A worrying shortage of nurses working in children’s palliative care is having a negative impact on care, a charity has warned Nursing Times ahead of a new drive to promote the specialty.
Together for Short Lives is preparing to launch a campaign to promote children’s palliative care as a rewarding career to nurses and nursing students.
“They will find it incredibly uplifting with the chance to keep their skills levels really high”
Its latest warning on staffing follows research that showed an ongoing average nursing vacancy rate of 10% among voluntary sector children’s palliative care organisations, with a knock-on for care.
A survey by the charity year found two thirds of hospices and community services reported nursing vacancies had affected the care they could offer families, with some even forced to close beds.
Others said vacancies meant they were able to offer less respite care, while lack of permanent staff and reliance on bank and agency nurses harmed continuity of care and meant less time for training.
Gillian Dickson, the charity’s workforce and development manager, said the organisation’s research had focused on voluntary sector organisations but staffing shortages in children’s palliative care went wider than that.
“We know that in the UK there are more than 49,000 children with life-limiting conditions. These children are cared for in primary care, in the community by the NHS, in hospitals, in specialist centres and also in hospices and other voluntary organisations,” she said.
Children’s palliative care hit by nurse shortage
“The sort of recruitment problems we’ve measured in hospices point to a shortage of children’s nurses throughout,” said Ms Dickson.
She said factors that may deter qualified nurses from entering the sector included the fact it may mean leaving the NHS – although nurses can take their NHS pension with them – and differences in terms and conditions. Other concerns include losing skills and training opportunities.
These are among issues touched on in a short film specially created for the charity’s forthcoming #YouCanBeThatNurse campaign, which features three nurses at different stages of their careers who have chosen to work in children’s palliative care.
Ms Dickson hoped fellow nurses would be able to identify with the three, who speak passionately about how much they love their jobs.
“There is a worry sometimes among qualified nurses that they may move out of the NHS and lose nursing skills but it was quite the opposite for the nurses in our film,” said Ms Dickson. “They were really able to develop their nursing skills.
“Across the NHS and voluntary sector, there can also be a perception that working with children who are very poorly could be sad and we hope to dispel some of that anxiety,” she said.
“We want to get the message across that this can be for any qualified children’s nurses and any student thinking of what they might do with their registration as a nurse should consider a career in palliative care, because they will find it incredibly uplifting with the chance to keep their skills levels really high and opportunities for progression,” she added.
“It is a very varied role and not doom and gloom all the time”
As well as promoting children’s palliative nursing as a career, the charity also wants to see more nurses trained to ensure services can cope with significant increases in the number of children with complex, life-limiting conditions.
Ms Dickson said it was vital workforce planning took account of the fact much care happens outside the NHS.
“There are about 1,500 nurses working outside the NHS in children’s palliative care but when it comes to planning for future workforce these nurses are often not included in the numbers,” she said.
The film will be shared at a strategic level with bodies including NHS England and Health Education England and Together for Short Lives is working with universities to encourage them to feature it on the curriculum of children’s nursing courses.
Children’s nurse Amanda Williams, a team leader at Children’s Hospice South West, is one of the nurses featured in the film.
“We need to recruit more nurses in this area and I felt it was really important,” she told Nursing Times.
Children’s palliative care hit by nurse shortage
Ms Williams said she knew she wanted a career in children’s palliative care, having worked in the community looking after children at home.
“I think some people are put off by the fact you are looking after a dying child and can’t make them better,” she said. “But there is no other sector I would work in, because being part of that journey is such an amazing experience with its own rewards and challenges.
“The toughest bit of the job is working with somebody right at the end of their life – it is emotionally challenging more than anything,” she said. “But being there for the family at that time is so rewarding, it’s unbelievable.”
Ms Williams urged students and other nurses simply to “give it a try”. “It is a very different kind of job because you’re very one to one and it is different every day,” she said.
“One day you could be looking after someone at the end of life or doing a bereavement weekend, and another you could be making memories in a Jacuzzi or taking a child out for a trip. It is a very varied role and not doom and gloom all the time – it’s actually a lot of fun,” she said.
She noted that her clinical skills had increased as a result of working with children with complex health conditions and another bonus was support from fellow staff. “You get so much support from the team compared to in a hospital,” she said.