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Exclusive: Academics warn of ‘death knell’ facing children’s nurse education

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Plans to move towards more generic nursing degrees “would be the death knell for the children’s nursing qualification”, children’s nursing teachers have told Nursing Times.

The warning comes from a new UK-wide group of children’s nursing academics set up to give a stronger voice to the specialism in policy-making.

“We have to be very careful that we’re not considered to be some kind of add-on”

Debbie Fallon

Members of Children and Young People Nurse Academics UK fear a move to more generic nursing education risks the children’s speciality becoming no more than an “add-on”.

The Shape of Caring review into the future of nurse education recommended that students should receive two years of general training before specialising in a particular area such as children’s nursing in the third year of their degree.

“The problem we have as children’s nurses is when people talk about generic nursing, what they’re really talking about adult nursing,” said the group’s interim chair Debbie Fallon, senior lecturer in children and young people’s nursing at the University of Manchester.

“Sometimes you can feel like a bit of a side salad and the main dish is adult nursing, and we have to be very careful that we’re not considered to be some kind of add-on,” added Dr Fallow, who set up the group with the support of Tony Long, professor of child and family health at the University of Salford.

Dr Fallon said: “There was barely any mention of children in Shape of Caring. But we were concerned about this notion of a generic course, which would basically be the death knell for the children’s nursing qualification.”

As revealed by Nursing Times last month, similar warnings about the possible dilution of mental health as a specialty have been made by experts from that field.

In addition, the new children’s group has raised concerns about the potential for a new nursing role that spans the 0-19 age group, arguing it would be “impossible” to equip students with all the skills needed within a single undergraduate course.

The concept of a health worker that encompasses aspects of health visiting, practice nursing and other work with children and young people is currently being explored by Health Education England.

It was sparked by recent changes to the way children’s services are commissioned and organised, under the government’s Healthy Child Programme.

“We are open to change but any change must be in the best interests of children, young people and families and not about cost savings under the banner of educational ‘efficiency’, said Dr Fallon in an interview with Nursing Times.

“Trying to squeeze it all into two years is an impossible task”

Debbie Fallon

Group members have highlighted how “difficult” it would be to ensure students have both the clinical skills and confidence to cater for the physical and emotional healthcare needs of infants, children and teenagers across a range of settings.

One issue is the fact that health visitors and practice nurses tend to work more autonomously and it may be challenging for newly-registered nurses.

“We are not averse to the idea but it needs a considered approach,” said Dr Fallon. “If you think about all of the things we do in children’s nursing – mental health, learning disability, neonates, health promotion, all the physical specialities, research and ethics – trying to squeeze it all into two years is an impossible task.”

Other issues being explored by the group include shortages of children’s nurses, for example in neonatal care.

“There are many, many trusts at the moment that are having problems recruiting and there is a problem with retention too,” said Dr Fallon.

“When children’s nursing students go into some neonatal areas there aren’t enough children’s nurses to mentor them,” she said. “That becomes a self-fulfilling prophecy because if we don’t recruit enough into neonatal care we won’t be able to have children’s nursing students in there as we won’t be able to have them assessed.”

Dr Fallon said there was also a need to look at succession planning in children’s nursing education to ensure there were enough qualified teachers in years to come.

Children and Young People Nurse Academics UK

The group will meet twice a year and plans to publish position papers and respond to consultations, such as the current consultation on National Institute for Health and Care Excellence guidance on end of life care for children and young people.

Interim chair Debbie Fallon said she was keen for the new group to span all four UK nations. The group’s interim committee also includes Jane Davies, senior lecturer and director of partnerships in the school of healthcare sciences at Cardiff University, Sonya Clarke, senior lecturer and children’s nursing lead at Queen’s University Belfast, and Donald Todd, senior lecturer in women, children and young people in the nursing school at Robert Gordon University in Aberdeen.

There will be elections to appoint a substantive committee by January 2017. For more information go to the group’s website.

  • 8 Comments

Readers' comments (8)

  • Just as Dr Fallon rightly says that you cannot possibly put all the 0 - 19 range into a 1 year program, you probably couldn't do that in 2 or 3 years either. Similar with everything to do with adult, LD or MH programs, it's life long learning.
    Children's nursing has evolved over the years and needs to remain a distinct speciality and qualification. However, there is also a need for a firm grounding - the initial 2 years would surely be basic / general nursing that would be a suitable grounding for an RN going forward.
    All change feels a little threatening, we need though to influence and embrace, to make that change a little smoother. PS Written by a children's P2K Nurse

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  • As an RSCN who did my 3 years from 84 to 87 and experienced all specialties,it would be a sin if this was lessened.The training now does not give enough ward time to students and still are some paediatric nurses who may have had only one placement with sick children as they spent time in schools,nurseries etc.Please do not get rid of the three year course or there will be consequences in paediatric care .

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  • This plan looks remarkably similar to the Project 2000 format - I started that training course and was not impressed and did not complete it. The college I attended only expected about 50% of the students on our course to complete it. This seems to be taking a step backwards and would not be in the interest of the profession. To work in specialist areas you need full specialist training, not just 1 year.

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  • perhaps extending the course to a 4 or 5 yr course like some medical courses would benefit students more?

    then again that depends on funding..... :/

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  • I did an integrated course many moons ago, and it was very striking to note just how much difference there was between the training for adult and children's nurses. I would never have gone into the profession if I had not been able to specialise, and this meant starting with paediatrics. I think the education I received in paediatrics was good preparation for adult nursing, but the same could not be said the other way round. Communication with children is key, and I have never seen those skills being taught to adult nurses - even though they would be incredibly useful.
    We dismiss the specialism of paediatric nursing, with its dedicated and highly skilled teaching workforce, at our peril (and that of all our child patients in the future).

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  • We should have retained the specialist names for nurses RGN RMN RSCN and Rms/mh/ldN instead of a generic RN that way there could be no mistake in knowing what area you are registered and qualified to do, the public don't understand the numbers.

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  • i am a general nurse but have to say i think children nursing is a very special branch and deserves to be preserved.

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  • I must take issue with the comments posted by Rachel Tomlinson, specifically 'I think the education I received in paediatrics was good preparation for adult nursing, but the same could not be said the other way round.' This is a hugely broad statement to make. I completed my general nurse training and then undertook my paediatric nurse training. The interim period proved extremely valuable and I was able to take forward the many skills I had into paediatric nursing, which I have now been practicing for over 30 years. To suggest that I was not equipped to become a paediatric nurse is nothing short of insulting. I trained at Great Ormond Street Hospital and many of the students I met on the 4 year course were very thankful for their adult placement as they simply did not feel enough basic care was taught in the very specialized environment that was GOSH. Additionally, communication is the cornerstone of any nursing, be it adult or paediatrics. There are many, many patients who are unable to communicate effectively and adult nurses also need to adjust and hone their communications skills to cater to specific needs; to assume otherwise shows a lack of understanding of general nursing in it's many forms.

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