Nursing: Paediatrics

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More nurses are required to care for newborn babies, children and young adults.

There has never been a shortage of nurses looking to specialise in babies and children, but a would-be school or children’s community nurse (CCN) may have little idea of how much paediatric nursing has expanded in the past 20 years, says Fiona Smith, advisor in children’s and young people’s nursing at the Royal College of Nursing. “At one end of the spectrum, we have the survival of very tiny premature babies who may need specialist support for some years after they are born and at the other, young people with a condition such as cystic fibrosis; who would not normally have lived beyond the teenage years until relatively recently, enjoying a life expectancy of 40 or 50.” “With so many advances in medicine and technology in the past two decades, a typical children’s nurse is looking at an age span of newborn baby right up to the age of 25,” she adds.

While senior nurses would once have been re-routed into purely management posts, the advent of nurse consultant posts in 1999 has widened career options. All nurse consultants spend a minimum of 50 per cent of their time working directly with patients, but their job spec also includes developing personal practice, research and evaluation work and contributing to education and training. “There is far greater scope to remain in clinical practice today, both influencing developments and leading clinical teams,” says Smith.

Mark Whiting is a consultant nurse for children with complex needs at the West Hertfordshire Primary Care Trust and inevitably, much of his work involves supporting families and their carers. “For most families, there is ‘an expectation of normality’ when a baby is born and if that doesn’t turn out to be the case, life can be tough,” he says. “A child with breathing problems or a cleft palate would once have spent the first six weeks of its life in hospital, but nowadays, they are back home with mum and dad within a fortnight. “Parents have to be taught how to tube-feed their babies, how to handle artificial airway procedure and they also have to be supported when the challenging needs of their children or their dependence on technology means that they themselves are unable to get a proper night’s sleep. “Either way, it can be very daunting to have a constant stream of strangers in your house because you happen to have a child with complex health needs,” he adds.

Once trained, the settings in which children’s nurses work depend on the circumstances of the client. While community-based nurses will tend to support the families of babies and children with special needs at home – acting as co-ordinator with other healthcare professionals and making sure necessary facilities and equipment are provided, for example – school nurses may handle anything from a routine nit outbreak in 3C to offering learning support in the classroom. She, or increasingly he, may be employed directly by a school; particularly a private boarding or day school, or may be health centre-based with a remit to cover several state schools in the local area.

At least one quarter of all baby and children’s nurses are based in A&E departments and neo-natal units where they apply their specialist skills in high-tech support and paediatric intensive care to clients requiring routine or even major surgical procedures. “With many children’s nurses now reaching retirement age, as well as a sharp increase in the birth rate in some parts of the UK due to more Eastern European workers, there are many opportunities for new entrants,” says Smith. “Now that many health departments are starting to address the problem of insufficient training places, this is a sector of nursing that can only expand.”