Pediatric nursing education: Trends, challenges and aspirations

Abstract

Fewer nursing school graduates are entering pediatric nursing. In 2013, 6% of the national nursing workforce were employed as pediatric nurses; in 2017 that percentage was reported as 4.7% (Smiley et al., 2018Smiley R.A. Lauer P. Bienemy C. Berg J.G. Shireman E. Reneau K.A. Alexander M. The 2017 National Nursing Workforce Survey.Journal of Nursing Regulation. 2018; 9: S1-S88https://doi.org/10.1016/S2155-8256(18)30131-5Abstract Full Text Full Text PDF Scopus (194) Google Scholar). The explanations for this decline include lack of undergraduate nursing clinical training exposure to pediatric and child health care. It has been well documented that pediatric/child health content taught in undergraduate nursing programs has been in decline for years with the prospects of this trend to continue. Other problematic pediatric nursing education issues include teaching of didactic content that does not align with contemporary child health and pediatric care (Delack et al., 2015Delack S. Martin J. McCarthy A.M. Sperhac A.M. Nurse residency programs and the transition to child health nursing practice.The Journal of Nursing Administration. 2015; 45: 345-350https://doi.org/10.1097/NNA.0000000000000210Crossref PubMed Scopus (6) Google Scholar; McCarthy and Wyatt, 2014McCarthy A.M. Wyatt J.S. Undergraduate pediatric nursing education: Issues, challenges and recommendations.Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing. 2014; 30: 130-138https://doi.org/10.1016/j.profnurs.2013.07.003Crossref PubMed Scopus (20) Google Scholar; Mott et al., 2018Mott S. Fogg N. Foote N. Hillier M. Lewis D.A. McDowell B.M. Saunders K. Taylor J.T. Wiggins S. Ivey J.B. O'Brien Benedetto C. Beam P.H. McKnight K.B. Taha A.A. Vann-Patterson A. Society of Pediatric Nurses' Core competencies for the Pediatric nurse.Journal of Pediatric Nursing. 2018; 38: 142-144https://doi.org/10.1016/j.pedn.2017.11.006Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar). The health care priorities of this nation's children and adolescents are evident in Healthy People 2030. The newly released Healthy People 2030 are illustrative of the major health concerns affecting this nation's children as evidenced by the Leading Health Indictors (LHI), which are the high priority objectives of Healthy People 2030. Some of the LHI that address the health needs of children and adolescents include deaths due to drug overdoses, food insecurities and hunger, infant deaths, obesity, adolescent depression and use of tobacco products by adolescents (Office of Disease Prevention and Health Promotion, 2021Office of Disease Prevention and Health Promotion Leading health indicators. Healthy people 2030. U.S. Department of Health and Human Services.https://health.gov/healthypeople/objectives-and-data/leading-health-indicatorsDate: 2021Google Scholar). These are population health issues affecting children, adolescents and families that need to be addressed in pediatric nursing curriculums. Other challenges for pediatric nursing education include the difficulties with recruiting faculty who have the experience and expertise to competently educate novice nursing students about the comprehensive care needs of children, adolescents and their families (Delack et al., 2015Delack S. Martin J. McCarthy A.M. Sperhac A.M. Nurse residency programs and the transition to child health nursing practice.The Journal of Nursing Administration. 2015; 45: 345-350https://doi.org/10.1097/NNA.0000000000000210Crossref PubMed Scopus (6) Google Scholar; McCarthy and Wyatt, 2014McCarthy A.M. Wyatt J.S. Undergraduate pediatric nursing education: Issues, challenges and recommendations.Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing. 2014; 30: 130-138https://doi.org/10.1016/j.profnurs.2013.07.003Crossref PubMed Scopus (20) Google Scholar; Mott et al., 2018Mott S. Fogg N. Foote N. Hillier M. Lewis D.A. McDowell B.M. Saunders K. Taylor J.T. Wiggins S. Ivey J.B. O'Brien Benedetto C. Beam P.H. McKnight K.B. Taha A.A. Vann-Patterson A. Society of Pediatric Nurses' Core competencies for the Pediatric nurse.Journal of Pediatric Nursing. 