In December my second and final term as a member of the NMBI will come to an end. For the last five years I have been both a member and the Chairman of the Registration Committee, and now that my tenure is concluding, I want to reflect some of the many matters that the committee has considered during that time.

The terms of reference of the Registration Committee include the consideration and approval of registration policies and requirements as well as providing oversight on the performance and efficiency of the registration process within NMBI. The committee is also required to consider matters that are referred to it for consideration or decision, such as qualifications assessment or registration related appeals. 

When I first joined the committee I remember that the majority of our time was spent considering applications for registration in advanced divisions and making decisions on registration appeals. As time progressed however, the committee focused more on strategic developments and policy-related matters that would bring consistency to the registration process, provide information to registrants and further ensure public safety. Despite the many challenges posed by the Covid-19 pandemic, the committee has continued with its busy workload throughout 2020.

Quality and standards

In 2018 the committee approved a new suite of registration rules and oversaw the disbandment of the inactive file. In that year we also implemented the requirement of applicants for registration to meet revised English language requirements. The committee also approved an important mechanism where identified shortfalls in the qualifications of overseas applicants could be mitigated through the demonstration of the missing competencies in post-qualification employment.

MyNMBI

The single biggest project undertaken during my time as a member of NMBI was ‘Project Nightingale’ which involved the development of the new registration management system we now know as MyNMBI. The committee was actively involved in all aspects of this vital project and regular updates on its progress were given to it. We also approved a number of protocols that would be implemented as a part of the new system. In 2019, we focused on developing quality assurance processes and started to consider registration-related risks on an ongoing basis.   

Language requirements

With an increasing number of overseas applicants, we reconsidered the language requirements in 2020, and decided to align our requirements with other health professional regulators both nationally and internationally. The committee approved the formation of a Fit and Proper Panel to consider applicant disclosures and the procedures and criteria that would be followed when considering a health or character disclosure made by an applicant for registration. The committee also approved detailed policies for dealing with fraudulent applications.

Appeals

Throughout my tenure, the committee has considered many appeals, such as where applicants appealed against the failure of a compensation measure (adaptation period or aptitude test) or were appealing a decision not to grant them registration on other grounds.

Over time I noted that the committee had limited options when dealing with certain appeals against failed compensation measures. I therefore requested that a paper be developed to give applicants detailed information on the appeals process itself, and the role of the registration committee in it. This paper was subsequently approved by the committee and applicants with negative registration decisions are now directed to this paper which is provided on the NMBI website at the point when they are considering the submission of an appeal.

The future

I leave the committee at a very exciting time as the NMBI starts to process registration applications that are entirely electronic or digital. I note that this creates new challenges and requirements for further policies and validation methods not previously undertaken. I am confident that thanks to the work done so far by the Registration Committee it will embrace these new challenges to ensure the robustness of the registration process and ensure patient safety.

I would like to take this opportunity to thank all my Registration Committee members for their hard work, especially in dealing with the many challenges arising from the current pandemic. I especially want to thank the outgoing Director of Registration, Colm O’Leary who will soon be taking up the role as Director of Regulation in NMBI. I also want to thank my fellow Board member Martin Higgins (who joined the committee at a similar time to me) who is also completing his tenure in December. And finally, to you our registrants, I would like to say that while the five years have been busy it has been an absolute honour to work on your behalf.

I hope the next year is kind to you, take care of yourselves.

Sincerely,

Dermot Manning,

Outgoing Board Member and Chairman of the NMBI Registration Committee

On Monday, 28 September MyNMBI, our new online registration system launched as planned. Students and recent graduates have been the first users of the system. As a result of these initial interactions we continue to make tweaks and also consider our escalation process for those who need help. Over the next number of months we have a programme of high vigilance in place to continue to support users as more of you start to use the system.

Over 1,100 Graduates, 250 Candidates and 150 overseas applicants have already been registered via the new system and their certificates have been provided in the MyNMBI portal. Almost 100 existing registrants have also added additional divisions (Prescribing and Advanced Practice) to their registration.

By late November all registrants will receive a letter with their personal login details which will provide access to MyNMBI. User guides are available on our website to support you as you login for the first time. If you need further support you can email registration@nmbi.ie or call 1890 200 166.

The annual retention date of 31 December is approaching and the renewal process will be handled this year by the new MyNMBI registration system. We will issue renewal notices in late November with new login credentials for those who have not previously used the site.

As the email addresses held on the old registration system were of poor quality, we have decided to collect email addresses again from all registrants so that we can use email communication more widely in future. The first step of the process this year is that you enter and confirm your personal email address. Your email address and password will be the login credentials for MyNMBI into the future.

The annual renewal process will also request that you confirm your correspondence address and that you enter your employment details. This has been a legal requirement for some time but registrants have not been provided with a mechanism to record or update employment details. You will also be requested to confirm the divisions (from your registration) in which you are currently practising and whether you are providing direct patient care or are ‘patient facing’.

These additional questions will enable us to provide accurate statistics on practicing nurses and midwifes in Ireland to the EU and the OECD. The provision of these statistics will become a legal EU requirement. Previously we have only been in a position to report on the numbers of registered or licensed nurses and midwives which skews the data and depicts an inaccurately high ratio of nurses per 1,000 people. Examples of this data can be observed in the OECD report Health at a Glance 2019.

We attend Irish Times Higher Options every year with the aim of inspiring Ireland’s next generation of nurses and midwives. It is part of the support and guidance we provide which aims to deliver easy access to career information on nursing and midwifery, including information on education and training. This year like many things, Higher Options has also gone online.

All the information we will provide for students at the fair is on our website. Please do share it with budding nurses and midwives at home. If they have questions they can send them in at any time to careersinformation@nmbi.ie.

