TRAINING SCHOOL FOR ENROLLED NURSES g S.L.458.21 1 SUBSIDIARY LEGISLATION 458.21 TRAINING SCHOOL FOR ENROLLED NURSES REGULATIONS 16th September, 1986 LEGAL NOTICE 56 of 1986, as amended by Legal Notices 4 of 1987, 46 of 1988, 91 of 1989 and 94 of 1991. Title. Enrolled Nurses Regulations. Interpretation. requires- "hospital" means a hospital or any part thereof, approved by the Council for Nurses and Midwives as forming part of a training school; "training school" and "school" mean a complete training school, inclusive of one or more hospitals or any part thereof, approved by the Council for Nurses and Midwives, for nurses to be admitted to the roll of nurses kept by the said council. Conditions for admission. Substituted by: L.N. 91 of 1989. 3. The training school shall be open to candidates who on the closing date for applications for admission - ( a ) are not under sixteen years or over thirty-five years of age; and either ( b ) have successfully completed the approved course of studies at the Prevocational School (Health Care); or ( c ) hold a general certificate of education at ordinary level, or a Malta matriculation certificate, in English language, Maltese and mathematics. Entrance examination. Substituted by: L.N. 91 of 1989. 4. (1) The Chief Government Medical Officer may cause an entrance examination to be held for candidates who are not in possession of the qualifications referred to in paragraphs ( b ) or ( c ) of regulation 3 and candidates who pass this examination and satisfy the provisions of regulation 3( a ) shall be eligible for admission to a training school. (2) No candidate shall be admitted to the entrance examination referred to in subregulation (1) unless he has completed such studies as are equivalent to those of Form III of the Government Secondary School to be certified, in each case, by the Director of Education. (3) The entrance examination shall consist in a written test in English (two papers), Maltese and mathematics. Interview and medical certification. Substituted by: L.N. 91 of 1989. 5. No candidate shall be admitted to the training school unless he passes a selective interview and is certified medically fit to the satisfaction of the Chief Government Medical Officer. 2 g S.L.458.21 TRAINING SCHOOL FOR ENROLLED NURSES Pupil nurses to be under the direction of a principal nursing tutor. 6. Candidates admitted to the training school shall be known as pupil nurses and shall be under the direction of a principal nursing tutor. Such tutor shall be in charge of the teaching and training in theoretical and practical nursing. Course of studies. Amended by: L.N. 94 of 1991. 7. (1) The studies shall be made up of three parts: ( a ) the introductory part, which shall last for four weeks, during which basic instruction shall be imparted at a training school; and ( b ) (i) the intermediate part, which shall last for a period of forty-six weeks, and (ii) the final part, which shall last for a period of fifty-four weeks, during which Intermediate and final parts theoretical and practical instruction shall be imparted at a training school in accordance with the scheme of training laid down in the First Schedule. Provided that the Minister responsible for Health may, on the advice of the Council for Nurses and Midwives, make such alterations to the said schedule as may be considered necessary. (2) When advising the said Minister on such changes the Council for Nurses and Midwives shall be guided by the relative rules of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting. (3) Notwithstanding the provisions of subregulations (1) and (2), it shall be lawful for the principal nursing tutor to exercise discretion and permit minor deviations from such schedule if such deviations do not affect adversely the training of the pupil nurses. Work in hospital, etc. 8. (1) During the intermediate and final parts, pupil nurses shall be required to work in hospital wards and in the community care services of the Department of Health and to gain practical nursing experience in accordance with the scheme of training laid down in the First Schedule. (2) Pupil nurses shall also have to perform night duties at regular intervals. Examinations, etc. 9. There shall be an assessment at the end of the introductory part, known as introductory assessment, an examination at the end of the intermediate part, known as intermediate examination, and another after the end of the final part, known as final examination. Written and oral/ practical tests. 10. (1) The introductory assessment shall be conducted by the principal nursing tutor of the training school and shall consist of one written paper in anatomy, physiology and theory of nursing and first aid. The marks obtained by a pupil nurse for each written paper shall be out of a maximum of twenty marks and the principal nursing tutor shall submit a report on the assessment to the Council for Nurses and Midwives. (2) The intermediate examination shall consist of one written paper. The written paper shall consist of questions on the subject matter covered during the intermediate part in accordance with the TRAINING SCHOOL FOR ENROLLED NURSES g S.L.458.21 3 First Schedule. The result of the introductory assessment shall supplement the marks for the written paper of the intermediate examination with the remaining eighty marks being allocated for the written test questions bringing the total maximum marks up to one hundred: Provided that the result of such assessment shall not be taken into consideration in any supplementary examination. (3) The Final Examination shall consist of - ( a ) a written test (one paper on all aspects of nursing, and another paper on nursing ethics, including civics and human relations); and ( b ) a practical oral test (lasting one hour) which shall deal with the practice of nursing and with questions on the subjects specified in the syllabus for the course of studies, at which test pupil nurses will be required to present to the assessors their record of practical instruction and experience. Supplementary examinations. Substituted by: L.N. 91 of 1989. 