Why a Specialist? Nurse education consists of the theoretical and practical training provided to nurses with the purpose to prepare them for their duties as nursing care professionals. In the present world, the concept of family physician is non -existent and has been taken over by specializations and super specializations. A patient is referred to specialists depending on the signs and symptoms. The changes in the medical field have a direct impact on the training of nurses.

During past decades, the changes in education have replaced the more practically focused, but often ritualistic, training structure of conventional preparation. Nurse education integrates today a broader awareness of other disciplines allied to medicine, often involving inter-professional education, and the utilization of research when making clinical and managerial decisions. This is now out moded, and the impact of nurse education is to develop a confident, inquiring graduate who contributes to the care team as an equal. It is imperative that nurses update and keep them selves in line with the new advances in medical field.

General vs. Special
In General nursing education curriculum (Diploma/degree), the emphasis is laid on the laying the right foundations. The education is geared towards forming the base of medical surgical nursing and then extend its applications to various specialties.

(ENT, Ophthalmology, Mental Health, Child Health, Obstetrics and Gynecology etc). The education thus is not sufficient to meet the growing needs of the patient and doctors. The present education system is unable to provide a comprehensive, detailed exposure to each specialty. A gap exists between theory and actual practice. It is this gap which if widens, causes problems in delivering quality patient care.

A special training for each nurse is essential to create efficient, professional nurse who delivers best nursing care depending on the service area. For eg.

1. A nurse during the initial training is taught about Intake output charting, but she realizes its importance once she starts working in the critical care area and maintaining the hourly charting.

2. Another example is a student nurse is exposed to dialysis unit but she would not be able to function as a staff nurse independently immediately after the training.

Each area has its own unique features in terms of assessment, treatment and equipment. It is these features that would mold a general nurse to a special nurse.

Techniques of Creating Specialist –
1. Clinical exposure: Experience makes a nurse perfect. A nurse would be able to work effectively once she has been assigned to a specific unit for a period of time. It is essential that time is provided for a nurse to adapt and learn. Training should be more practical oriented and theoretical concepts to be taught by correlation in clinical practice.

2. Induction: A well planned induction of the area of her placement is essential for bridging the gap. The orientation should emphasize the policies, records, documents, modern devices and its use that would enable a new entrant to adjust and deliver.

3. Certificate Course: Small certified courses could be implemental by hospital authorities. It is also essential that Nurses completing the specialized course to be placed accordingly. The nurses with additional training should be given extra remuneration than others.

4. Post Graduation: In the changing world, it is becoming necessary to create super specializations in nursing as well. These super specializations could be either as Post Graduate Diplomas/ Masters Program/ Nurse Practitioner.

Autonomy to nurses will help in making them more responsible for their actions and also boost their morale

Challenges In creating specialist Nurses:
1. Rapid turnover of Nurses
2. Inadequate exposure/ training/ induction
3. Improper remuneration
4. Inadequate specialized posts

Principles for Creating Specialist Nurses:
4 A’s could serve as guiding principles for preparing nurses providing specialized patient care.

1. Awareness: A nurse in a specific unit should be made aware about each and every minute detail that would assist her in daily functioning. Along with the practical component, a thorough understanding related to knowledge aspect needs to be emphasized. This would enable her thinking and sharpen her skills.

2. Analyze: The nurse should be exposed to various clinical scenarios within the area by mentoring. The mentor should be responsible to ensure that the novice nurse analyzes every situation and uses rationale for her actions.

The exposure would assist in developing critical thinking ability.

3. Application: The nurse should remember that actions speak louder than words. She should be able to convert her knowledge, analyzing ability into action. This would help her to identify problems and prevent complications that may arise.

4. Autonomy: A nurse should be given a certain amount of autonomy and not just considered as some professional responsible for following doctor’s orders. Autonomy to nurses will help in making them more responsible for their actions and also boost their morale. A symbiotic relationship between nurses and doctors is a key for effective care.

Conclusion:
A nurse who has intricate knowledge would still not be considered a specialist if she lacks the basic necessities of a nurse. ‘N: Nurturing; U: Understanding; R: Respect others; S: Support; E: Empathy’.

Remember, the modern devices are an AID for better care, but not an end in themselves. A nurse would be incomplete if she lacks in using her senses, providing a helping hand and being there when required. To nurse others as our own takes a different kind of attitude, courage, patience and understanding. Thus, we can create nurse specialist by training; but Nursing as a profession itself is a specialization.