Blog Highlight: Children are our future: Challenges impacting nursing care for youngsters and young people

This week on EBN Blog, Editor-in-Chief Kerry Gaskin @GaskinKerry introduces our theme for September 2024 – “Children are our future – challenges affecting the future of nursing care in CYP”.

Over the following five weeks, EBN can be featuring a series of blogs and magazine content on the worldwide challenges facing children and child and adolescent nursing (CYP). This will include the EBN Resources Page and an upcoming editorial (October issue) by Danielle Edge, Lecturer in Child and Adolescent Nursing @danniedge and Professor Kerry Gaskin, EBN Contributing Editor. The blogs will consider aspects influencing children’s rights, CYP nurse education, cultural humility in CYP nurses, the worldwide delivery of paediatric critical care, child and adolescent mental health (CAMH) and palliative care services.

Why is that this topic vital? Almost one third (28%) of the world’s population is under the age of 18¹. Globally, the health and well-being of CYP are being impacted by quite a lot of aspects, including the coronavirus (COVID-19) pandemic, conflict, and climate change. The results of a global study on child health professionals’ experiences of climate change were published on 21^saint August 2024, Royal College of Paediatrics and Child Health. Study finds clinicians are already feeling the consequences of climate change on healthcare; ‘CYP are being exposed to heat, poor outdoor air quality, household air pollution and increased incidence of infectious diseases’²Dr Helena Clements, RCPCH climate change officer, said: “Kids have basic human rights to clean air, safe water, sanitation, affordable and nutritious food and shelter, yet millions of children in the UK and around the world do not have access to these key determinants of health”².

Healthcare inequalities have been high on the political agenda for a while now.^3-4; Marmot review^5-6 ‘identified’“giving every child the best start in life” as considered one of five priority areas. The unprecedented rise in infant mortality in England over the past decade has disproportionately affected the poorest areas of the country⁷In the yr ending March 2023, the West Midlands had the best child mortality rate, with the best rates being for Black or Black British children (56.6 per 100,000 population) and Asian or Asian-British children (50.8 per 100,000 population).⁸.

As CYP nurses, we’re uniquely placed to influence the longer term of kid health within the UK and globally by understanding and addressing complex and interconnected social aspects in our practice, research, policy documents and curriculum. Furthermore, as Professor Lucy Bray from Edge Hill University points out and can explore in her blog, “we’ve got to work with CYP (especially those that are less heard of) to challenge accepted practices and exclusion‘And’professionals and institutions must recognise their competences and rights in on a regular basis practice – reminding that small things could make a giant difference, preserving humanity in services under pressure‘.

The health service has clearly come under enormous pressure throughout the COVID-19 pandemic, with CYP nurses and community nurses being redeployed to work in adult and intensive care units, for instance⁹negatively impacting on service provision for CYP and their families. In addition, there’s emerging evidence of the extreme impact of the pandemic on the mental health and well-being of kids and fogeys¹⁰The impact of the pandemic and other challenges on CAMH can be explored in a forthcoming blog by Rebecca Reynolds and Yasmin Smith, Senior Lecturers on the University of Plymouth. Healthcare professionals should be vigilant in regards to the potential consequences of deteriorating mental health, and further research is required to explore the longer-term impact of the pandemic on each parents and kids.^11. The recent government must prioritise rebuilding essential services resembling nursing and faculty care.^12.

While pediatric critical care has also been affected by the pandemic, other local, national and international aspects are influencing the delivery of critical care world wide. Data from Save the Children¹³ shows that in 2022, 2,985 children died in 24 countries, with almost 200 million children living on this planet’s deadliest war zones; the best number in greater than a decade, exacerbated by the war in Ukraine. In these war-torn countries, demand for critical care has increased at a time when service provision has been catastrophically affected by damage to healthcare facilities. In the UK, major tragic incidents resembling the Manchester Arena bombing in 2017¹⁴ and stabbings of kids require care for youngsters and their families in essentially the most difficult circumstances¹⁵Professor Lyvonne Tume, Edge Hill University, Professor Joseph Manning, University of Leicester and Dr Julie Menzies, Bristol Children’s Hospital, will take a look at the challenges faced by paediatric intensive care nurses of their upcoming blog, while Gilda Davis, Senior Lecturer in Paediatric Nursing on the University of Worcester, will consider the important thing aspects influencing palliative and end-of-life care.

