How nurses on the frontline approach their work in terms of attitude and character is just as important as their clinical skills, according to the newly revised fitness to practice guidance.

The Nursing and Midwifery Council (NMC)'s guidance on best practice for nursing staff has placed more emphasis on nurses personal traits than the original document published in 2002. In the guidance, the NMC recommends that a good character is as valued as highly as competency with providing clinical treatment.

"It's possible to deliver care that is clinically competent, but uncaring" says the new document. "attitude and character are just as important as competence."

It recommends that those in nurse manager jobs ensure that their workforce are providing service that is "capable, safe, knowledgeable, understanding and completely focused on the needs of the people in their care." It also states that they should work with more senior management or private employers to ensure that staff have access to training courses, as inexperience or a lack of confidence in skills can be damaging in several ways in health care.

A new section in the guidance document provides advice on judging whether or not staff have a "bad character" that makes them unsuitable for the job - or as the document puts it, if they are "the right sort of person to be giving people care." It lists several "bad character" traits such as ignoring general rules on downloading illegal material from the internet or exploiting patients; many of the traits would result in a serious legal conviction in any case.

Dickon Weir-Hughes, the chief-executive and registrar of the NMC said: "Our role is not to punish nurses and midwives. Our role is to safeguard the health and wellbeing of the public from nurses and midwives whose fitness to practice is impaired and whose situation cannot be managed locally."