2018; 38: 142-144https://doi.org/10.1016/j.pedn.2017.11.006Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar). Complicating recruitment of pediatric faculty members is the disparity associated with salaries as typically faculty salaries are not comparable with advanced practice, education and administrative positions in clinical settings. As well, challenges exist in accessing training sites for pediatric placements, particularly in areas wherein there are numerous undergraduate nursing program, which compete with clinical training allotments. Coupled with these challenges is the current and projected retirement of the aging generations of nurses. By 2030, nurses of the baby boomer generation will be 70 years and older creating a tremendous strain of available, experienced nursing experts. By 2030, it is estimated that 2 million years of nursing experience and expertise will no longer be available as the aging nursing workforce retires. Obviously, pediatric nursing care will be greatly affected with the impending retirement of its nursing colleagues (Buerhaus et al., 2017Buerhaus P.I. Skinner L.E. Auerbach D.I. Staiger D.O. Four challenges facing the nursing workforce in the United States.Journal of Nursing Regulation. 2017; 8: 40-46https://doi.org/10.1016/S2155-8256(17)30097-2Abstract Full Text Full Text PDF Scopus (60) Google Scholar). Another challenge for pediatric nursing educators, influencers and leaders is to craft messaging and outreach that attracts and motivates new generations of young adults and nursing students into pediatric nursing. Generation Z and the Alpha Generation have been raised in worlds very different from previous generations (Adamson et al., 2018Adamson M.A. Chen H. Kackley R. Micheal A. For the love of the game: Game- versus lecture-based learning with generation Z patients.Journal of Psychosocial Nursing and Mental Health Services. 2018; 56: 29-36https://doi.org/10.3928/02793695-20171027-03Crossref PubMed Scopus (10) Google Scholar; Betz, 2019Betz C.L. Generation X, Y, and Z.Journal of Pediatric Nursing. 2019; 44: A7-A8https://doi.org/10.1016/j.pedn.2018.12.013Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar; Pew Research Center, 2018Pew Research Center Early benchmarks show ‘post-millennials’ on track to be Most diverse, best-educated generation yet.http://www.pewsocialtrends.org/2018/11/15/early-benchmarks-show-post-millennials-on-track-to-be-most-diverse-best-educated-generation-yet/Date: November 2018Google Scholar). These generations have been raised within the imminent and pervasive environment of technology. The Z and Alpha generations are far more technologically savvy and accustomed to continual, convenient and rapid access to technology resources unlike previous generations. Younger generations view the educational process differently as it is process that is seen and experienced as “gamified” (McCrindle, 2020McCrindle M. Understanding generation alpha.https://mccrindle.com.au/insights/blog/gen-alpha-defined/Date: 2020Google Scholar; Stechyson, 2020Stechyson N. What is generation alpha? Everything to know about the kids of millennials. Huff post.https://www.huffingtonpost.ca/entry/what-is-generation-alpha_ca_5dde809ae4b0913e6f7719c8Date: 2020Google Scholar). Are pediatric nursing educators ready to incorporate social media as viable instructional tools for learning? Recent survey findings reported provide insights and understanding as to the generational divides that exist that have profound impact on lifestyle choices and attitudes, and importantly, of learning styles. According to recent surveys conducted by the Pew Research Center, usage of social media platforms vary greatly by age groups. Over 80% of adults, ages 18 to 49 years reported accessing social media sites compared to the decreasing percentages of those 50 to 64 years (73%) and seniors ages 65 years and older (45%) (Pew Research Center, 2021Pew Research Center Social media use in 2021. Internet and Technology.https://www.pewresearch.org/internet/2021/04/07/social-media-use-in-2021/Date: 2021Google Scholar). These generational differences are most apparent in terms of the social media platforms used. Adolescents and emerging adults (18 to 29 years) most often identify the social media platforms of Instagram, Snapchat and TikTok. In contrast older adults more often refer to using Facebook and YouTube (Pew Research Center, 2021Pew Research Center Social media use in 2021. Internet and Technology.https://www.pewresearch.org/internet/2021/04/07/social-media-use-in-2021/Date: 2021Google Scholar). Questions arise as to the extent to which these social media platforms used extensively by younger generations will be integrated into nursing education programs. Other educational considerations that will influence knowledge development in pediatric nursing is the growing influence of international perspectives (Betz, 2021aBetz C.L. Racial and ethnic disparities special collection.Journal of Pediatric Nursing. 