- Email: [email protected]
Neonatal nursing in Scotland
Journal of Neonatal Nursing (2012) 18, 1e5
www.elsevier.com/jneo
EDITORIAL
Neonatal nursing in Scotland Available online 21 December 2011
KEYWORDS Neonatal nursing; Scotland; Scottish neonatal nurses’ group; Scottish neonatal transport service; Neonatal nurse education
Abstract There are four aspects of Scottish neonatal nursing discussed in this article. Firstly, the organisation of neonatal units and the development of Managed Clinical Networks are explained. Secondly the design and function of the Scottish Neonatal Transport Service are outlined. Thirdly the educational opportunities for neonatal nurses in Scotland are discussed. Lastly the structure and work of the Scottish Neonatal Nurses’ Group are highlighted. ª 2011 Neonatal Nurses Association. Published by Elsevier Ltd. All rights reserved.
Introduction This article describes neonatal nursing in Scotland in late 2011. An overview of the organisation of units will be followed by an explanation of the Scottish Neonatal Transport Service (SNTS), the education available to neonatal nurses and the Scottish Neonatal Nurses’ Group (SNNG).
Since the establishment of MCNs and the employment of key personnel, there has been considerable work to develop A Quality Framework for Neonatal Care in Scotland in line with the Health Care Quality Strategy for NHS Scotland (The Scottish Government, 2010). The purpose of the framework will be to give neonatal services and MCNs direction in developing services, care pathways and guidelines which are person-centred, safe, effective, efficient, equitable and timely.
Organisation of Scottish neonatal units There are 16 neonatal units in Scotland. Of these, 12 are designated as level 3 (Maximal Intensive Care), 2 as level 2 (High Dependency Care and short term Intensive Care) and 2 as level 1 (Special Care). Recently, three managed clinical networks (MCNs), east, west and north, have been established incorporating all the Scottish units. There is one national referral centre for neonatal cardiology services and one national referral centre that offers neonatal Extracorporeal Life Support/ Membrane Oxygenation, both in Glasgow.
Scottish Neonatal Transport Service (SNTS) In 2003 the SNTS was established with three regions (4 teams) to provide road and air transport for the whole country, including remote and rural areas. Each centre has core medical and nursing staff and a rota of ‘dedicated’ staff so that neonatal unit staffing is not affected by the transport service needs, as it had been in the past. Evaluation of the SNTS has always been positive and while most
1355-1841/$ - see front matter ª 2011 Neonatal Nurses Association. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jnn.2011.11.011
2
Editorial
aspects have persisted, the most recent evaluation has lead to the appointment of a national Strategic Manager and a Consultant Transport Nurse. A further service review is currently being undertaken. All neonatal transports between and within hospitals are conducted by the SNTS. There are approximately 1500 neonatal transports per annum; 90% of these are by road and 10% are by air; 30% are emergencies and 70% are planned transports; 30% are “out of hours” transports; and in 21% of transports the baby is ventilated. As can be seen in Table 1, the highest percentage (42%) are transports lead by an Advanced Neonatal Nurse Practitioner. The SNTS offers training in stabilisation and transport for all SNTS staff. In 2007, SNTS published a Stabilisation Handbook, a valuable resource for staff in all Scottish units as well as the SNTS staff (Greig et al., 2007). A second edition is in press. The SNTS also offers a stabilisation course for midwives working in community led midwifery units and those midwives working in remote and rural settings. The perceived increase in participants’ skills and competence has been locally evaluated as very positive.
