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Caring from the first moments

Written by: Doreen Crawford
Published on: 1 Aug 2019

Children’s nursing offers so many opportunities to grow and develop your career. More or less anything that is available to nurses in the adult, learning disability and mental health fields is also available for children’s nurses – but there is so much more besides. How many nurses on adult wards get to kick off a medicines round with a game of hide and seek in a play room, for example?

A great start is so important. As I tell my students as they prepare to qualify, your learning really starts now, and I tell newly qualified nurses that, if you ever have a day when nothing new happens and you are not excited by your job, it is time to take some time out to refresh.

It is not as though you will jump straight from the classroom to extracorporeal membrane oxygenation and critical care, but be ambitious in the field that you love.

If neonatal care or critical care excited you when you were a student, think about starting as a newly qualified nurse in a neonatal unit (NNU) or agree a preceptorship that will involve some work on an intensive care unit.
This is possible because leaders in neonatal and intensive care would rather grow their own than try to recruit ready-made nurses especially as the supply of specialists has been drying up.

If you’re interested in this area, you need to ask about your induction and how you can attain the competencies you need to practise and learn to keep babies and their families safe as you become an expert in providing skilled care.

Terminology varies but typically an NNU can offer you a programme of preparation that will see you start in a low-dependency area, sometimes called a special care area or a low-dependency nursery. Once you are expert in this, it is time to progress to a high-dependency area. It can feel a bit like starting over again, but you will have the firm foundations in place and the thirst to learn and push yourself further.

One thing you have to be prepared for is more studying. Children’s nursing is a generic preparation and, with your first qualification under your belt, you can start to think of specialising.

Many universities offer comprehensive neonatal pathways; De Montfort, where I work, offers a 15-credit foundation module, a 30-credit high-dependency module and an intensive care module, which also carries 30 credits. Completion of all of these will gain you a qualification in your specialty.

You might then seek to extend your role, perhaps in research, teaching or management. That said, it is important to stay current so try to retain a clinical element or you might forget what drew you into nursing in the first place. Not everyone wants to share their clinical time with other responsibilities and swap the cardiac monitor for the computer but consider all options to keep your career progressing.

Consider also an outreach service, designed to facilitate early discharge into the community, or you could forge a role in supporting the neurodevelopment of infants, which is an exciting and emerging area.

If you are an adrenaline junkie consider becoming an advanced neonatal nurse practitioner (ANNP). The ANNP qualification is an important route to other opportunities, perhaps neonatal transport nursing or taking on your own clinical caseload and supporting medical colleagues. I am not suggesting that senior nurses are ersatz junior doctors, but experienced ANNPs function as registrars and will lead teams.

This is only one speciality within children’s nursing, much the same could be written of oncology, cardiac and other aspects of children’s care throughout the UK. But for now it is over to you; your future starts here.

Doreen Crawford is consultant editor of Nursing Children and Young People. She is a senior lecturer and governor at De Montfort University, Leicester