faculty focus
Healing the child
The idea of postgraduate specialisation, such as paediatrics, for nurses is being debated. Is it time to change the structure of degrees? By Louis White
For a parent, there is nothing more precious than the welfare of their children. This care escalates off the scale should that child develop any kind of illness. While the first port of call is a doctor, it is often the nurse that spends the greatest amount of time with a patient – in this case, the child.
As it stands in Australia at the moment, both registered nurses and specialist paediatric nurses care for an ill child. While all nurses are suitably qualified to care for all ill patients, paediatric nurses specialise in the care for babies, children and adolescents.
They work in schools, hospitals and community centres around the country caring for not only a sick child but comforting the family as well.
Unfortunately, around the world more and more new diseases are spreading almost quicker than the medical profession can diagnose them. This being the case,
28 | May 2013 the time has arisen for more nurses to specialise in specific illness and specific categories, just as doctors do.
Should all nurses who work in paediatrics have specialist qualifications?
“ Paediatrics is very different to adult nursing,” Linda Shields, professor of Nursing – Tropical Health Research Unit for Nursing and Midwifery from James Cook University, says.
“ Children’ s physiology means they have different physical requirements to adults, such as drugs work much more rapidly and anaesthetics wear off much more quickly.
“ They are at different stages of development, as they grow, their physiology changes in relation to developmental stage. This doesn’ t happen in adults.
Emotionally of course things are very different to adults – psychology, emotional needs, and social needs, legal, ethical – think of a three-year-old in hospital compared with a 30-year-old.
“ They need their parents close by, or at least a family member. And they need them at all hours, not just visiting hours. Check out John Bowlby’ s 1952 film A Two-Year Old Goes to the Hospital to see what happens to kids whose parents aren’ t with them.”
Professor Shields has spent a long time in involved in working and researching in paediatric and child health nursing. She believes it is time to overhaul university degrees.
“ In undergraduate nursing courses, paediatrics often gets left out because the three year degree in Australia means that a lot of things get left out( not just paediatrics) – we need a four-year degree. So post-graduate qualifications in paediatrics are the only way to get the knowledge needed to work in paediatrics.”
There are several specialty areas in paediatric nursing such as intensive care, oncology, mental health and child development. Some employers require nurses to have specialist paediatric nursing qualifications before they can work.
“ Qualified nurses are aware of the complex needs of both children and their parents and other family members such as siblings and grandparents,” says professor Shields.
“ Without specialist knowledge, these needs are often overlooked. Nurses who do not have paediatric qualifications and begin work in children’ s wards are often very confused because they’ ve not come across these highly specific needs before.
“ We also need specialist knowledge about communication with children relevant to developmental stage; how to