Neonatal nurse education Historically in Scotland, medical neonatal units were staffed by midwives. This pattern has changed over the last decade due mainly to the interpretation of what constitutes midwifery practice in the neonatal environment and therefore an individual midwife’s ability to fulfil Post Registration Education and practice (PREP) requirements, and the introduction of unequal pay between midwives and nurses for the same role due to ‘banding’. As a consequence, staff nurses recruited to neonatal units are now usually registered adult or children’s nurses. However pre-registration preparation does not enable these nurses to practice competently in
Table 1 Percentage of total transports split by designation of the senior member leading the transport. Designation of senior member
Percentage of transports leading transport
Consultant Senior trainee Advanced Neonatal Nurse Practitioner Nurse only transports
13 36 42 9
neonatal units at the point of registration and therefore there is an ongoing requirement for local induction, education and supervised practice. The Scottish Multiprofessional Maternity Development Programme (www.scottishmaternity.org) has designed several courses that provide Continuing Professional Development (CPD) opportunities; those suited to neonatal nurses include basic neonatal resuscitation, examination of the newborn and training for trainers. Scottish neonatal nurses are encouraged to undertake advanced resuscitation courses, e.g. the Resuscitation Council UK (www.resus.org.uk) Neonatal Life Support course. All SNTS staff must successfully complete such a course as well as the stabilisation and transport course run by SNTS. It has long been recognised in Scotland that the provision of neonatal nursing care required an education structure at post-registration level that ensured the current and future workforce was appropriately skilled and experienced to provide high quality care. In Scotland work was undertaken in 2001 with the National Board for Scotland and representatives of the neonatal community to establish core competencies and a curriculum for neonatal nurse education to Qualified in Specialty (QIS) level (National Health Service Education for Scotland (NES), 2002). Since then, work has been done by the SNNG alone (SNNG, 2003, 2004, 2005) and in collaboration with NES, Higher Education Institutions (HEI) and clinical staff to provide a standardised competency framework aligned to service need and a career framework (NES and SNNG, 2010). This framework guides the current provision of QIS and higher levels of neonatal nurse education in Scotland and has been well received. This framework and the previous work undertaken by the SNNG was recognised by the Royal College of Nursing (RCN) and “.forms the backbone.” of the recently published RCN guidance on a competence and education framework applicable across the United Kingdom (RCN, 2011 p. 3). As in other areas of the United Kingdom there is a requirement for Advanced Neonatal Practitioners (ANP) and whilst much of what is often called ‘advanced practice’ does not need statutory regulation, in neonatal nursing this is not the case. A standardised education and training infrastructure with associated competencies to support this role in neonatal nursing is required. However in the interim, the nationally agreed Scottish career and development framework provides significant relevant guidance to managers and to HEIs offering
Editorial Advanced Practice programmes in Scotland (NES and SNNG, 2010). There are also concerns that where ANPs are working in areas other than tertiary centres, they are not given opportunities to maintain competency or develop their skills further. There may be opportunities to address these concerns within the MCNs. It is also of concern that continued formal education provision for neonatal nurses in Scotland remains precarious as the reduction in workforce numbers and the competitive market contribute to a low student volume that affects the viability of HEI programmes. Because of the issues of neonatal unit staffing at all levels, skill mix is being re-examined and the number of ‘unregistered’ staff is being increased. Whilst much ‘low dependency’ care can be carried out under the supervision of a QIS neonatal nurse, an infrastructure that supports education and training of unregistered staff is required. Nurses have to be confident that the delegation of traditional nursing duties to unregistered staff is appropriate and that mechanisms are in place to support their position. To this end, Health Boards have been working with NES to develop and implement a national approach to support and develop assistants to nurses, midwives and allied health professionals at levels 2 to 4 of the Career Framework for Health; this is articulated in the publication ‘A Guide to Health Care Support Workers (HCSW) Education and Role Development (NES, 2010). As with the neonatal nurse competency and career frameworks, education providers need to collaborate with service providers as to the format and content of neonatal education specifically tailored to HCSWs.
