To listen to our local paediatricians you might think that money needs to be found for about 5 different types of specialist nurse just so that they can make sure children get a service even worthy of mention. In days gone by, when these decisions were based on what was wanted rather than what was actually needed then about £200k might have been found by the NHS trust on the promise that money would have been saved by better use of resources and throughput. Experience has taught me and those of us working in the side of the NHS that coughs up the money that such savings aren’t always going to happen. The other problem is that what I might call specialist and what they call specialist are two different things. They want a nurse who can be at their beck and call. Who can perform the tasks that they think should be performed and at the same time pacify patients and their families into thinking that what they are getting is something special. They don’t want someone who can think independently, who will challenge practice and who might want that practice changed and improved. What they want is a paediatric nurse with a special interest in say allergy, autism, ADHD, someone they can have control of.

My idea of a specialist nurse is someone who works at the forefront of their speciality, who advocates best practice and most of all works in partnership with the medical consultant. They consultant diagnoses the illness, but the specialist nurse takes part in the process of that diagnosis. He or she also offers the patient and their family the opportunity for a quality of care that they couldn’t otherwise have. This is no cheap option and rather than save money this kind of service might actually cost  more. Quality costs after all.

Our doctors need nurses who have an understanding of the patients under their care, they need to know how to work under supervision and to help free up the doctor to spend time doing things that require a specialist knowledge and skill. What they need are regular paediatric nurses who have been skilled up, who have addditional knowledge and who work at a level above the norm. In my book they are not specialist nurses, unless of course you consider a paediatric nurse a specialist in their field anyway.