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Nurses need training to manage childhood continence

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A recent Nursing Times survey revealed significant gaps in training and education for continence management. What does this mean for those working in childhood continence? Natasha Collins, Education Coordinator at ERIC comments.

One of the most alarming findings was that more than one-third of over 1,000 respondents had not received any continence education in their nurse training, and 53% had no training after registration. The survey showed that, while most nurses (95%) believe continence care is their responsibility, they are not getting enough training to be able to deliver effective treatment.

The survey also identified 43% of nurses have never referred a patient to a continence advisor and 42% do not know who their local advisor is. This problem is often amplified in childhood continence as the route to services can be more complicated. There are school nurses, continence clinics, GP’s and health visitors. It is understandable there can be a degree of confusion when it comes to referring children with continence problems. This isn’t always the case, in some PCT’s there are excellent continence services with specialist paediatric continence advisors clearly signposted but unfortunately, these PCT’s are in the minority.

Incontinence is a large-scale problem costing the NHS billions of pounds every year.  We need to ensure it is recognised that the initial cost of training a nurse to promote continence is substantially less than the cost of their patients remaining incontinent for the rest of their lives, not to mention the greater quality of life each patient will receive as a result.  Across the country, continence training varies from PCT to PCT with some giving it a higher priority than others. Often when training does take place, nurses struggle to attend due to low staff levels or lack of funding. We need to promote how essential training is to nurses’ development and ultimately, the care children will receive. There should be no compromise when it comes to training.

Professionals working with children will appreciate what a sensitive issue incontinence can be. For some, becoming continent can be a long and difficult process which can be frustrating for both the child and their family. We receive calls to our Helpline from health professionals who often don’t have a basic knowledge of childhood continence due to a lack of training. While ERIC is always available to support health professionals, it is still crucial that those working in this field are properly trained to promote best practice in continence care. For some families, the social stigma that accompanies incontinence can be immense and we need to ensure all children have access to qualified professionals.

ERIC provides specialist childhood continence training days on nocturnal enuresis, daytime wetting and soiling and toilet training including children with special needs. Between January 2008 to July 2009, 61% of delegates who attended ERIC training were nurses. We find the majority of our training courses are well subscribed which shows those with an interest are taking up the training.

But what about those who don’t? The Nursing Times survey results indicate there is much work to be done to improve access to continence training for nurses. But on a positive note, the past 20 years have seen many improvements in continence services and the establishment of a number of continence related organisations. Those working in the field must maintain a positive outlook and continue to champion the cause. Through this approach, we stand the best chance of changing attitudes towards the provision of continence training and delivering a quality service for all. 

For more information about ERIC training visit or email

ERIC courses provide information on current developments relating to the continence assessment, treatment and management process, all ERIC courses qualify for CPD accreditation and comply with the Skills for Health Nursing Competencies Framework. Courses open to all professionals run nationally and bespoke seminars can be tailor made to meet an individual PCT’s training requirements.

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