The Scottish Neonatal Nurses’ Group The Scottish Neonatal Nurses’ Group (SNNG) was formed in 1989 to represent and work towards the recognition of the specific needs of neonatal nurses/midwives in Scotland. The aims of the group are: To promote best practice in neonatal nursing for the benefit of babies, their families and the neonatal staff involved in their care. To encourage collaboration between neonatal nurses and midwives, other professional groups and stakeholders concerned with the provision of neonatal care in Scotland. To share and disseminate information, updating members on developments in clinical
3 practice via the SNNG website, meetings and conferences. To provide sponsorship that facilitates the education and professional development of neonatal staff. To strengthen the voice of neonatal staff in Scotland on all matters relevant to neonatal care through participation in Scottish, United Kingdom and international consultations, projects and working groups. To promote research, audit and developments in neonatal care. Full membership is open to Nursing and Midwifery Council (NMC) registered midwives and nurses (adult and children’s) employed in a neonatal nursing capacity. Current full members include staff from all Scottish medical and surgical neonatal units, neonatal educators, neonatal transport nurses, network managers and clinical managers. Associate and Honorary memberships are also available to those who are directly or indirectly concerned with neonatal nursing or who have made a particular contribution to neonatal nursing or to the work of the SNNG. The SNNG Council consists of a representative from each Scottish unit the Scottish Neonatal Transport Service the Advanced Neonatal Nurse Practitioner Scotland Group the Managed Clinical Network Managers HEI neonatal education. Council meetings are held three times per year and members are encouraged to alert their Council representative to any issues they would like raised for discussion at the Council meeting. The SNNG Executive Committee is composed of the following officers:
Chairperson Treasurer Membership Secretary Web Master Events’ Organiser
The HEI neonatal education representative is also a member of the Executive Committee along with co-opted members as are required. The Executive Committee members are involved with the day-to-day running of the SNNG and they, along with SNNG Council members represent the SNNG on many related national and international groups such as the:
4
Editorial Scottish Neonatal Consultants’ Group Scottish Paediatric Educationalists and Nurses Scotland Scottish Multiprofessional Maternity Development Group Scottish Perinatal Mortality and Morbidity Review Advisory Group West of Scotland Planning Group Royal College of Nursing Committee on Children and Young People’s Nursing Keeping Childbirth Natural and Dynamic British Association of Perinatal Medicine, Perinatal Forum Neonatal Expert Advisory Group.
The SNNG is also consulted on papers developed by the United Kingdom and Scottish governments, Royal Colleges and other national bodies as well as being asked to join working groups considering issues and developments relevant to this population within Scotland. Such representation and consultation responses allow the Scottish neonatal nurse perspective to be addressed/taken into account in a variety of initiatives and developments that have recently included the neonatal workforce and workload planning tool, BLISS publications, HCSW development, a workforce summit and ANP job descriptions. In an effort to meet all its aims, the SNNG has established short term working groups and informally published the work in relation to neonatal unit staffing, job descriptions, a career framework and competencies (SNNG, 2003, 2004, 2005). A publication by members of the Executive in the journal ‘Infant’ focused on the SNNG’s competency framework and core clinical skills (Greig et al., 2006). As indicated above, SNNG members have collaborated with NES and the RCN in formal publications (NES and SNNG, 2010, RCN, 2011). The Annual General Meeting enables members to gather to hear reports from officers and participate in discussions relevant to the development of the SNNG and neonatal nursing. The SNNG offers a subsidised annual conference and in recent years a venue in Glasgow has provided excellent accommodation for this. The Group is indebted to the neonatal nurses who attend each year and the individuals who generously give of their time and experience to present papers at the conference. The medical and other companies related to neonatal care who have participated in the conference exhibition are also a source of information and the conference delegates have always enjoyed the opportunity to see new products and to discuss these with the exhibitors.
Although a non-profit organisation, the SNNG usually has funds to offer sponsorship each year to members who wish to undertake a small study, attend a conference or educational module. The SNNG is also an associate member of the Council of International Neonatal Nurses (COINN) and welcomes the opportunity to participate professionally with neonatal nurses across the world.
Conclusion Scotland is a relatively small country with neonatal services designed for the population and geography. Continuing developments refine and improve these services. Involvement in this dynamic environment gives neonatal nurses stimulus for professional development. However Scottish neonatal nurses, like other nurses in the United Kingdom, are affected by complex economic, educational and social factors that impact on their practice. Nevertheless, while changes to Scottish neonatal services are inevitable, there are opportunities for neonatal nurses either independently or via the SNNG, to influence such changes in a very positive way.
