There is often quite a lot of confusion and frustration regarding protected learning time for Trainee Nursing Associates (TNA). Much of this confusion seems to result from the assumption that protected learning time is the same as being supernumerary or allocated to work as a TNA for a shift as opposed to a health care assistant (HCA).
The Nursing and Midwifery Council (NMC) does not require TNA’s to be supernumerary while working in a base area – although this is an option depending on who you are studying with (NMC, 2018). However, the NMC does require that TNA’s receive at least 20% protected learning time through academic studies at university and external placements. Each approved educational institution (AEI), employer, and practice learning partners decide how to implement protected learning time (NMC, 2018). It is important to remember that these institutions will implement the programme in different ways and so comparing your own schedule to that of others at different institutions is usually not possible.
The NMC defines protected learning as time in a health or care setting during which students are learning and are supported to learn (NMC, 2018). Here are some examples of what constitutes protected learning:
- Being supernumerary.
- Watching surgery.
- Practicing new skills.
- Shadowing a member of the multidisciplinary team such a physiotherapists.
- Building therapeutic relationships.
- Attending employers mandatory study days.
- Spending time with specialist nurses.
- Receiving constructive feedback.
- Being involved in difficult conversations.
- Providing health promotion.
- Being observed practicing new skills such as phlebotomy, ECG, bladder scans, etc.
- Spending time in other clinical areas.
Being Proactive
In reality, it’s important to accept that we are training in hectic workplace environments. Busy colleagues and understaffing often mean that as trainees, we need to seek out our own protected learning opportunities. An example could be that you are working with a nurse and have spent time carrying out regular duties. The nurse is busy and has a long list of tasks that need to be completed. One of the tasks is that a phone call needs to be made to handover a patient to another ward. Volunteering to take this take if you confident with it presents an ideal opportunity for learning and also helps your colleague. If this is something you have not done before – ask to listen in on the conversation so you can do it next time. Again, that is protected learning time.
The nature of nursing means that no two patients are ever the same. For me, this means there are learning opportunities every day with every patient.
Simple Tasks Can Also Be Learning Opportunities
Assisting a patient to walk to a bathroom presents several opportunities, especially if you have been able to build up a trusting therapeutic relationship.
- How well is this patient walking – could you speak to physiotherapy if you have concerns?
- You’re having a conversation with them and discover they are having problems their mental health – escalate to the nurse or medical team.
- You ask how well they are eating and they tell you they have been getting mouth ulcers so eating is a problem. Check their mouth when you can. What can you see, what should you do?
- They tell you they are constipated – you could check their medication to see if there’s any cause. Let your nurse know and ask if you can be the one to inform the doctor. What action would you request?
- The patient confides in you that they are worried about going home due to abuse. What do you do now?
I would class all of these as protected learning opportunities that became available from a relatively simple task.
I hope this has helped you to see that learning opportunities exist on every shift. Sometimes you have to remind yourself that every simple task is actually built up from many smaller, and often more complex tasks.