We would like to thank all who are giving their personal time over the two-day period of the fair. Over 30 nurses and midwives have stepped up to support students in their decision making. If you would like to see the schedule or the details for the panel discussion, please check out the news section of our website.

We would also like to thank the Office of the Nursing and Midwifery Services Director for their support of this event.

The poll to elect three registrants to be members of the Board of NMBI closed on Wednesday, 23 September 2020 at noon.

The successful candidates in the three categories were: 

Category 1: A registered nurse from the practice of general nursing engaged in clinical practice

Joseph Shalbin Kallarakkal

Category 2: A registered nurse from the practice of children's nursing

Marian Vaughan

Category 3: A registered nurse or a registered midwife employed in the public health sector and engaged in the education of nurses and midwives

Lorraine Clarke-Bishop

Appointments are with the Minister for Health for confirmation. We would like to thank all who ran for election and all who voted.

The 99th edition of the HPRA Drug Safety Newsletter includes information on the following medicines:

• Erythromycin – Updated warnings regarding cardiovascular risks and infantile hypertrophic pyloric stenosis
• Vascular Endothelial Growth Factor (VEGF) pathway inhibitors – Risk of aneurysm and artery dissection
• Implanon NXT (etonogestrel implant) – Updated insertion and removal instructions due to risk of neurovascular injury and implant migration
• Insulin-containing medicines – Risk of cutaneous amyloidosis and potential for associated changes in glycaemic control
• Leuprorelin-containing depot medicines – Risk of lack of efficacy due to incorrect reconstitution and administration
• Xeljanz ▼(tofacitinib) – Updated recommendations due to increased risk of venous thromboembolism and serious and fatal infections
• Risk of respiratory depression and sedation associated with Epaclob 1mg/ml and 2mg/ml oral suspension (clobazam)

For further details please visit the HPRA website.

In this month’s issue, we shine a light on Muireann Ní Riain, CNS Acute Hospital Liaison Nurse at St Michael’s House, Ballymun Road, Dublin 9.  

If you have a story that you would like to share to celebrate the International Year of the Nurse and Midwife please send it along with pictures to communications@nmbi.ie

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Our interview with Muireann

Why did you choose a career in nursing/midwifery?

Initially it would have been the childhood aspiration of helping and caring for people when they are sick into wellness. Both my grandmother and aunt were nurses and my mother also worked in healthcare as a dietitian so I could see the value of working to help people. They also showed me the commitment it takes and the value of being responsible and compassionate in what you do on a daily basis.

Why do you think it’s important to celebrate the International Year of the Nurse and the Midwife? What message would you like to send in this context to your team or your profession in general?

I think this is important because as nurses we often forget to celebrate ourselves, the skills we have and the value that is placed on those skills by the people we work for and with.

As a RGN and RNID, I would like the wider profession to remember that nursing is a wide spectrum of professionals and that the skill base is diverse. To this end there should be an openness to request support from those who have the skills that you may not possess to help improve an individual’s pathway through whichever aspect of healthcare they are in during that moment in time.

How have you made a difference as a nurse/midwife?

Making a difference when working with people with an intellectual disability is a wide continuum – from the person you helped with their breakfast this morning, to the person you helped understand their healthcare needs, to supporting someone build skills to maximise their ability to live in their own community.

In my current role as a CNS Acute Hospital Liaison Nurse, I make a difference by supporting people with intellectual disability through the acute hospital setting. This can entail liaising with medical and nursing teams in the hospitals to ensure we have good information about the condition of an individual going through an acute phase of illness and plan towards a safe and effective discharge; from supporting the individual and their support (staff, family) to understand any changes to the care and management of needs coming from an admission. It can also be more proactive by linking with hospital colleagues to help them understand the needs of an individual with an intellectual disability during an admission and also working with someone in the build up to an elective admission by using resources to help them understand the steps ahead.

Do you have a memory in your job that really stands out?

I do have many memories that stand out across my career and they are entwined with the people for whom I work and serve – people with an intellectual disability are true individuals and they don’t always do as you would expect.

If they are happy they will include you; they have skills that most of us can’t name; many can’t speak but they communicate their needs, wants and wishes very loudly; they know how to fight - when they are very unwell that will come through. If they don’t want to do something they won’t BUT then if they see something in you that is of value they will cherish it and show you that you also have skills that you can’t name. They will help you to understand their communication so you can communicate for them and they will get you to fight for them and in working with them you will see that every day is a new day for them.

The memories are a smile from someone coming out of illness or having a bad day, a touch of a hand from someone who doesn’t like touch, a successful day trip, a family member who says ‘I never thought they would do that’, time in giving comfort and ease to pain at the end of life, getting someone to experience something they never thought they could (as simple as sitting still in a coffee shop or as complex as supporting them through a tough hospital admission) – the list is endless and as individual to the nurse working in intellectual disability and whoever she or he serves.

Has COVID -19 made a difference to nursing? Are there any positives that you will take with you?

I think it will make a difference but its full impact has yet to be seen. I hope in the intellectual disability sector that we will see how nursing skills have shaped the support and management of minimising the impact of Covid-19 on the population for whom we work. I think we will be seen as a flexible workforce that has adapted to the needs of the service that was required, working to support our amazing profession that supports the diverse group of people we work with and for.

If you could, what advice would you give to 19 year old you, starting out?

I would say to her...

The road is not going to go the way you planned but roll with it and learn from everything that is put in front of you. Some days will be much harder than others but you will get through them. You will be touched by things people do and say in a positive and sometimes negative way but once you keep the patient/service user/client/person who you work with at the centre of what you do, you will be proud of what you do every single day.