References Greig, C., Gray, M., Kerr, L., Wright, A., 2006. Developing a competency framework and core clinical skills for neonatal nurses in Scotland. Infant 2 (4), 152e155. Available from: http://www.infantgrapevine.co.uk/pdf/inf_010_kac.pdf. Greig, C., Mitchell, A., Sykes, A., Bain, J., Wilson, A.M., Drimmie, F., Smith, C., 2007. Scottish Neonatal Transport Service Stabilisation Handbook. Scottish Neonatal Transport Service, Edinburgh. National Health Service Education for Scotland (NES), 2002. A Route to Enhanced Competence in Neonatal Nursing. NES, Edinburgh. National Health Service Education for Scotland (NES), 2010. A Guide to Healthcare Support Worker Education and Role Development. NES, Edinburgh. Available from: http:// www.nes.scot.nhs.uk/media/350213/hcsw_report_final. pdf. National Health Service Education for Scotland (NES) and Scottish Neonatal Nurses’ Group (SNNG), 2010. A Career and Development Framework for Neonatal Nurses in Scotland. NES, Edinburgh. Available from: http://www.nes.scot.nhs.uk/ media/233682/neonatal_nurses_career_and_development_ framework_sept_2010.pdf. Royal College of Nursing (RCN), 2011. Competence, Education and Careers in Neonatal Nursing:RCN Guidance. RCN, London. Available from: http://www.rcn.org.uk/__data/ assets/pdf_file/0015/401118/004118.pdf. Scottish Neonatal Nurses’ Group (SNNG), 2003. Staffing survey. Unpublished. Available from Chairperson, SNNG. Scottish Neonatal Nurses’ Group, 2004. Report on Neonatal Nurse Staffing and Career Pathways Available from: http:// www.snng.org.uk/publications/datafiles/SNNG%20Report% 20on%20Neonatal%20Nurse%20Staffing.PDF.
Editorial
5
Scottish Neonatal Nurses’ Group, 2005. The Competency Framework and Core Clinical Skills for Neonatal Nurses Available from: http://www.snng.org.uk/publications/ datafiles/SNNG%20Competency%20Framework.PDF. The Scottish Government, 2010. The Healthcare Quality Strategy for NHS Scotland. The Scottish Government, Edinburgh. Available from: http://www.scotland.gov.uk/ Resource/Doc/311667/0098354.pdf.
Alison Wright*, Scottish Neonatal Nurses’ Group Senior Nurse Neonatal Services/ANNP, Scottish Neonatal Nurses Group (Chair), NICU, Ninewells Hospital, Dundee DD1 9SY, United Kingdom *Corresponding author. Tel.: þ44 (0) 1382 660111. E-mail address: [email protected]
Available online at www.sciencedirect.com
www.elsevier.com/jneo
EDITORIAL
Neonatal nursing in Scotland Available online 21 December 2011
KEYWORDS Neonatal nursing; Scotland; Scottish neonatal nurses’ group; Scottish neonatal transport service; Neonatal nurse education
Abstract There are four aspects of Scottish neonatal nursing discussed in this article. Firstly, the organisation of neonatal units and the development of Managed Clinical Networks are explained. Secondly the design and function of the Scottish Neonatal Transport Service are outlined. Thirdly the educational opportunities for neonatal nurses in Scotland are discussed. Lastly the structure and work of the Scottish Neonatal Nurses’ Group are highlighted. ª 2011 Neonatal Nurses Association. Published by Elsevier Ltd. All rights reserved.
Introduction This article describes neonatal nursing in Scotland in late 2011. An overview of the organisation of units will be followed by an explanation of the Scottish Neonatal Transport Service (SNTS), the education available to neonatal nurses and the Scottish Neonatal Nurses’ Group (SNNG).
Since the establishment of MCNs and the employment of key personnel, there has been considerable work to develop A Quality Framework for Neonatal Care in Scotland in line with the Health Care Quality Strategy for NHS Scotland (The Scottish Government, 2010). The purpose of the framework will be to give neonatal services and MCNs direction in developing services, care pathways and guidelines which are person-centred, safe, effective, efficient, equitable and timely.
Organisation of Scottish neonatal units There are 16 neonatal units in Scotland. Of these, 12 are designated as level 3 (Maximal Intensive Care), 2 as level 2 (High Dependency Care and short term Intensive Care) and 2 as level 1 (Special Care). Recently, three managed clinical networks (MCNs), east, west and north, have been established incorporating all the Scottish units. There is one national referral centre for neonatal cardiology services and one national referral centre that offers neonatal Extracorporeal Life Support/ Membrane Oxygenation, both in Glasgow.
