ABSTRACT
Nursing has evolved through several philosophical eras. Elliot (1995) eloquently describes the move from the asceticism of Florence Nightingale’s era, whereby the nurse was entrenched in the values of self-sacrifice and self-denial, through to the task-orientated era of the periods surrounding the First and Second World Wars. Task-orientated care, as observed by Ford and Walsh (1994), resulted in ritualistic practice, a far cry from today’s notion of evidence-based practice. During the 1960s, hospitals, recognising the need for post-basic education, set up ‘in-house’ courses to equip nurses with the necessary skills for varying specialties. These courses tended to be task-orientated, were not transferable and had no academic recognition (Scott 1998). The development of the nursing process, with its philosophy of humanistic existentialism, in the 1970s aimed to replace the task-orientated, traditional model of care and foster the ethos of individual rights and informed choice (Elliot 1995). In neonatal nursing practice this was manifested by the introduction of family-centred care nursing models (Casey 1988). The Joint Board of Clinical Nursing Studies set up post-registration specialty courses, including ones for neonatal intensive care, in an attempt to standardise post-registration nurse training and discourage the previous trend of ‘in-house’ training (Scott 1998). In 1979 the United Kingdom Central Council (UKCC) replaced the General Nursing Council (GNC) and established the four National Boards. The UKCC’s main function was to establish and improve standards of training in post-registration
Factors influencing the development of the neonatal nurse role
Introduction
as well as pre-registration education (the GNC’s remit had been primarily concerned with pre-registration education). Nursing was also by this time attempting to become a graduate profession in its own right and shed its medical model of practice (O’Brien and Watson 1993). During the 1970s and 1980s more attention was focused on the provision of post-registration courses such as the ENB 400, 402, 405, 409 and 904 courses, these educational programmes being considered as the basic requirements for nurses wishing to develop clinical and theoretical expertise in neonatal care. One of the driving forces for this initiative was the identification of a lack of nurses qualified in specialty (NHS Management Board 1989).
