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'Integrate the four fields of nursing,' leading academic tells the Nursing Standard podcast

A two-stream system should be introduced to replace the four fields, nurse leader Alison Twycross tells Nursing Standard podcast

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The four fields of nursing should be scrapped in place of a two-stream system, a leading academic has told Nursing Standard podcast.

London South Bank University deputy dean and nurse Alison Twycross said proposed changes to pre-registration nurse education do not go far enough.

In an interview for a bonus feature for Nursing Standard podcast series 2 episode 1, Professor Twycross proposes scrapping children, mental health, learning disability and adult nursing branches.

Instead, she said, one set of nurses should qualify as children’s nurses with skills in children and young people’s mental health and learning disabilities.

The second would specialise in adult health, with skills pertinent to adult mental health and learning disability needs.

Missing an opportunity

Professor Twycross speaks from the unusual position of being a registered mental health, adult and children’s nurse.

When discussing the Nursing and Midwifery Council’s proposed education changes, to be voted on a meeting on 28 March, she said she believed the regulator had missed an opportunity to go further.

‘Having worked in education for more than 20 years, I think one of the unintended consequences of Project 2000, which brought the training of nurses into universities and bringing in the four fields of nursing, has been we have a generation of adult nurses who don’t know how to care for the mental health needs of their patients and potential mental health nurses who can’t meet the physical needs of their patients,' Professor Twycross said.

‘There is anecdotal information of people being in an emergency department late at night and people having to be shipped down the road to the local psychiatric hospital and patients from the psychiatric hospital being sent to A&E for their physical needs to be dealt with.

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‘My vision for nurse education in the UK would be an integrated programme and that is different from a generic programme.’

Professor Twycross said the strength of a nurse is to care for a patient holistically.

'I think if we are going to have a nurse education fit for the 21st century, we need nurses to be able to care for the whole patient.’

Similar proposals

She said the idea had similarities to proposals from Lord Willis in his Raising the Bar: Shape of Caring report for Health Education England, where nurses would have two years of education in all fields, before specialising in the third year.

‘Potentially there would need to be rebranding, so people do not think of the current programmes we have. I don’t have a solution for a name – answers on a postcard,’ Professor Twycross said.

The Nursing and Midwifery Council draft proposes the four fields of nursing will remain separate, but students will be required to demonstrate a basic level of knowledge across the board.

The proposal proved controversial during a public consultation, with some concerned the individual specialities and skills would be lost.

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