The Commission on Nursing, which reported in 1998, recommended that pre-registration nursing education move from a three year diploma programme to a four year degree programme in each of the disciplines of general, psychiatric and mental handicap nursing. The Government expressed its commitment to implementing the programme, providing capital investment in excess of €240 million to ensure the provision of purpose-built facilities for nursing students, with state-of-the-art clinical skills and human science laboratories. In addition, when the programme has a full cohort of students in 2006, the total annual revenue cost will be in excess of €90 million. The new nursing degree commenced in 13 higher education institutes in autumn 2002, with an annual approved intake of 1,640 students across the three disciplines concerned. This level of intake is 70% higher than it was in 1998.
In 1996, the education of sick children's nurses became a post-registration education qualification. It is an 18 month course open to nurses already registered with An Bord Altranais. Previously there had been direct entry courses in sick children's nursing and a key factor in the move to post-registration qualification was the increasing difficulty in recruiting students. Many nurses with only a sick children's nursing qualification had found it difficult to obtain employment outside the major Dublin paediatric hospitals. Developments in medical diagnosis and therapeutics meant that acutely ill children who might not previously have survived, were now being cared for by sick children's nurses. It was suggested that the nature of sick children's nursing and the changing nature of the family, with an increase in the number of single teenage parents, required a greater degree of maturity in the practice of sick children's nursing. In addition, the development of the degree programmes for direct entry nursing disciplines may lead to duplication between the current sick children's nursing programme and the pre-registration degree programmes.
The Commission on Nursing recommended that the qualification of sick children's nursing remain a post-registration qualification. However, the commission also proposed that, prior to the transfer of direct entry nursing disciplines to a degree programme, directors of nursing from the paediatric hospitals, sick children's nurse educators and An Bord Altranais should review the content, duration and academic award of the sick children's nursing course in the light of the proposed degree course curricula. In accordance with the above recommendation, I made funding available to UCD to undertake work on curriculum development for an integrated sick children's-general nursing degree programme.
It must be recognised that the costs of introducing an integrated sick children's-general nursing pre-registration degree are very high. Using the same costing template for the pre-registration nursing degree programme, it is estimated that the total annual revenue cost of an additional yearly intake of 133 students — the current intake into the post-registration course is 133 — would be in the region of €9.5 million. In addition, the third level institutions have indicated to my officials that it would not be possible to proceed with the transfer of paediatric education without incurring significant capital costs. The capital cost of transferring some 585 additional sick children's nursing students to the third level sector is almost €20 million.
While I recognise that there is concern in the profession that sick children's nursing has not moved to pre-registration degree level, it must be borne in mind that, given the current budgetary restraints and the substantial funding already allocated to the other pre-registration degree programmes, my officials must consider all the possibilities to ameliorate the high cost of the proposed integrated programme. As the closing date for applications for third level courses to the CAO has passed, it will not be possible to commence the integrated sick children's-general nursing degree in autumn 2004.