11. (1) Any pupil nurse who fails in the intermediate examination shall be allowed to sit again for such examination provided he gives evidence, to the satisfaction of the Council for Nurses and Midwives, of having undergone further satisfactory training and, if successful, to continue his course of studies: Provided that any such pupil nurse who fails at his second attempt at the intermediate examination shall, saving always the production of evidence that he has undergone further satisfactory training, be allowed to sit for the examination for the third time but, if successful, he shall - ( a ) if the following course of studies has started more than six months after the course of studies he is currently following, sit for the final examination in accordance with the provisions of regulation 10 but not earlier than four months and not later than six months after the date when such final examination is due, during which period he must undergo further training to the satisfaction of the principal nursing tutor; ( b ) in any other case, join the final part of the following course of studies: Provided further that no pupil who will have failed for the third time in the intermediate examination will be allowed to continue the course of studies. (2) For the purposes of this regulation, and of regulation 13, absence from an examination or from any part thereof shall be deemed to be a failure at that examination or part thereof. Eligibility to sit at intermediate and final examinations. Amended by: L.N. 46 of 1988; L.N. 91 of 1989. 12. (1) No pupil nurse may sit for the Final Examination unless - ( a ) he shall have passed the intermediate examination and has applied to sit for such examination and submitted the relative certificate as provided for in regulation 18; 4 g S.L.458.21 TRAINING SCHOOL FOR ENROLLED NURSES ( b ) the Council for Nurses and Midwives is satisfied that such pupil has undergone the required level of training. For the purpose of this paragraph, the principal nursing tutor shall report to the said Council every six months, on the progress made by such pupil nurse, which report shall be in accordance with such format as may be required by the said Council. (2) No pupil nurse shall sit for the final examination if he has absented himself on sick leave or other cause (excluding vacation leave) in excess of an aggregate period of twenty days throughout the duration of the prescribed course of studies at the training school, unless he has made up for the excess absenteeism by attending for practical duties at a government hospital to the satisfaction of the principal nursing tutor before sitting for the final examination: Provided that where the curriculum of studies includes study blocks in accordance with curricula as may from time to time be approved by the Council for Nurses and Midwives, any period of absence for whatever cause, exceeding twenty per cent of the duration of the theoretical instructions of any of such study blocks shall render the candidate ineligible to sit for the final examination unless he has made up for this absenteeism by attending for the specific instruction for which he had been absent before sitting for the final examination. (3) After making up for the absenteeism as provided for in sub- regulation (2), such pupil nurse shall not be entitled to a special session of the final examination but may sit at a session not earlier than that which is due in the normal course of events. (4) Any pupil nurse may, subject to the provisions of sub- regulation (2), make up for the absenteeism referred to in the same sub-regulation or for any part thereof, by forfeiting an equivalent number of days of vacation leave to which he may be entitled. Pupil nurses must pass final examination. Amended by: L.N. 4 of 1987; L.N. 46 of 1988; L.N. 91 of 1989. 13. (1) A pupil nurse shall not be deemed to have passed the final examination unless he shall have obtained a pass mark in the written test and in the practical and oral test to the satisfaction of the Board of examiners. (2) A pupil nurse - ( a ) who fails in any paper or in the practical and oral test of the final examination shall be allowed to sit again for that examination in any such paper or test if he produces a certificate from the principal nursing tutor, to the satisfaction of the Council for Nurses and Midwives, that he has undergone further intensive training at a school: Provided that no pupil nurse may avail himself of this concession to sit for such a supplementary examination at any time before the lapse of three months from the date on which he last sat for the said examination; TRAINING SCHOOL FOR ENROLLED NURSES g S.L.458.21 5 ( b ) who does not produce a certificate as is referred to in paragraph ( a ) shall be entitled to sit for a supplementary examination in accordance with the other provisions of these regulations, at any session which is due in the normal course of events after the expiry of six months from the date of the session in which he last failed: Provided that, however, no pupil nurse may avail himself of any of these concessions at any time later than three years from the date on which he first sat for the final examination. Pass mark in tests. Amended by: L.N. 91 of 1989. 