Scottish Neonatal Transport Service (SNTS) In 2003 the SNTS was established with three regions (4 teams) to provide road and air transport for the whole country, including remote and rural areas. Each centre has core medical and nursing staff and a rota of ‘dedicated’ staff so that neonatal unit staffing is not affected by the transport service needs, as it had been in the past. Evaluation of the SNTS has always been positive and while most
1355-1841/$ - see front matter ª 2011 Neonatal Nurses Association. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jnn.2011.11.011
2
Editorial
aspects have persisted, the most recent evaluation has lead to the appointment of a national Strategic Manager and a Consultant Transport Nurse. A further service review is currently being undertaken. All neonatal transports between and within hospitals are conducted by the SNTS. There are approximately 1500 neonatal transports per annum; 90% of these are by road and 10% are by air; 30% are emergencies and 70% are planned transports; 30% are “out of hours” transports; and in 21% of transports the baby is ventilated. As can be seen in Table 1, the highest percentage (42%) are transports lead by an Advanced Neonatal Nurse Practitioner. The SNTS offers training in stabilisation and transport for all SNTS staff. In 2007, SNTS published a Stabilisation Handbook, a valuable resource for staff in all Scottish units as well as the SNTS staff (Greig et al., 2007). A second edition is in press. The SNTS also offers a stabilisation course for midwives working in community led midwifery units and those midwives working in remote and rural settings. The perceived increase in participants’ skills and competence has been locally evaluated as very positive.
Neonatal nurse education Historically in Scotland, medical neonatal units were staffed by midwives. This pattern has changed over the last decade due mainly to the interpretation of what constitutes midwifery practice in the neonatal environment and therefore an individual midwife’s ability to fulfil Post Registration Education and practice (PREP) requirements, and the introduction of unequal pay between midwives and nurses for the same role due to ‘banding’. As a consequence, staff nurses recruited to neonatal units are now usually registered adult or children’s nurses. However pre-registration preparation does not enable these nurses to practice competently in
Table 1 Percentage of total transports split by designation of the senior member leading the transport. Designation of senior member
Percentage of transports leading transport
Consultant Senior trainee Advanced Neonatal Nurse Practitioner Nurse only transports
13 36 42 9
neonatal units at the point of registration and therefore there is an ongoing requirement for local induction, education and supervised practice. The Scottish Multiprofessional Maternity Development Programme (www.scottishmaternity.org) has designed several courses that provide Continuing Professional Development (CPD) opportunities; those suited to neonatal nurses include basic neonatal resuscitation, examination of the newborn and training for trainers. Scottish neonatal nurses are encouraged to undertake advanced resuscitation courses, e.g. the Resuscitation Council UK (www.resus.org.uk) Neonatal Life Support course. All SNTS staff must successfully complete such a course as well as the stabilisation and transport course run by SNTS. It has long been recognised in Scotland that the provision of neonatal nursing care required an education structure at post-registration level that ensured the current and future workforce was appropriately skilled and experienced to provide high quality care. In Scotland work was undertaken in 2001 with the National Board for Scotland and representatives of the neonatal community to establish core competencies and a curriculum for neonatal nurse education to Qualified in Specialty (QIS) level (National Health Service Education for Scotland (NES), 2002). Since then, work has been done by the SNNG alone (SNNG, 2003, 2004, 2005) and in collaboration with NES, Higher Education Institutions (HEI) and clinical staff to provide a standardised competency framework aligned to service need and a career framework (NES and SNNG, 2010). This framework guides the current provision of QIS and higher levels of neonatal nurse education in Scotland and has been well received. This framework and the previous work undertaken by the SNNG was recognised by the Royal College of Nursing (RCN) and “.forms the backbone.” of the recently published RCN guidance on a competence and education framework applicable across the United Kingdom (RCN, 2011 p. 3). As in other areas of the United Kingdom there is a requirement for Advanced Neonatal Practitioners (ANP) and whilst much of what is often called ‘advanced practice’ does not need statutory regulation, in neonatal nursing this is not the case. A standardised education and training infrastructure with associated competencies to support this role in neonatal nursing is required. However in the interim, the nationally agreed Scottish career and development framework provides significant relevant guidance to managers and to HEIs offering
Editorial Advanced Practice programmes in Scotland (NES and SNNG, 2010). There are also concerns that where ANPs are working in areas other than tertiary centres, they are not given opportunities to maintain competency or develop their skills further. There may be opportunities to address these concerns within the MCNs. It is also of concern that continued formal education provision for neonatal nurses in Scotland remains precarious as the reduction in workforce numbers and the competitive market contribute to a low student volume that affects the viability of HEI programmes. Because of the issues of neonatal unit staffing at all levels, skill mix is being re-examined and the number of ‘unregistered’ staff is being increased. Whilst much ‘low dependency’ care can be carried out under the supervision of a QIS neonatal nurse, an infrastructure that supports education and training of unregistered staff is required. Nurses have to be confident that the delegation of traditional nursing duties to unregistered staff is appropriate and that mechanisms are in place to support their position. To this end, Health Boards have been working with NES to develop and implement a national approach to support and develop assistants to nurses, midwives and allied health professionals at levels 2 to 4 of the Career Framework for Health; this is articulated in the publication ‘A Guide to Health Care Support Workers (HCSW) Education and Role Development (NES, 2010). As with the neonatal nurse competency and career frameworks, education providers need to collaborate with service providers as to the format and content of neonatal education specifically tailored to HCSWs.
