Endocrine Abstracts

Background: There have been a number of drivers that have led nurses to take on extended roles that have been traditionally been the domain of doctors. Competency frameworks for specialist nurses have been developed in other paediatric specialities, such as diabetes, oncology and epilepsy. However, this has not been established for paediatric endocrine nurses.

Aim: To establish a competency framework for paediatric endocrine nurse specialists.

Methods: The Royal College of Nursing (RCN) Paediatric Endocrine Special Interest Group formed a UK wide voluntary working group in 2006 of nine nurses and one paediatric endocrinologist to ensure that optimum clinical nursing care is delivered to this group of children, young people and their families, by ensuring specific detailed competencies are achieved at varying levels of nursing expertise. The paediatric epilepsy nurse competency framework was used as a guide, and members volunteered to focus on particular sections to concentrate on which were of interest. Levels of competencies were then linked in with the Department of Health's (DoH) NHS Knowledge Skills Framework (KSF) and the DoH Skills for Health competencies, in line with the DoH Modernising Nursing Careers' initiative.

Outcome: The competency framework focuses specifically on care of the child and young person with growth and endocrine disorders, including the period where the diagnosis has not yet been reached, once the diagnosis is confirmed, endocrine testing and transition, and also nursing considerations and understanding of children and young people with growth and endocrine disorders, encompassing factors influencing growth, auxology, assessment of skeletal maturity and physiology and pathology. Three levels of nursing expertise are put forward, based on Benner's Novice to Expert continuum: Competent, Experienced and Senior or Expert Practitioners, with suggested timelines for achievement. Descriptions of specific competencies, KSF indicators, performance criteria, nursing knowledge and understanding, attitudes and behaviours, and contextual factors are described in detail.

Discussion: It is important that the whole multidisciplinary team is aware of differing levels of nursing competence, and it is visualised that this framework will be utilised when establishing the person specification for new posts and alongside the appraisal process to form the basis of personal development plans for both new and experienced paediatric endocrine nurses. Specific levels are in line with the NHS Agenda for Change bandings, and nurses achieving such competencies will enhance their individual career progression, also enabling ease of service delivery planning. The competency framework will be accessible from the RCN website from Autumn 2008.