Children and young

people’s nursing:
a philosophy of care
Guidance for nursing staff
CH ILDREN AND YOU NG PEOPLE’S N URSI NG: A PH ILOSOPHY OF CARE

Children and young people’s nursing: a

philosophy of care
Guidance for nursing staff

Originally published in 1991, this philosophy has been updated and amended
by the Royal College of Nursing’s (RCN) Children and Young People’s Field of
Practice. The principles and commitments set out in this document form the
basis of all RCN policies relating to the care of children and young people.

Introduction
Encompassing a range of forums and recognising the RCN’s definition of
groups, the RCN Children and Young nursing1, the field of practice believes that
People’s Field of Practice is: the nurse’s primary focus is to assist the
child or young person and their family to
✦ a focus for RCN members interested in prevent or manage the physiological,
the nursing of children and young physical, social, psychological and spiritual
people, providing them with networks effects of a health problem or condition and
and opportunities for support, advice its treatment. To a lesser or greater degree,
and professional development depending on the context, the role may
✦ a voice for children’s nursing within the encompass:
RCN and for nursing within the world ✦ health promotion
of child health
✦ investigation
✦ developing the art and science of
✦ diagnosis and treatment of medical
children’s nursing and its specialties. conditions
Children and young people’s nursing ✦ counselling
practice is underpinned by beliefs that are
✦ childcare
based upon the nature of the child or young
person and their status and rights within ✦ other interventions and therapies.
both the family and society. In addition to

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all settings where they receive care and

The needs of the treatment. This includes being cared for
child or young in a culturally sensitive environment;
and ensuring privacy and confidentiality
person as an during all episodes of care2,3
✦ recognise each child or young person as
individual a unique individual whose best interests
must be paramount, whilst considering
Whilst recognising the individual needs of their physical, psychological, social,
each child or young person, the RCN field cultural and spiritual needs, as well as
of practice: those of their families
✦ acknowledges the impact of ✦ respect the right of children, according
inequalities in current health service to their age and understanding, to
and social care provision and the effect appropriate information, facilitating
of the inter-relationships between informed participation in decisions
social, physical and political about their health care.
environmental factors upon the health
and well-being of children and young
people The child or young
✦ promotes the recognition of the
distinct needs of children and young person in the family
people across all health care settings.
This includes the need for: access to In caring for children and young people,
education, health promotion and nurses should:
collaborative working between health ✦ recognise and use the knowledge and
service providers, social care and caring experience of parents or carers in
education to ensure seamless care, all aspects of their child’s health care
particularly during the transition to
adult service provision. ✦ facilitate a reciprocal relationship with
the family, within which children, young
Nurses caring for children and young people and families are able to
people should: determine the level of participation they
✦ listen to children and young people, desire at any one time unless, in
providing a means for them to convey exceptional circumstances, this is not in
their opinions and feelings and using the best interests of the child or young
these to guide decisions about the way person.
health care is delivered ✦ recognise and respect differences within
✦ promote and protect the individual and between families in the amount
rights of children and young people in they wish or are able to be involved in

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CH ILDREN AND YOU NG PEOPLE’S N URSI NG: A PH ILOSOPHY OF CARE

their child’s care, whilst recognising that

effective health care is fully negotiated Nursing services
with the child or young person and their
family
for children, young
✦ promote the rights of children and people and their
young people to be accompanied by a
familiar and trusted person - usually families
parents or carers - in any environment
where care is delivered The RCN Children and Young People’s Field
✦ ensure sufficient information, education of Practice:
and support is provided to promote and ✦ endorses the need for a named
enable active participation and professional,who has children and young
consultation with children, young people people’s health service experience and
and their families in all aspects of health expertise,to be responsible for
care provision and decision-making commissioning services at local level.
✦ inform the child or young person and Further,we support the Kennedy 4
their family of the different roles and recommendations for a lead executive on
responsibilities of members of the every policy-making body.The latter
health care team person should have a remit for overseeing
✦ seek feedback, suggestions and views via the strategic development of services for
user surveys to minimise complaints, children,with responsibility to
developing policies collaboratively with implement the principles outlined in this
children, young people, parents and philosophy
carers ✦ supports the work of the government
✦ ensure procedures for managing minister responsible for children and
complaints are child-friendly, clearly young people in each of the countries of
communicated and regularly updated the UK,and the Children’s and Young
People’s Unit.In addition,we continue to
✦ respect and value cultural and religious
campaign for a children’s commissioner
diversity within and between family
in all four countries of the UK,with a lead
groups.
director at national level in each country
who is responsible for children and young
people’s health services
✦ campaigns for accessibility and equity of
health care provision for all children and
young people,and the implementation of
national standards to meet their specific
needs

