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Guidance for nurses specialising in early pregnancy care

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The skills and knowledge needed to become a clinical nurse specialist in early pregnancy care have been laid out for the first time in new guidance designed to help nurses carve out a career in the field.

The guidance, published by the Royal College of Nursing, sets out specific skills – in areas such as ultrasound, clinical practice, data collection and leadership – that are required for the specialist care of women in the first trimester of pregnancy.

“Clinical nurse specialists are well placed to give enhanced care”

Carmel Bagness

The role of nurses working in early pregnancy services mainly revolves around supporting women who miscarry but it can also involve caring for those affected by complications, such as extreme early morning sickness, noted the RCN.

The guidance, which was produced in collaboration with the Association of Early Pregnancy Units (AEPU), describes the roles of a clinical nurse specialist in early pregnancy care as “an exciting career option”.

“This is an opportunity where nurses can make a really positive difference to women and their partners at a vulnerable and potentially very stressful time in their lives,” it stated.

Nurses wishing to become specialists in the field should be educated to master’s degree level and have extensive experience of working in a gynaecology or women’s health setting, according to the new guidance.

“This is an opportunity where nurses can make a really positive difference to women… at a vulnerable time”

RCN guidance

They will be expected to lead and develop services, ensure strong links with primary care and other services, work closely with fellow healthcare professionals and raise awareness and understanding of early pregnancy care.

Key clinical practice skills include providing “compassionate care to pregnant women, including breaking bad news effectively and providing emotional support”, said the document. Nurse specialists should ideally be nurse prescribers and able to run nurse-led clinics and telephone support services.

It is also recommended that all those in clinical nurse specialist roles should develop skills to perform safe manual vacuum aspiration for women experiencing miscarriage – a procedure that can be carried out under local anaesthetic without the need to go to theatre.

As leaders, specialist nurses should be able to act as the woman’s advocate and “be actively engaged in service development, commissioning and provision of complex care pathways”, it noted.

As well as setting out the skills and competencies nurses require, the guidance is intended to inform commissioners and managers seeking to create new specialist posts, said the RCN.

Royal College of Nursing

Women facing ‘barriers’ to gynaecological healthcare

Carmel Bagness

“One in four pregnancies in the first trimester will miscarry,” said Carmel Bagness, professional lead for midwifery and women’s health at the RCN.

“It is vital that woman are supported through the first stages of their pregnancy and clinical nurse specialists are well placed to give enhanced care and advice during this period,” she added.

“Early pregnancy units should be established and maintained locally and the role of the nurse is constantly evolving in the specialty,” she said.

Until now the role of clinical nurse specialist in early pregnancy care had not been clearly defined, said Ms Bagness.

“Working together, the RCN and AEPU recognise the need to provide educational support for nurses working in these essential services and this standard will guide them in their career and revalidation process,” she added.

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