The Commission of Nursing, established in 1997, examined the role of the nurse in the health service and produced a report the following year entitled A blueprint for the future. The Commission’s report highlighted the need to promote the distinct identity and unique working environment of intellectual disability nursing. Recommendations were made to develop a strategy—in consultation with nurse educators, intellectual disability nurses and service providers—to promote intellectual disability nursing as a career. Following this report much has changed; next year will see a new four-year degree course in intellectual disability nursing being provided by universities and third level educational colleges.
With much debate about nursing, many changes are taking place. Last year saw an end to the traditional apprentice student nurse model of training, in which students were working and studying throughout their training. The main feature of future nursing training is an emphasis on learning nursing knowledge and clinical skills without the pressure of working at the same time. The current position for this year, September 2001–2002, is that the eight traditional schools of nursing, in association with universities and third level educational colleges, are providing a three-year national diploma programme in nursing. This year’s graduates are the first students to qualify under this system with a university-recognised qualification.
Starting in September 2002, nurse training will leave the traditional nursing schools based in hospitals and residential centres, to locate in Irish universities and third-level colleges. The necessary clinical experience will still be part of nurse training, with student clinical placements in hospitals, residential centres and community and associated health services that are all part of a modern healthcare system.
Intellectual disability nursing has eight nursing training schools at present. The new courses will be offered by four universities and four third-level colleges to provide eight intellectual disability nursing training programmes at degree level.
Degree in Intellectual Disability Nursing
|Dublin City University||Dundalk Institute of Technology|
|University College Cork||Letterkenny Institute of Technology|
|Trinity College Dublin||St Angela’s College, Sligo|
|University of Limerick||Waterford Institute of Technology|
A Nursing Education Forum was established following recommendation by the Nursing Commission. It believes that students graduating from the new nursing degree programme should be professional nurses who are safe, caring, competent decision makers, willing to accept personal and professional accountability for evidence-based practice. It considers that graduates in intellectual disability nursing should be flexible, adaptable and reflective practitioners, integral members of the multidisciplinary team, with a life-long approach to learning.
The nursing degree programme will involve considerable change, requiring a proactive and sustained approach from both universities and health service providers. One practice to be discontinued in the new process is the assessment test and interview for school leavers to enter nurse training. The nurse application system is transferred to the Central Applications Office (CAO), which handles applications for entry to all registration diploma nursing programmes and future nursing degree programmes.
For each nursing education programme, a quota of places is allocated specifically for applicants on grounds of mature years (over 23 years) who would not meet the standard educational requirements. Given that the proportion of mature applicants for nursing rose from 14% in 1977 to 29% in 2000, and that current demographic trends indicate that the number of school leavers is expected to drop in the future, intellectual disability nursing will be attracting more mature people in future years.
Another change in intellectual disability nursing is the update and review in the syllabus for intellectual disability nurse training which was completed in November 2000, as part of the requirements and standards for nurse educational programmes. The syllabus is indicative. It allows scope for the continuing development of subject matter and for the extension of new knowledge to accommodate emerging trends in intellectual disability. It is divided into four areas: nursing and professional development; person-centred care; health sciences and applied nursing principles; and nursing, sociology, law and the environment. Information technology, life-course planning, disability, society and barriers to inclusion, assistive technology, and research-based nursing practice are all new aspects of the syllabus of intellectual disability nursing in the new millennium.
Change is occurring at an astonishing rate in the field of healthcare, in intellectual disability and in nursing, driven by economic, political and technological forces. To achieve successful change, everyone involved—health care providers, people with intellectual disability, parents and nurses—need to be empowered to fully participate in bringing about changes that ultimately improve care. To quote Florence Nightingale (1860): ‘There are two classes of people in the world—those who take the best and enjoy it and those who wish for something better and try to create it. The world needs the appreciation of the first and the discontent of the second.’