Central to this topic is the continued review of pre-registration nursing education; do we want areas of practice?¹⁶ or return to general nurse training¹⁷. The blogs will undoubtedly generate discussion around curriculum content related to the important thing challenges highlighted on this series. The EBN resources page includes links to previous journal content, in addition to additional contemporary resources resembling the national Fit4CYP project¹⁸ The aim of this study is to determine how the structure and content of pre-registration educational programmes affect the readiness of newly qualified paediatric nurses to practise Fit for Children and Young People Project (Fit4CYP) – University of PlymouthDeveloping cultural humility through decolonising the curriculum is an integral a part of the academic preparation of nurses caring for CYP and their families. This can be explored in additional detail in a forthcoming blog by Laura Maguire, Kathryn Sethi, Emma Tonks and Waheeda Zaman, CYP Nursing Lecturers at Birmingham City University.

References

1. United Nations (2024) World Population Prospects, available at: World Population Prospects – Population Distribution – United Nations [accessed 18/7/24]
2. RCPCH (2024) The changing climate is already impacting the way in which healthcare employees work world wide, available at: https://www.rcpch.ac.uk/news-events/news/changing-climate-already-impacting-way-healthcare-professionals-work-around-world [accessed 23/8/24]
3. NHS England (2019) NHS Long Term Plan. Healthcare, www.longtermplan.nhs.uk
4. Public Health England (2019) Place-Based Approaches to Reducing Healthcare Inequalities: Introduction and Executive Summary.PHE, www.gov.uk/government/publications/health-inequalities-place-based-approaches-to-reduce-inequalities/place-based-approaches-for-reducing-health-inequalities-foreword-and-executive-summary
5. Marmot, M. (2010) Just societies, healthy lives: the Marmot review: a strategic review of health inequalities in England post-2010 ISBN 9780956487001
6. Marmot M, Allen J, Boyce T, Goldblatt P, Morrison J. (2020) Health equity in England: the Marmot review 10 years on. Institute of Health Equity, available at: https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on [accessed 20/2/24]
7. Taylor-Robinson D, Lai ETC, Wickham S et al (2019) Assessing the impact of rising child poverty on the unprecedented increase in infant mortality in England between 2000 and 2017: a time trend evaluation. BMJ Open, 9:e029424. doi:10.1136/bmjopen-2019-029424
8. National Child Mortality Database (2023) Child Mortality Review Data Release: Year ending 31 March 2023 https://www.ncmd.info/publications/child-death-data-2023/ [accessed 20/2/24]
9. Mallory J et al (2021) COVID-19 pandemic: redeployment of paediatric cardiology nurses to adult intensive care units – could we do it? Available at: https://blogs.bmj.com/ebn/2021/10/03/covid-19-pandemic-redeployment-of-paediatric-cardiac-nurse-specialists-to-adult-intensive-care-units-could-we-do-it/ [accessed 23/8/24]
10. Hamilton D (2020) Impact of COVID-19 on children and families, available at https://blogs.bmj.com/ebn/2020/10/25/impact-of-covid-19-on-children-and-families/ [accessed 23/8/24]
11. Gaskin, K. L., Hope, L., & Lewis, A. (2024). “This has shaken up my whole parenting plan”: experiences of oldsters staying home with their newborn throughout the COVID-19 pandemic. Comprehensive care for youngsters and youth1–17. https://doi.org/10.1080/24694193.2024.2389415
12. NHS Service Providers (2024) The Forgotten Generation: Shaping Better Services for Children and Young People, available at: https://nhsproviders.org/forgotten-generation-shaping-better-services-for-children-and-young-people [accessed 18/7/24]
13. Save the Children (2024) 10 Most Dangerous Countries for Children Living in Conflict, available at: https://www.savethechildren.org/us/charity-stories/worst-confused-affected-countries-to-be-a-child [accessed 17/7/24]
14. Craigie RJ and others (2020) Manchester Arena bombing: lessons learned from the mass casualty incident BMJ Mil Health 2020;72-75.
15. RCPCH (2024) RCPCH responds to major incident in Southport, available at: https://www.rcpch.ac.uk/news-events/news/rcpch-responds-major-incident-southport [accessed 23/8/24]
16. Barrett D (2016) available at: Nursing disciplines: do we want them, what should they be, and when should nurses select theirs? – Evidence-Based Nursing blog (bmj.com)
17. Purssell E, Sagoo R (2023) Pediatric nursing: is it time to rethink discipline-specific training? Nursing for youngsters and adolescents32(2): 12.
18. Carey M et al (2024) Fit4CYP, available at: Fit for Children and Young People Project (Fit4CYP) – University of Plymouth.[accessed 20/2/24]

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