Woah in no way did I suggest adult nurses were ever "superior". Every branch of nursing are worth their weight in gold and they all have their place. I stated that in an elderly mental health setting where the nurses are MH trained only, they really struggle to grasp the physiology side of nursing and don't understand co-morbidities. It's not all in my imagination, I've had plenty of elderly patients admitted from MH wards come in with trivial matters that could have been managed over there but the MH nurses don't have the knowledge or the skills to manage it. I have also heard accounts from my RGN friend who works on an elderly mental health ward who says the same thing but they also haven't really given her any extra training for the MH side of things.
It's the same on my acute DME ward. Practically all of our patients have dementia and/or delirium with acute medical problems. We are very adept at treating the medical conditions. We are also very good at looking after patients with dementia and managing their challenging behaviours but there is a lot we have got to learn and I think some of the girls would benefit in going on to do modules in mental health to gain a better understanding of how mental health conditions affect the elderly, how the psychiatric medications impact on the elderly and the risks of using them. Not just AP's and benzos increasing risks of falls etc. but things like SSRI's causing chronic low sodium and the effect of lithium on the kidneys etc.
You are also right in saying that adult nurses aren't great in some things. We could be a lot better at non verbal communication, and it's not an excuse but on an acute hospital ward such as mine you don't often get enough time to sit down properly with the patient so we do a lot of anticipation. We can pretty much tell if somebody wants the toilet, is in pain, wants to go to bed, wants something etc. And in all honesty in my nursing career I have only ever come across 1 patient that needed to communicate via sign language and her dementia was so advanced she barely used sign language anyway. We are in the middle of a project to completely overhaul the way we care for our elderly patients which is going to be costly to the trust but it involves changing the environment and hiring staff who will be non clinical (but have clinical backgrounds) to spend time with these patients and their families, stimulating them, running activity groups and physio groups. I also hope they will send some of the nurses on MH related modules. I myself teach a dementia module but I was never given any time off the ward to do this.
There's certainly things I could not do as a nurse. You couldn't just throw me onto a children's ward because I would have no clue what to do. Just like you wouldn't throw a children's or MH nurse straight onto an acute medical ward. There's even specialities within each branch that have specialist training and knowledge. For example you couldn't just throw me into somewhere like CCU or ICU. I wouldn't even know where to start. We have had patients sectioned on the ward to be tube fed and medicated and I felt really out of my depth dealing with it because the MHA is not really in my expertise, but it couldn't be managed on a MH ward because the nurses were not NG trained so it had to be done in the acute hospital.
There are definitely fields of nursing where dual training would definitely be helpful and I think DME and Psych/Geri wards are definitely those areas. From what I understand from some of my children's nurse colleagues they are also getting many young people sectioned under the MHA and end up stuck on acute children's wards for months because there are no paediatric/adolescent beds in the country and they struggle to manage their behaviour at times so that is also another area that could benefit. There are probably other areas too where different specialities cross over. It's not a criticism of any one or any speciality because we all have our strengths and weaknesses, but nursing is changing, our population is changing and we face many more complexities. My ward has changed drastically in the 4 years I have worked there. Yes, we have always had patients with dementia who would wander, become aggressive etc. But it didn't used to be nearly all 28 of them. So I do think there is a need for us to expand our skills and knowledge to give our patients the best possible care.
Btw, we only use pumps on our ward unless we have a solution that needs to be infused carefully as the medicine could potentially be fatal if they infuse too quickly (patient unbends arm and position of arm changes which can speed up the infusion if infusing with gravity). So solutions such as high concentrate potassium, magnesium, phosphate and continuous infusions such as furosemide, GTN, sliding scale insulin, heparin etc. Those types of drugs require pumps so it's not that adult nurses can't work out the drip rates to infuse via gravity it's because the drugs are dangerous and need to infuse through the pump to ensure it is infused safely. We infuse most of our infusions via gravity unless the drug we are infusing is a high risk drug that does require a pump.