The Scottish Neonatal Nurses’ Group The Scottish Neonatal Nurses’ Group (SNNG) was formed in 1989 to represent and work towards the recognition of the specific needs of neonatal nurses/midwives in Scotland. The aims of the group are: To promote best practice in neonatal nursing for the benefit of babies, their families and the neonatal staff involved in their care. To encourage collaboration between neonatal nurses and midwives, other professional groups and stakeholders concerned with the provision of neonatal care in Scotland. To share and disseminate information, updating members on developments in clinical
3 practice via the SNNG website, meetings and conferences. To provide sponsorship that facilitates the education and professional development of neonatal staff. To strengthen the voice of neonatal staff in Scotland on all matters relevant to neonatal care through participation in Scottish, United Kingdom and international consultations, projects and working groups. To promote research, audit and developments in neonatal care. Full membership is open to Nursing and Midwifery Council (NMC) registered midwives and nurses (adult and children’s) employed in a neonatal nursing capacity. Current full members include staff from all Scottish medical and surgical neonatal units, neonatal educators, neonatal transport nurses, network managers and clinical managers. Associate and Honorary memberships are also available to those who are directly or indirectly concerned with neonatal nursing or who have made a particular contribution to neonatal nursing or to the work of the SNNG. The SNNG Council consists of a representative from each Scottish unit the Scottish Neonatal Transport Service the Advanced Neonatal Nurse Practitioner Scotland Group the Managed Clinical Network Managers HEI neonatal education. Council meetings are held three times per year and members are encouraged to alert their Council representative to any issues they would like raised for discussion at the Council meeting. The SNNG Executive Committee is composed of the following officers:
Chairperson Treasurer Membership Secretary Web Master Events’ Organiser
The HEI neonatal education representative is also a member of the Executive Committee along with co-opted members as are required. The Executive Committee members are involved with the day-to-day running of the SNNG and they, along with SNNG Council members represent the SNNG on many related national and international groups such as the:
4
Editorial Scottish Neonatal Consultants’ Group Scottish Paediatric Educationalists and Nurses Scotland Scottish Multiprofessional Maternity Development Group Scottish Perinatal Mortality and Morbidity Review Advisory Group West of Scotland Planning Group Royal College of Nursing Committee on Children and Young People’s Nursing Keeping Childbirth Natural and Dynamic British Association of Perinatal Medicine, Perinatal Forum Neonatal Expert Advisory Group.