2021; 57: A7-A8https://doi.org/10.1016/j.pedn.2021.01.025Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar). Traditionally, pediatric nursing practice has been siloed from the science and practice of our international colleagues unlike other health care and basic science disciplines. What new sources of evidence and models of care can we introduce to nursing students that have been developed, implemented and tested from other parts of the world? The body of international literature in other health disciplines is evident. One only has to look at the recipients of the Nobel Prizes in Physiology or Medicine to appreciate the contributions of these extraordinary scientists worldwide from China, United Kingdom, Japan, France and the United States. The recently published document by the World Health Organization (WHO), entitled, State of the World's Nursing: Investing in Education, Job and Leadership, provides important insights about nursing practice achievements, challenges and aspirations globally (World Health Organization, 2020World Health Organization State of the world's nursing 2020: Investing in education, jobs and leadership. World Health Organization, Geneva2020Google Scholar). Of significant importance and priority in pediatric nursing care is addressing the health care needs and challenges of underserved and under-resourced children, adolescents and their families not only in this country and worldwide as well. Our recent Special Collection, Racial and Ethnic Disparities (Betz, 2021bBetz C.L. Time again? Research priorities in Pediatric Nursing.Journal of Pediatric Nursing. 2021; 56: A7-A9https://doi.org/10.1016/j.pedn.2020.11.017Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar) and Special Issue on Social Determinants of Health (Lipman and Lobo, 2017Lipman T.H. Lobo M.L. Special issue on social determinants of health.Journal of Pediatric Nursing. 2017; 37: 1-2https://doi.org/10.1016/j.pedn.2017.09.004Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar) are demonstrative of the scope and depth of the issues pertaining to the inequities and challenges these populations face. The recently approved American Association of Colleges of Nursing, 2021American Association of Colleges of Nursing AACN essentials.https://www.aacnnursing.org/Education-Resources/AACN-EssentialsDate: 2021Google Scholar and Society of Pediatric Nurses, 2017Society of Pediatric Nurses Retrieved on April 21, 2021 from.http://www.pedsnurses.org/page/core-competenciesDate: 2017Google Scholar provide frameworks and guidance in addressing the needs of these population of children, adolescents and families. These are formidable yet exciting challenges for our specialty of professional nursing practice. Pediatric and child health nursing leaders in education, service and research have opportunities to forge innovations and visions that build upon our rich professional history and the contributions made by their predecessors to improve health and wellness outcomes for children, adolescents and their families. Lastly, kudos to the organizers of the 31st Annual Society of Pediatric Nurses Conference. This year's conference was held virtually and was well attended. This year's Keynote Speaker, Dr. Renee Thompson spoke on a relevant practice issue-workplace incivility and bullying in her presentation entitled, Creating a Healthy Workforce by Eliminating Bullying and Incivility. There were so many worthwhile and excellent presentations that highlighted research and evidenced-based practice projects and clinical innovations. A spectrum of timely issues were featured included screening for human trafficking, virtual educational experiences for nursing students, telehealth programs, clinical practice simulations and nurse-led programmatic efforts. Care of children topics explored adverse childhood experiences, the cultural influences affecting weight management, childhood poverty, and impact of the Pandemic. The chat room was abuzz with a myriad of comments from those attending-a hallmark of genuine participants' interests and the success of the conference itself in providing a forum for learning and networking.