How I Can Practice In Adult Nursing As A Children's Nurse And Why I Do This

"Nurses can give their all to a specialism for a period of time, and then, one day, find it is something they can no longer manage. We need to recognise when change would be positive"

I qualified as a Children's Nurse and still practice with children. But following competency training I can now work with adults as well. My journey shows how we can be flexible in our careers and why that’s important sometimes.

Topics Covered In This Article

Introduction

I’m A Children's Nurse But I Also Look After Adults

Areas Of Flexibility In Nursing Skills

How Did My Transition To Providing Specific Adult Nursing Care Begin?

Completing The Competencies Needed

Improving Skills Benefitted My Employer At The Time, My Patients And Me

Why I Would Recommend This For Your Nursing Career Journey

As A Nurse You Can Gain Skills To Practice In A Specific Area Outside Of Your Nursing Field Of Practice

A Nurse qualified in one Nursing branch (in my case, Children's Nursing) may work in a specific field of another branch (Adult Nursing) without re-qualifying or becoming dual qualified.

This is allowed under the NMC code, subject to the correct training and qualifications in that specific area of practice.

I want to explain how this works because I have done this and it has probably meant I have stayed working as a Nurse and not left the profession.

Here’s my story.

I’m A Children's Nurse But I Also Look After Adults

Even though I am qualified as a Children's Nurse I am now competent to practice with Adults needing total parental nutrition via central lines or picc lines and also to look after adults with complex care as long as my clinical skills match their requirements.

This is because I’ve done the necessary paperwork around that specific practice.

And it does not mean I can work in Adult Nursing settings, say an Adult Nurse Ward or a Nursing Home for Adults.

I have not re-qualified as an Adult Nurse. And I am not a dual-qualified Nurse. But I have trained in IV for adults to the required standard, so I am safe to do this and am employed to do this as part of my Nursing job.

It’s given my role greater variety and enabled me to enjoy it more.

Areas Of Flexibility In Nursing Skills

The beauty, I think, of the UK Nursing branches is that all four Nursing branches (Adult, Children's, Learning Disability, Mental Health) do slightly merge into each other.

This is especially true of Paediatric Nursing as some of your patients will have learning disabilities or mental health, plus, they all have adult care givers.

So, along with the job, you are very often working with people with needs that straddle the branches.

How Did My Transition To Providing Specific Adult Nursing Care Begin?

For me there seemed a natural and smooth transition to working with adults, while continuing to work with children.

It all came about because I was already specialized in my practice as an enteral Nurse (tube feeding) as a Children's Nurse and my employer had Adult Nurses carrying out the same routines on adults.

It really helped working for the leading company in this specialized area who ensured we were experts in what we did and had all the up to date information and training.

In this role I covered an on-call service for adults and paediatrics.

It was always the case (rightly so) that the Nurse would only be able to help if they were deemed competent in that specific task.

For example, we would be able to prevent a patient having to go to hospital by changing their nasogastric tube/gastrostomy tube at home as long as it was safe.

I was of course doing this for the paediatric patients as it was part of my normal day job but not regularly for adults so I would have to send adults to hospital if they called when I was on-call.

However, I didn’t think this was fair on them and since it was the same procedure but just on an adult not a child I brought it up at our staff meeting suggesting it might be more efficient if I could also carry out these tube changes on adults.

After all, we were all competent on the procedure of tube feeding.My employer agreed, but wanted everything to be done with clinical competency.

So I decided to look into becoming competent and qualified in this, without needing to re-qualify as an Adult Nurse. As a business, we also looked at the reverse:

e.g. allowing Adult Nurses to be able to carry out the procedure on children if they so wished.

It was more vital for the adult patients who didn’t have any community NHS service that the children did.

Completing The Competencies Needed

As I said, the company I worked for were, quite rightly, strict about best practice and training.

They insisted I would only carry out the procedure with competency documents being signed off.

What we set about doing was ensuring I was completely competent on the theory and practical procedures.

These are some of the theory areas we looked at:

● consent for adult safeguarding

● best interests

● different medications that adults could be on that would affect their tube (e.g. warfarin that affects INR levels)

I was provided with the questions that I needed to be able to answer.

The company required us to do this when we did any new clinical procedure and also to be re-assessed yearly.

To complete my competencies I observed Adults Nurses and then they came out and observed me and I was signed off as competent on the company paperwork. (This didn’t require submission to NMC.)

This is obviously a win for my employer, and it has widened my area of expertise and injected variety into my Nursing job.

Improving Skills Benefitted My Employer At The Time, My Patients And Me

Learning this skill meant patients could be seen at home without having to go into hospital which can be massive for a patient even just the practical side of it such as getting them there when they may be bed bound.

It can be very distressing for them and their families.

Plus some of them are already quite fragile, unwell and possibly immunosuppressed meaning serious consequences if they catch something else whilst in hospital.

It benefitted me by being able to help in this way and develop my own skills and confidence as a Nurse.

It benefitted the NHS with cost savings keeping patients at home.

I’m not an Enteral Nurse Specialist anymore. I am happily able to work with adults confidently in my IV TPN role as well as continuing with children in a complex care role.

Why I Would Recommend This For Your Adult Nursing Career Journey

I believe in the maxim ‘a change is as good as a rest’ (and there’s a lot of Nurses who need a rest!)

I was only 17 when I went into Nursing. Now I’m 37.

A lot can change with a person in the years and decades after qualifying.

As many Student Nurses will tell you, it can be hard to know which branch to pick in the when you’re starting out.

Halfway through my Nursing course we had an adult placement and I found myself quite enjoying it and did consider changing branches even then.

Working with unwell children is certainly emotionally hard at times.

When I was at the hospital I would often feel troubled by the screams of children in pain.

I’ve heard the same with other Nursing roles, such as palliative care.

Perhaps, this is something that is more common than we know: Nurses can give their all to a specialism for a period of time, and then, one day, find it is something they can no longer manage.

We need to recognise when change would be positive.

Adding a new element to my role has allowed me to enjoy all of my responsibilities even more.

In my current roles, which are much different to my previous roles, I get to work regularly with the same patients and get to know THEM - which I prefer.

And I’ve done this relatively easily, because it was a need of the organisaton that was recognized.

So my employers were able to support me with this and in turn made a difference to the lives of our patients which is what it is all about.

For this I am truly grateful for the privilege we have as Nurses to make such improvements to people’s lives, even if we only make things easier for one family or stop one person being in pain for so long we know it was worth it.