Adult Nursing OSCE Update

Three new Professional Values scenarios have been added to the Adult Nursing OSCE. These scenarios will only be used for candidates taking their test from 26 October 2026 onwards.

New Professional Values topics

The three new topics are:

• Self-medication from ward stock
• Unsafe staffing levels
• Use of bed rails

These scenarios introduce new situations, but they continue to assess the same professional values and standards contained within the NMC Code.

What candidates may be expected to demonstrate

Candidates should be prepared to:

• Recognise concerns that could compromise patient safety.
• Demonstrate professional responsibility and accountability.
• Apply the NMC Code, relevant legislation and local policies.
• Communicate concerns clearly and professionally.
• Use professional judgement when deciding what action to take.
• Escalate concerns promptly through the correct channels.
• Report and document events accurately and objectively.
• Consider ethical and legal implications.
• Recognise when disciplinary action or an investigation may be necessary.
• State that they would cooperate honestly with any investigation.

What the new topics may involve

Self-medication from ward stock

Candidates may need to recognise that taking medication from ward stock for personal use is unauthorised and may be regarded as theft. It is also a breach of professional accountability and medication-management policies.

Answers should consider the risks to patients, the colleague and the organisation, as well as the possible professional, disciplinary and legal consequences. Candidates should explain how they would challenge the behaviour, report it appropriately and provide an accurate account if an investigation took place.

Unsafe staffing levels

Candidates may be asked to explain how they would respond when there are insufficient staff to provide safe care.

Answers should link the staffing shortage to specific patient risks, such as delayed recognition of deterioration, medication errors, falls and missed or delayed care. Candidates should explain how they would escalate the concern, request appropriate additional staff, prioritise patients according to clinical risk and document the risks and actions taken.

They should also recognise which tasks cannot currently be completed safely and continue to reassess the situation throughout the shift.

Use of bed rails

Candidates may need to consider whether bed rails are appropriate for an individual patient rather than assuming they should always be used to prevent falls.

Answers should consider the patient’s risk factors, the potential benefits and dangers of bed rails, capacity, consent, autonomy and the legal implications of restricting a person’s liberty. Candidates should consider practical, least-restrictive alternatives and explain how the patient and family would be involved in decision-making.

If the patient lacks capacity, decisions must be made in their best interests and in accordance with the Mental Capacity Act. All assessments, discussions, decisions and actions should be documented accurately.

The Professional Values format remains the same

The new scenarios follow the traditional Professional Values format. Candidates must:

1. Recognise the concern.
2. Explain why it is unsafe, unethical or unprofessional.
3. Use professional judgement.
4. Take appropriate action.
5. Escalate through the correct channels.
6. Follow relevant policies and procedures.
7. Document the situation accurately.
8. Write clearly and legibly.

Candidates who have prepared using the existing Professional Values scenarios should find the new additions familiar. The circumstances may be different, but the same professional principles and structured approach continue to apply.

No other Adult Nursing additions

There are:

• No new APIE patient scenarios
• No new clinical skills
• No new Evidence-Based Practice topics

The only additions to the Adult Nursing OSCE are the three new Professional Values scenarios.