The Newly Qualified Registered Practitioner in Acute Settings

Given the importance which is now placed on child health in our society, Jeremy Jolley???s historical analysis in chapter one shows us that acute children???s nursing, or nursing children & young people (CYP) in a hospital setting, has a surprisingly short history. Indeed it wasn???t until the damaging effect of industrialisation that public attention was roused to the appalling health of children in this country (Brookes and Hawarth 1993, Webster 2001). It was consequently only towards the middle of the nineteenth century that the notion of child health or paediatrics as a separate entity was really introduced (Platt 1959). Before this childhood illness was regarded as highly contagious, incurable and dangerous (Barnes 1999, Pelling 1998). The gradual transition towards improved child health services, as shown in chapter two, has concurred with a role for nurses trained specifically to look after the needs of sick children. Over the past few decades the role of the children???s nurse has seen significant developments and it is both an interesting and fast changing time for all those involved in child health. The tremendous decrease in childhood mortality in the past half century has simultaneously seen an increase in childhood morbidity, particularly in chronic disease management (Hendrick et al. 1998), as well as current day issues such as increased childhood obesity (Chinn & Rona 2001, Chinn et al. 2005), allergic diseases (Burney and Jarvis 1998) and teenage pregnancy (Kane and Wellings 1999). There is thus an even greater need for trained professionals to treat and care for CYP and their families through periods of ill health. The focus of children???s nursing on ill-health has changed however. The titles ???Children???s Nurse???, ???Paediatric Nurse??? or ???Children???s and Young People???s Nurse??? have replaced what was originally referred to on the nursing register as the ???Sick Children???s Nurse???. The latter titled assumed a child must be sick in order to be nursed whereas the 21st century children???s nurse is recognised as having involvement in every aspect of a CYP???s growth and development. In this chapter we will draw on the work presented in the first three chapters of this book to examine what challenges currently face newly qualified registered children???s nurses today.