14. A pupil nurse shall not be deemed to have passed any of the tests unless he shall have obtained at least fifty per cent of the marks awardable at any of the written papers or in the oral and practical test. Conduct of examinations and of assessment. 15. (1) The intermediate and the final examinations shall be conducted by a Board of examiners, to be appointed by the Council for Nurses and Midwives. (2) The Board of examiners for the intermediate examination shall include at least two nurses whose names are entered in the general part of the register of nurses kept by the Council for Nurses and Midwives. (3) The Board of examiners for the final examination shall consist of - ( a ) a principal medical officer, or a senior medical officer, or any other medical officer performing administrative duties in the Department of Health, as chairman; ( b ) two medical practitioners, one being a physician and the other a surgeon; and ( c ) three nurses, two being persons whose names are entered in the general part of the register of nurses and the other being a person whose name is entered in the roll of nurses. (4) The Board of examiners shall submit the respective results to the Council for Nurses and Midwives for approval and ratification prior to publication. Holding of examinations and relative applications. 16. (1) Not less than one month’s notice shall be given of the date on which the intermediate and final examination shall be held, which notice shall be exhibited on the notice board of the school. (2) A pupil nurse who intends sitting at either the intermediate examination or the final examination shall, together with the relative fee for the examination, submit to the Council for Nurses and Midwives an application on the form prescribed in the Second Schedule accompanied by a certificate signed by the principal nursing tutor also as per said Schedule certifying - ( a ) the fact that the pupil nurse has completed the practical nursing experience required under regulation 8(1); and 6 g S.L.458.21 TRAINING SCHOOL FOR ENROLLED NURSES ( b ) the conduct and the regular attendance of the said pupil nurse during the relative period of training in accordance with the requirements of these regulations. Successful pupil nurses to be awarded a certificate. Amended by: L.N. 94 of 1991. 17. (1) Pupil nurses who, on the completion of the full period of training, pass the final examination shall be awarded a certificate signed by the chairman of the Council for Nurses and Midwives, stating that the pupil nurse has undergone the prescribed course of studies at the training school and has been approved at the prescribed examinations. Cap. 464. (2) Such certificate shall be deemed to be the certificate referred to in Part IV of the Health Care Professions Act. Male pupil nurses. Substituted by: L.N. 91 of 1989. 18. The Council for Nurses and Midwives may exempt male pupil nurses from gaining clinical nursing experience in - general medical nursing of females; general surgical nursing of females; maternity care and gynaecological nursing care; geriatric or long stay chronic sick nursing of female psychiatric or mentally handicapped patients. Other certificate courses. Added by: L.N. 94 of 1981. 19. (1) The provisions of these regulations need not apply to any certificate course for enrolled nurses organised and run by the Institute of Health Care of the University of Malta or by any school recognised by the Council for Nurses and Midwives if the said Board is satisfied with the conditions for admission to the course and with the curriculum and assessments and examinations of the said course. Cap. 464. (2) The Chairman of the Council for Nurses and Midwives shall issue a certificate to successful candidates from the course referred to in subregulation (1) for the purposes of the Health Care Professions Act. TRAINING SCHOOL FOR ENROLLED NURSES g S.L.458.21 7 FIRST SCHEDULE (Regulations 7 and 8) SCHEME OF TRAINING (PUPIL NURSES) Weeks (both inclusive) INTRODUCTORY PART 1-4 Lectures in: ANATOMY PHYSIOLOGY NURSING FIRST AID INTRODUCTORY ASSESSMENT Weeks (both inclusive) INTERMEDIATE PART 5-10 Practical Nursing Experience 1. MEDICINE/SURGERY 11-12 Study Block 1 (Theoretical Instruction) 13-18 Practical Nursing Experience 2. SURGERY/MEDICINE 19 Holidays 20 Study Block 2 (Theoretical Instruction) 21-32 Practical Nursing Experience 3. GYNAECOLOGY/ UROLOGY/ MATERINTY CARE/ CARE OF THE NEWBORN 33 Holidays 34 Study Block 3 (Theoretical Instruction) 35-36 Practical Nursing Experience 4. ACCIDENT AND EMERGENCY DEPARTMENT/ ORTHOPAEDICS/ MEDICAL OR SURGICAL SPECIALITY (includes experience in Oncology and Fever Unit at Boffa Hospital, and in Outpatient Department) 47-48 Holidays 49-50 Study Block 4 (Theoretical Instruction) INTERMEDIATE EXAMINATION Weeks (both inclusive) FINAL PART 51-60 Practical Nursing Experience 5. GERIATRICS (includes Community Geriatrics)/ PAEDIATRICS 61 Holidays 62 Study Block 5 (Theoretical Instruction) 8 g S.L.458.21 TRAINING SCHOOL FOR ENROLLED NURSES Allocated Periods: Introductory Part: 4 weeks Study Blocks: 11 weeks Practical Nursing