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Nursing Education Begins with Children

At the UW School of Nursing, all undergraduate students learn about caring for children. Whether or not students go on to specialize in this area of care, the experience helps them to be better parents, neighbors and members of their communities. At the graduate level, the School’s Pediatric Nurse Practitioner (PNP) program is considered one of the best in the country and is the only such program in Washington, Alaska, Montana and Idaho.

Dr. Kathryn Barnard is a professor of family and child nursing and one of the foremost experts in the country on early child development and its assessment. Both undergraduate and graduate students benefit from her teaching and internationally acclaimed research.

A recent report on America’s kindergartners by the U.S. Department of Education was remarkable in many ways. Compared to children in prior decades, the 22,000 kindergartners who were sampled in this first-ever study were revealed to be much more diverse in terms of their racial, ethnic, economic and language backgrounds. Many came from single-parent or stepparent families. They also differed in the types of childcare and educational experiences that they had prior to kindergarten.

But perhaps most remarkable was the study’s conclusion that the most important factor in determining a child’s preparation for school and chances for success was something much more fundamental – the early parenting environment. For Dr. Kathryn Barnard, this was a strong affirmation of nursing science, particularly her own three decades of studies measuring the environmental factors critical to cognitive development.

"The kindergarten report verifies the importance of the before-school years in getting children ready. One of the things highlighted is that it is the effect of the family as well as the mother’s level of education and whether she has a partner that most determine school readiness. Behavior problems are more common with single mothers."

Barnard notes that single parents have taken offense with this statement, but that studies have shown that the most common traits associated with adults who have problematic life outcomes are single parenting and alcohol or drug abuse.

"To me what this says is that the job of raising children is so demanding that, if things go right and you’re a single parent, you’re going to make it. But if things go wrong – your child is sick, or you lose your job – there are hundreds of possible complications. We as a society also negatively discriminate against single parents. We don’t have the resources to help them out. This is unfortunate because statistics show that almost 27% of our children are born to single mothers. This is a huge increase from 25 years ago, when it was 5%. The issue is not to condemn single parents but to say that we need to find ways to help with more respite care and more counseling and guidance."

"In my class on behavioral and developmental challenges of children," she continues, "one of the assignments that I give is to have my students ask parents about their experiences with the health care system. Parents state that they do not find the primary health care providers offering help with developmental or behavioral issues."

Barnard noted that one parent who was queried said that she had never had a discussion about behavior and development with her child’s pediatrician, and that her children had never had a developmental screening.

"We hope to see that change. Our pediatric nurse practitioners are prepared to practice differently," Barnard noted.

Barnard believes that nurses will be the future "information brokers" for parents, giving them help in dealing with health and wellness situations. Technological advances such as web pages or chat rooms will help facilitate parents’ acquisition of knowledge.

"I see that all the time with my students," she explains. "Once you help them understand how important behavior and development issues are, they are just so effective in working with families. I see it in the papers they turn in, and what they say in class. If we can just figure out ways within the public domain to facilitate acquisition of this knowledge, we can really make a difference with our children."