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✦ supports the view that the child or ✦ maintains that the environment of care
young person’s needs should be should reflect the psychosocial and
paramount in the development of developmental needs of children and
services, rather than professional roles young people, in terms of play,
or boundaries recreational facilities and educational
provision. There should be specific
✦ promotes the provision of services that
provision for those with special needs
are child and young person-orientated.
Facilities should be designed to meet the ✦ promotes the role of children’s nurses
specific needs of children and young within primary care organisations.
They should work alongside children
people and they should be involved in
and young people’s public health
the planning and development of future
nurses† to provide a comprehensive
services
community health care service,
✦ campaigns for the collection of national reducing unnecessary in-patient
and local data on health care admissions and hospital attendance
interventions and outcomes to guide ✦ focuses on health promotion to
future children and young people’s minimise lifestyle factors that may
health care service provision. This compromise the health and well-being
should incorporate the views of of children and young people
children, young people, parents and ✦ reinforces the role of all nurses in
professionals safeguarding and protecting children
✦ embraces the development of and young people.
comprehensive, integrated, multi-agency
child health services to provide seamless
care across organisational boundaries Developing and
✦ promotes collaborative and integrated
working between services for children, maintaining clinical
young people and adults to ensure a
smooth transition between health care
competence
providers The RCN Children and Young People’s Field
✦ asserts the right of children and young of Practice:
people in all settings to be cared for by ✦ believes that nurses have a right to be
appropriately qualified and registered supported and able to access
nursing staff, who have received specific professional leadership at local level.
training to meet their needs. The levels They should receive the appropriate
and skill-mix of staff should reflect the education to undertake their role in
specific needs of children and young
† Including school nurses and health visitors
people and their families

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CH ILDREN AND YOU NG PEOPLE’S N URSI NG: A PH ILOSOPHY OF CARE

providing holistic care for children, Field of Practice can be obtained from
young people and their families RCN Direct on 0845 772 6100. Separate
✦ encourages effective communication to lists relate to documents in England,
share and develop the evidence base for Wales, Scotland and Northern Ireland, and
practice include RCN guidance and other policy
documents such as:
✦ offers nurses access to the range of
knowledge and skills needed to work in Scottish Executive (2000) Protecting
dynamic health services children, a shared responsibility – guidance
✦ promotes the need for continuing for health professionals in Scotland. NHS
professional development and specific MEL 5, ISBN 0 7480 8272 7v
post-registration education and Scottish Office (1998) The Scottish Office
training opportunities for nurses NHS policies for children – 1974-1998.An
working with this client group. This overview.Available at
includes specific provision regarding www.scotland.gov.uk/library/documents6/
the protection of children and young
chilpol-00.htm
people
✦ enhances reciprocal exchanges, both Carlile Review (2002) Too serious a thing.
within the RCN and other relevant Copies can be obtained from the National
professional bodies, to ensure there is a Assembly for Wales. Telephone 02920
broad perspective in all aspects of work. 823480 or access at www.wales.gov.uk
Nursing services for the acutely ill child
(1999) Belfast DHSS
Supporting Health Select Committee (1996/97)
evidence and Hospital services for children and young
people. Fifth report of session 1996/97.
information Volume 1: Report, together with the
proceedings of the committee paper 128-1.
Governments, professional and voluntary London: The Stationery Office
bodies have produced a wealth of policy Department of Health (2001) Health visitor
statements, reports and recommendations and school nurse development programme
about children’s and young people’s health resource packs. Available from the NHS
services. The RCN Children’s and Young Response line, telephone 08701 555 455 or
People’s Field of Practice strives to access at www.innovate.had.online.org.uk,
continuously influence and shape policy or email doh@prolog.uk.com
development, whilst also lobbying for the
full implementation of guidance Hogg C (1996) Health services for children
recommendations. Lists of key documents and young people: a guide for
which are endorsed or fully supported by commissioners and providers. London:
the RCN Children’s and Young People’s Action for Sick Children

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Royal College of Nursing (1999) Skill mix

and staffing in children's wards and
departments. London: RCN.Available from
RCN Direct on 0845 772 6100, quote
publication code 001 054

The RCN fully supports those members

who seek to raise concerns about the care
of children and young people or the
protection of their rights. For specific
advice, contact RCN Direct on: 0845 772
6100 or your local RCN office – see your
RCN members’ guide to services and
benefits for contact details.

References
1 Royal College of Nursing (2003) Defining
nursing. London: RCN. Publication code:
001 998, can also be downloaded at
www.rcn.org.uk
2 UN Convention on the Rights of the Child
(1989) 20. Xi. 1989; TS 44; Cm 1976
3 The Resolution of the European Parliament
on a Charter for Children in Hospital
(1986)
4 BRI Inquiry (2001) The Report of the Public
Inquiry into Children’s Heart Surgery at the
Bristol Royal Infirmary 1984-1995:
Learning from Bristol. London: The
Stationery Office.

The term ‘child’ refers to any individual from birth through infancy (including neonates), childhood and
adolescence, recognising the particular needs of specific ages, particularly the transition period to
adulthood. The ‘family’ refers to the child or young person’s significant carer(s), as defined by the
individual and/or their parent(s)/carer(s)/legal guardian(s).

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April 2003
Published by the
Royal College of Nursing
20 Cavendish Square
London
W1G 0RN
020 7409 3333
The RCN represents nurses and
nursing, promotes excellence in
practice and shapes health policies.

Publication code 002 012