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NurChat 22/11/16 - Raising concerns in practise - the role of the student nurse

Student nurses are uniquely placed to be the eyes and ears of a healthcare setting. In their capacity as learner and future registered nurse they have departmental and geographical mobility, moving from ward to ward, clinical to clinic, hospital to community and sometimes hospital to hospital. Placement learning is widened through a number of ‘spoke’ placements, which allows for time to be spent with individual services or clinical specialists whilst accruing the 2,300 practice hours required for NMC registration (NMC, 2010). 

This arrangement gives student nurses the opportunity to gain experience in a diverse range of clinical environments and to compare practices throughout. But what if there are concerns to be raised during this time?

Since the Frances Inquiry and the subsequent report of 2013, there has been much focus on all staff raising concerns if they witness poor practise. In 2013 the Nursing and Midwifery Council first published and subsequently further updated their guidance entitled ‘Raising Concerns: guidance for nurses and midwives’ (NMC, 2015). In addition to this the Royal College of Nursing published ‘Raising Concerns: a guide for RCN members’ (RCN, 2015) with both guides giving advice on how to raise concerns in their workplace with suggested processes to follow. Within both guidelines, student nurses are included in their guidance.

Initially, the Francis review of 2013 largely failed to recommend how student nurses should be supported in their quest for justice for patients if they witness poor practise and wish to raise concerns.  This was rectified with the release of the ‘Freedom to Speak up’ review (Francis, 2015) with the review stating; 

“Whilst students are on placement they are exposed daily to real situations where they may witness incidents concerning public and patient safety. They are therefore in a particularly good position to spot things that might be going wrong. Most will bring a new perspective and an independent viewpoint when they enter clinical environments. They are a fresh pair of eyes, keen to learn and provide constructive challenge based on current learning and research” (8.2.2)

The review recommended that training for students about raising concerns should be “embedded” within undergraduate courses. However, the report went on further to state that;

“There is evidence that support and protection for students and trainees generally is patchy and that they can fall between health education institutions, the regulators and providers of healthcare” (8.2.16)

In this #NurChat discussion, we will explore the student nurses perspective and share experiences of raising concerns, for example:

  • What preparation have you had regarding raising concerns?
  • How prepared do you feel they are to raise concerns if you witness poor practise?
  • How likely are you to raise concerns?
  • Do you know how to raise concerns and what support is available if you do?
  • Have you raised concerns in your role as a student nurse?
  • Have you witnessed other raising concerns? 

This session will be led by @NursingBolton, the Nursing School of the University of Bolton (UoB). In support will be @createyourself9 – Jayne Hardicre, Senior Lecturer, UoB; @Julichap – Julie Chapman, Senior Lecturer UoB and @leegorman35 – Lee Gorman, Clinical Tutor, Bolton NHS Foundation Trust.

Further reading:

Francis:, R. (2015) Freedom to Speak Up:. Available from http://webarchive.nationalarchives.gov.uk/20150218150343/http://freedomtospeakup.org.uk/the-report/

NMC (2010) Standards for pre-registration nursing education. Available from: 


NMC (2015) Raising concerns: guidance for nurses and midwives. Available from:


RCN (2015) Raising Concerns: a guide for RCN members. Available from:



Read back over the discussion here