Experience: 80 weeks Holidays: 9 weeks 63-74 Practical Nursing Experience 6. GERIATRICS (includes Community Geriatrics)/ MENTAL DISORDER AND HANDICAP 75 Holidays 76 Study Block 6 (Theoretical Instruction) 77-88 Practical Nursing Experience 7. COMMUNITY CARE (includes Home Nursing)/ MEDICAL OR SURGICAL SPECIALITY (includes experience in Oncology and Fever Unit at Boffa Hospital and in Outpatient Department)/ MENTAL DISORDER AND HANDICAP 89 Holidays 90 Study Block 7 (Theoretical Instruction) 91-100 Practical Nursing Experience 8. MEDICINE/SURGERY 101-102 Holidays 103-104 Study Block 8 (Theoretical Instruction) FINAL EXAMINATION TRAINING SCHOOL FOR ENROLLED NURSES g S.L.458.21 9 SECOND SCHEDULE Training School for Enrolled Nurses Regulations Application for admission to the Intermediate/Final * Examination for Student Nurses (ADDRESS) ....................................... ........................................ (DATE) ........................................ The Registrar Council for Nurses and Midwives, I beg to apply for permission to sit for the Intermediate/Final * Examination for Pupil Nurses which will be held during ...................................................................................................... in terms of the Training School for Enrolled Nurses Regulations. In support of my application, I am forwarding herewith a certificate signed by the Principal Nursing Tutor certifying that I have completed the practical nursing experience at the ........................................... Training School for Nurses (which I joined on the ...................................................) in terms of sub- regulation (1) of regulation 8 of the Training School for Enrolled Nurses Regulations and also my conduct and regular attendance during the relative period of training. I am also forwarding herewith the relative fee for the examination. Signature ........................................ Name in Block Letters ........................ (Pupil Nurse) * Delete whichever is inapplicable 10 g S.L.458.21 TRAINING SCHOOL FOR ENROLLED NURSES PART IIA Training School for Enrolled Nurses Regulations Certificate by Principal Nursing Tutor for the Purposes of the Intermediate Examination for Pupil Nurses * The Registrar Council for Nurses and Midwives (Date) ...................................... I hereby certify, as Principal Nursing Tutor, that Miss/Mr ........................................ a Pupil Nurse, Daughter/Son of ...................................... born at ................................................... aged ............ and residing at ........................................................... a. has completed the practical nursing experience required under sub-regulation (1) of regulation 8 of the Training School for Enrolled Nurses Regulations in respect of the Intermediate Examination, and b. has regularly attended the relative period of training, in accordance with the said Regulations. The conduct of Miss/Mr ............................................................ has been satisfactory/not satisfactory throughout the relative period of training. This is her/his first/second/third attempt ......................................... In case of the first attempt only: Her/His marks in the Introductory Assessment were ..................... (maximum 20 marks). In case of second or third attempt only: Further satisfactory training has further been undergone in accordance with sub- regulation (1) of regulation 11 of the said Regulations. Yes/No. Signature: .............................................. (Principal Nursing Tutor) Name (BLOCK LETTERS): Name of Training School: * This Certificate is to accompany the relative application for admission to the Intermediate Examination for Pupil Nurses. TRAINING SCHOOL FOR ENROLLED NURSES g S.L.458.21 11 PART IIB Training School for Enrolled Nurses Regulations Certificate by Principal Nursing Tutor for the Purpose of the Final Examination for Pupil Nurses * The Registrar Council for Nurses and Midwives (Date) .................................. I hereby certify, as Principal Nursing Tutor, that Miss/Mr ........................................ a Pupil Nurse, Daughter/Son of ............. ................... born at .................... aged ........... and residing at ............................................................ a. has completed the practical nursing experience required under sub-regulation (1) of regulation 8 of the Training School for Enrolled Nurses Regulations, in respect of the Final Examination, and b. has regularly attended the relative period of training, in accordance with the said Regulations. The conduct of Miss/Mr ............................................................ has been satisfactory/not satisfactory throughout the relative period of training. This is her/his first/second/third attempt ......................................... Miss/Mr .............................................. has passed the Pre1iminary Examination held in ....................................................................... In case of second or third attempt only: Further satisfactory training has further been undergone in accordance with regulation 13(2) of the said Regulations. Yes/No. Signature: .............................................. (Principal Nursing Tutor) Name (BLOCK LETTERS): Name of Training School: * This Certificate is to accompany the relative application for admission to the Final Examination for Pupil Nurses.