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Education plans 'must reflect children’s nursing complexity’

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Academics have called for the “increasingly complex nature” of children’s nursing and the “chronic” shortage of staff working in the field to be recognised in light of major changes to pre-registration education.

Children with disabilities or life-limiting conditions are often living longer, young people are at increasing risk of mental health problems - including suicide and self-harm - and complex disease processes are expanding in number, they said.

“A generic nursing programme is insufficient for any field of practice in the increasingly complex arena of nursing”

Children and Young People’s Nurse Academics UK 

In addition, the UK is falling behind many western European countries on infant mortality rates, emergency admissions and deaths associated with childhood asthma, they added.

In a paper launched last week laying out its position on training (attached below), the Children and Young People’s Nurse Academics UK group also highlighted the “chronic shortage” of staff practising in the field.

The academics noted children and young people make up approximately 25% of the population – but only 5% of registered nurses have a children’s nursing qualification.

In particular, community services in England have just under 50% of children’s nursing posts empty, they said, referring to figures from 2015 in a report by the Migration Advisory Committee.

As a result of both the increasing complexity of the role and the shortage of staff, the group said the future education of children’s nurses should not be focussed on general nursing skills.

”A significant increase in mental health input is required in the undergraduate children’s nursing curriculum”

Children and Young People’s Nurse Academics UK 

A generic nursing course is “repeatedly advocated as a cheaper or more flexible option” than the range currently taught, in either adult, children’s, mental health or learning disability nursing, they said.

“A generic nursing programme is insufficient for any field of practice in the increasingly complex arena of nursing,” said the group, which is chaired by Dr Debbie Fallon, from the University of Manchester.

The academics said that, instead, “strategic efforts” were needed to continue and increase the provision of field-specific undergraduate courses.

While some parts of the country were trying to plug staffing gaps by re-training adult nurses as children’s nurses though post-registration courses, this “should be viewed as a problem rather than a solution”, they said.

The group said any attempt to adopt this approach more widely – in which children’s nursing would become a further qualification after completing a three-year generic undergraduate course - would be a “retrograde step”. It would also be costly and take longer, said the group.

At the same time they also said a ”significant increase in mental health input is required in the undergraduate children’s nursing curriculum” due to the growing number of young people presenting in paediatric environments with these issues.

Earlier this year the Nursing and Midwifery Council said the four fields of nursing would not be removed as part of its current education review due to legal requirements, but did not rule out the possibility of it happening in the future when legislation is altered to allow nursing associates onto the register.

Earlier this month the NMC launched its consultation on new pre-registration training standards for nurses.

The proposals include a list of technical and communication skills that all nurses, regardless of field of practice, will be required to be competent in.

The NMC claimed its proposals had “cracked” the challenge of incorporating mental and physical healthcare education but mental health academics have claimed the tasks are still too focused on adult nursing and hospital care.

The NMC also wants to increase the number of hours that pre-registration students can spend in simulation, from a maximum of 300 hours to half of the time spent in practice.

The CYPNAUK said it was “fortuitous” that simulation teaching had progressed in universities in recent years “given the extensive list” of clinical skills students would have to demonstrate under the education proposals.

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