about the scope of the work you will undertake. As an NSW you must ensure you do not work beyond the expected level of competence for the role. Contact the RCN Advice team for support if necessary.
Guidance on working as an NSW during this interim period
- Read the job description.
- Ensure you understand the details of the role you are employed to do and the limitations of the role.
- Discuss any concerns that you have with the senior nurse.
- Ensure that you are rostered as an NSW, not as a registered nurse.
- Wear the correct uniform for the NSW post.
- Raise your concerns immediately if you are asked to undertake any role or task that is not within the responsibility of an NSW’s duty of care.
Using this time positively
- Take this opportunity to familiarise yourself with the clinical environment.
- Get to know the team.
- Start to understand the routines and day-to-day work patterns.
- Shadow and work with the registered nurses to better understand the role you will be taking on.
- Complete induction tasks that are required for your current NSW post – many of these will be the same as those for a registered nurse post.
- Reflect on what you will need when you do make the transition from NSW to registered nurse and discuss this with your senior nurse.