NIPE Qualification Completed!

I am so excited to officially say that I am NIPE Qualified. NIPE stands for Newborn and Infant Physical Examination. It is a screening on newborn babies within 72 hours of birth, and then once again between 6 to 8 weeks. It can not pick up on or diagnose all problems so education should still be given to families if serious symptoms appear. The second screen is needed because some conditions appear later on. It especially looks at babies hearts, hips and eyes. 

Traditionally, the examination is completed by paediatricians and general practitioners but over recent years, it has become widely accepted that the midwife, having received specialist training, is the appropriate health professional to conduct the examination on low-risk infants. Not only does this prevent delays in care, but it also recognises the importance of continuity of care and the more in depth, careful communication. This allows the midwife to continue to lead normal care and also ensures holistic care. 

My year of student midwives at the University of Nottingham, was the first year to have the option to complete the NIPE qualification alongside their undergraduate studies. Although other universities also offered it, most midwives gained the accreditation post-qualifying. Whilst it was optional, I felt that it made the most sense for the reasons above, as well as improving my employability in the future. Since then, as of 2020, it is now a compulsory requirement of the undergraduate midwifery programme, dictated by the Nursing and Midwifery Council, to have it be included in the course. I actually feel this will be much better as there will be requirements set out at the starting point, with clear guidance throughout and specific taught content to ensure adequate teaching. I found that as ours was a relatively new and last minute addition to the programme, it was a little confusing and drip fed. 

So what did we have to do? 


In first year, it was relatively simple. We had to watch NIPE qualified practitioner complete 10 examinations and then write 3 reflections on normal heart auscultations. I found the reflection aspect quit repetitive and a little pointless if I'm honest, but had great learning by watching others complete them. 


In second year, we had to complete 20 NIPE examinations ourselves under direct supervision. I had a lot of practitioners repeat the hip and heart aspects understandably, as they are the most important. We also had some theoretical teaching on how to perform the examination and also in Clinical Skills. The written component again focussed on the heart, but this time we were required to write 5 separate reflections all on different parts of circulation: heart auscultation, femoral pulses, visual signs etc. 


Finally, for third year we had to complete another 20 NIPE examinations under direct supervision. Originally, and usually, these would be completed under indirect supervision but due to not having an NMC pin, the decision was made to have it under direct in the end. Once they were completed, I then had to complete one formative assessment, followed by 3 summative assessments...there was a lot of paperwork! We then had to write three separate pieces focussing on the three main aspects: heart, hips and eyes. For each we had to write a detailed document on undertaking the examination (how and why), risk factors, incidents of problems and follow up - whether positive or negatively screened. I found this the most important and relevant writing because it actually helped with the understanding and learning of guidelines. Of course, we also had theoretical content with recorded (due to Covid-19) lectures and then group work to prepare presentations on different aspects too, to then teach to others in the cohort. 


Or so I thought. When I started at my trust, I also had to have two assessed NIPE's by the screening midwife lead. That might not be the same across all hospitals, but it didn't take too long. I got to do it on shift and the whole process of talking through it and being assessed, took about 2 hours. I then got all my login details, plus a PowerPoint explaining how it works which I can then refer back to at a later date if needed. 

Overall, I've really enjoyed being able to become NIPE trained and I think it's also made me a better midwife, better at examining babies routinely. Whilst it has been a little bit of extra work, I think it's been worth it in the long run and I'm very happy I can now completely care for low risk women and their babies independently, from start to finish. I found the commitments additional to prior workload weren't that much more as I managed to fit it into my normal placements, however it does require a lot of self-directed planning and awareness. I think if you're open and honest with mentors and supervisors about goals and expectations at the start of placements, it still easy to achieve.