The SNNG is also consulted on papers developed by the United Kingdom and Scottish governments, Royal Colleges and other national bodies as well as being asked to join working groups considering issues and developments relevant to this population within Scotland. Such representation and consultation responses allow the Scottish neonatal nurse perspective to be addressed/taken into account in a variety of initiatives and developments that have recently included the neonatal workforce and workload planning tool, BLISS publications, HCSW development, a workforce summit and ANP job descriptions. In an effort to meet all its aims, the SNNG has established short term working groups and informally published the work in relation to neonatal unit staffing, job descriptions, a career framework and competencies (SNNG, 2003, 2004, 2005). A publication by members of the Executive in the journal ‘Infant’ focused on the SNNG’s competency framework and core clinical skills (Greig et al., 2006). As indicated above, SNNG members have collaborated with NES and the RCN in formal publications (NES and SNNG, 2010, RCN, 2011). The Annual General Meeting enables members to gather to hear reports from officers and participate in discussions relevant to the development of the SNNG and neonatal nursing. The SNNG offers a subsidised annual conference and in recent years a venue in Glasgow has provided excellent accommodation for this. The Group is indebted to the neonatal nurses who attend each year and the individuals who generously give of their time and experience to present papers at the conference. The medical and other companies related to neonatal care who have participated in the conference exhibition are also a source of information and the conference delegates have always enjoyed the opportunity to see new products and to discuss these with the exhibitors.
Although a non-profit organisation, the SNNG usually has funds to offer sponsorship each year to members who wish to undertake a small study, attend a conference or educational module. The SNNG is also an associate member of the Council of International Neonatal Nurses (COINN) and welcomes the opportunity to participate professionally with neonatal nurses across the world.
Conclusion Scotland is a relatively small country with neonatal services designed for the population and geography. Continuing developments refine and improve these services. Involvement in this dynamic environment gives neonatal nurses stimulus for professional development. However Scottish neonatal nurses, like other nurses in the United Kingdom, are affected by complex economic, educational and social factors that impact on their practice. Nevertheless, while changes to Scottish neonatal services are inevitable, there are opportunities for neonatal nurses either independently or via the SNNG, to influence such changes in a very positive way.
References Greig, C., Gray, M., Kerr, L., Wright, A., 2006. Developing a competency framework and core clinical skills for neonatal nurses in Scotland. Infant 2 (4), 152e155. Available from: http://www.infantgrapevine.co.uk/pdf/inf_010_kac.pdf. Greig, C., Mitchell, A., Sykes, A., Bain, J., Wilson, A.M., Drimmie, F., Smith, C., 2007. Scottish Neonatal Transport Service Stabilisation Handbook. Scottish Neonatal Transport Service, Edinburgh. National Health Service Education for Scotland (NES), 2002. A Route to Enhanced Competence in Neonatal Nursing. NES, Edinburgh. National Health Service Education for Scotland (NES), 2010. A Guide to Healthcare Support Worker Education and Role Development. NES, Edinburgh. Available from: http:// www.nes.scot.nhs.uk/media/350213/hcsw_report_final. pdf. National Health Service Education for Scotland (NES) and Scottish Neonatal Nurses’ Group (SNNG), 2010. A Career and Development Framework for Neonatal Nurses in Scotland. NES, Edinburgh. Available from: http://www.nes.scot.nhs.uk/ media/233682/neonatal_nurses_career_and_development_ framework_sept_2010.pdf. Royal College of Nursing (RCN), 2011. Competence, Education and Careers in Neonatal Nursing:RCN Guidance. RCN, London. Available from: http://www.rcn.org.uk/__data/ assets/pdf_file/0015/401118/004118.pdf. Scottish Neonatal Nurses’ Group (SNNG), 2003. Staffing survey. Unpublished. Available from Chairperson, SNNG. Scottish Neonatal Nurses’ Group, 2004. Report on Neonatal Nurse Staffing and Career Pathways Available from: http:// www.snng.org.uk/publications/datafiles/SNNG%20Report% 20on%20Neonatal%20Nurse%20Staffing.PDF.
Editorial
5
Scottish Neonatal Nurses’ Group, 2005. The Competency Framework and Core Clinical Skills for Neonatal Nurses Available from: http://www.snng.org.uk/publications/ datafiles/SNNG%20Competency%20Framework.PDF. The Scottish Government, 2010. The Healthcare Quality Strategy for NHS Scotland. The Scottish Government, Edinburgh. Available from: http://www.scotland.gov.uk/ Resource/Doc/311667/0098354.pdf.
Alison Wright*, Scottish Neonatal Nurses’ Group Senior Nurse Neonatal Services/ANNP, Scottish Neonatal Nurses Group (Chair), NICU, Ninewells Hospital, Dundee DD1 9SY, United Kingdom *Corresponding author. Tel.: þ44 (0) 1382 660111. E-mail address: [email protected]
Available online at www.sciencedirect.com