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49
In January 1971 the G.N.C. circulated a directive covering, broadly, the aspects of community care of
which the nurse should have experience. It was left to individual Training Schools and local authorities to
come to amicable arrangements and plan their courses. No precise objectives were given, and it was not
stated how the nurse is expected to use this experience. There is however a general feeling that, as
undoubtedly patients will be discharged earlier from hospital, and with the coming of "Best Buy" hospitals,
this experience will be useful. It will not of course qualify them to work in the community and whether in
fact it will be taken into consideration by the other multiple bodies responsible for post-registration
training, remains to be seen.
The content of the Final Examination will not be changed before 1974. How community experience will
be tested is not yet known and there appears to be no formal machinery for assessment other than
comparisons of proposed programmes submitted by the individual training schools to the G.N.C.
The City of Westminster is responsible for providing community experience for 3 large training hospitals
in the area and early in 1971 discussions commenced between the hospitals and the local authority as to the
form the training should take. A 6-week programme was agreed on. Each hospital would send 2-4 students
at a time and students from all hospitals would commence their community experience at the same time. It
was decided that services in the area surrounding each hospital should be used for the training of their own
students and the Community Nursing Officers would undertake tutorials as far as possible. The first
hospital started their students in June 1971 and the second in October 1971. The third hospital has not
pursued the matter any further as yet, although an area has been allocated and arrangements can be made at
any time.
The programme has now been running for one year and this would seem an appropriate time to attempt
to answer the following questions:—
(a) How effective is the planned programme?
(b) Has the extra burden on local authority staff altered the service to the community in any way?
(c) How much does it cost the local authority to provide the training?
In an attempt to answer the first question a Scheme of Internal and External Validation was drawn up.
Plan
(a) Each nurse at the commencement of her Community Care Programme will be asked to complete a
personal questionnaire.
(b) She will be given a copy of the Course Objectives and be expected to use them for reference
throughout the programme.
(c) She will be given a Personal Action Plan Book in which she should state at the end of each session
how she feels it can be used in relation to her hospital work. At the end of each week a carbon
copy of the Action Plans will be given to the Nursing Officer for use in discussion. They will then
be attached to the students' Personal Questionnaire and filed.
(d) At the end of her Nurse Training period she will be sent a short test paper which it is hoped she
will complete and return. This will be added to her file.
A personal Questionnaire is necessary to give some indication of the student's previous experience as the
effectiveness of training will be influenced by the student's basic attitude, skill and knowledge patterns
acquired from past experience.
It is assumed that she should have a copy of the Course Objectives so that she can see clearly how in fact she
is meant to apply her training to her job and what exactly she will ultimately be expected to do with the
experience.
The Action Plan Book will provide an incentive for her to think constantly about the application of the
training and the objectives of the course. It will indicate to the Nursing Officer the student's understanding
of each session and provide a basis for discussion geared to the needs of the individual student. It should
also be a guide to the usefulness of particular sessions and possibly to the ability of the instructor or teacher
involved with each session.