New youth health nursing framework

1 October 2014

Better meeting the health needs of young people is a major aim of a new nursing framework.  FIONA CASSIE finds out more about the National Youth Health Nursing Knowledge and Skills Framework, which outlines the essential skills all nurses should have, as well as those specialising in working with youth.

The unmet health needs of young people continues to be an issue, says the co-presidents of the Auckland School Nurses Group.

Diana Nicholson and Celeste Gillmer, says that was one of the motivations behind the Auckland School Nurses Group (ASNG) working with the Society of Youth Health Professionals Aotearoa New Zealand (SYPHANZ) and supporting the development of the first framework for youth health nursing.  The work began in 2008 and the framework was released earlier this year.

"We know young people find it difficult to navigate the health care system and continue to have unmet health needs," says Nicholson and Gillmer. "The Framework has been developed to assist nurses, employers and education providers to determine the skills and level of knowledge that are required by nurses working with young people."

Youth Health nurse practitioner Maria Kekus says the framework helps put youth health nursing on a professional footing to the benefit of both nurses and their employers – particularly those working in schools.

Kekus, the past – and founding - chair of SYPHANZ says nursing services in secondary schools for a long time evolved without a framework or guidelines.

The result was that, up until the relatively recent past, school "nursing" roles could include non-qualified "local mums" applying band aids in the sick bay; as well as highly skilled registered nurses delivering a sophisticated range of youth health services.

" I remember when I first started nursing in Auckland 15 years ago ­­­­– and even up to as recently as nine years ago – there were still non-qualified people calling themselves 'nurses' working in schools," says Kekus.

She sees the framework not only providing a professional career pathway for nurses working with youth to follow but also a guideline for employers – like schools – about the range of services that suitably qualified registered nurses can provide to young people.

"Particularly employers  (like schools) who don't understand the scope and potential of a nurse and also don't understand the professional boundaries placed on them (i.e. dispensing medications).

Gillmer and Nicholson say the framework is intended for all nurses who interact with young people and wish to demonstrate they are delivering appropriate care.

But it also provides nurses working in clinical areas with a specific youth focus with a clearer and more structured pathway to plan a career in youth health.

"The development of this framework is an important document for the continuing growth of an experienced and well trained youth-focused nursing workforce," said the co-presidents.  "A nursing workforce with the ability to support and enhance the potential of young New Zealanders to become productive and contributing members of society."

National Youth Health Nursing Knowledge and Skills Framework

Three skill levels

Essential: outlines the knowledge and skills that every nurse who encounters/interacts with young people should have.

Specialty: builds on the essential skills to further develop nurses who work with young people as their core clientele e.g. School Nurses; Youth One Stop Shop.

Advanced: outlines the knowledge and skills that nurses who work in an advanced youth specialty role require.

The four domains at "essential" skill level

Understanding young people (including an understanding of youth development)

Engaging young people (including limits of consent and confidentiality regards to safe practice)

Clinical skills (including HEEADSSS assessment, sexual & reproductive health, mental health, chronic conditions and alcohol & drugs)

Working with others (including engaging and collaborating with other health professionals and agencies working with youth)

Source: The National Youth Health Nursing Knowledge and Skills Framework, which is available to download at: