'We must find a solution to the neonatal nursing crisis'

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Headlines scream: 'National shortage of neonatal nurses'. TV screens flicker with images of nurses tending to ventilated premature babies under ultraviolet lights. Nurses are stressed because of the added pressures they face.

Patients' families have to contend with long journeys to cots in distant units – with all the attendant risks.

You might think I'm referring to the current neonatal nursing climate. No. I'm thinking back to the same crisis over 20 years ago. When I saw those pictures in the mid 1980s, I was near the end of my nurse training, thinking 'blimey, I could never do that job'. Two decades later, I was doing just that.

Government initiatives to address staffing in neonatal units have not overcome those original problems. One reason for dividing nurses into D, E, F and G grades was to reward us for working in specialist areas. The process was excruciatingly divisive and time has shown that it was not a solution.

Fast forward to the noughties: post Agenda for Change, band Ds became band 5s and Es band 6s – but neonatal units are still at breaking point. One nurse caring for one patient should be an accepted standard in the ICU. Yet premature baby charity Bliss is currently running a campaign to promote one-to-one nursing as best practice.

A spokesperson from the Neonatal Nurses Association describes the present situation as 'depressing' and neonatal nurses as being 'despondent'. The NNA has seen a decline in the number of nurses joining. Attendance at NNA study days is down. That's partly due to trusts not funding places or being reluctant to release staff. It's also due to nurses not believing there are good career development opportunities in neonatal nursing.

Having cared for adult, child and neonatal ICU patients, I'd say neonatal wins hands down in terms of stress. You're caring for the parents as well the patient. In adult ICU, nurses can keep relatives away from the bedside if deemed necessary; in paediatric and neonatal nursing I soon learnt that was a definite no-no. If you asked me: 'what's the most challenging experience you've had in nursing?', I'd say without hesitation: 'Trying to care for a mother screaming "no, my baby's not dead".'

Over the past twenty years the Department of Health has tried regrading, reorganising and even throwing money at the problems in neonatal nursing. And we're still waiting for an answer.

Brian Belle-Fortune is a student practice facilitator at Great Ormond Street Hospital

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