Why should Health Visitors be loved?
I have recently read again about the negativity around health visitors and how parents are keeping information from them during contacts. My question Why? Why are health visitors so feared by parents so much, in particularly mothers who feel that they must hide certain details from their health visitor or over clean the house. Do we see so much hate towards other professionals, the answer is No we don’t. Would we see mothers refusing a midwife, probably not! Yet the health visitor is seen to be unwanted and one which is refused by parents.
Read any parenting site and there will be some variety of health visitor bashing. The newest nickname I have read for the health visitor is the Draconian, one which I feel is harsh and unfair. Health Visitors are specialists in their field of 0-5 years and offer evidence based advice to parents. However, they can only…
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Am sure there is a clever analogy/political statement that could be made between the lack of posts on this blog and the plummet in moral (echoed by the drop in HV numbers) of the last 12 months.
I revalidated last month – 18 years since I first registered as an RN(child) and have realised how that time and experience has broadened my shoulders, built my resilience and enabled me to adapt in my transition from student to independent health visitor.I’m not alone in finding the job not quite what I signed up for, and feeling like any element of seeking health needs and building communities has been replaced by hitting targets and keeping commissioners happy while they congratulate our teams by slashing budgets further often with a side order of cutting or downgrading roles.
My fab friend Su highlighted The issues she faces in Staffordshire, but it feels one of the biggest hurdles we face is getting those with the loudest voices to help us, and so much of it seems to come down to what feels like an echo chamber of past negative experiences and lack of knowledge of what we actually do.
I widely shared a blogpost yesterday by JentheM which wonderfully breaks down for new parents what expectations to have/how to handle those first few bewildered days following delivery. It signposted to fantastic sleep and breastfeeding advice and left me feeling like parents who had support from JentheM and myself would feel they had consistency and could even suspect some collaboration between our services. So much I agreed with, I didn’t check every link, and didn’t hit the link to Milli Hill’s article. The thrust of the article about how difficult the first few weeks are as a parent are, how finding what works and treading that line between your instincts and what you see the societial norms/expections are. Unfortunately, wrapped up within it is a fair bit of health visitor bashing (I am never going to compete with the Daily Telegraph’s readership!).
Milli uses her experiences of three years earlier (2013 as the article its self is a year old) around safe sleeping and being advised not to co-sleep to suggest that all health visitors are still giving that advice, and even suggesting families lie about sleeping arrangements (thus preventing honest, open discussion and building distrust in the HV service) while with no sense of irony, quoting the NICE guidelines and evidence base we use and base our advice on – blind to the idea that as a profession we might have seen this too and adapted the way we approach the subject of safe sleep. Even having engaged on twitter with Milli, the belief still seems to be that I’m part of a small select group of health visitors who give correct advice.
It is so frustrating, as especially in the current arena of ongoing cuts and threats to services, those with the level of influence of Milli should be on our side – being aware that most health visitors are better informed than those she encountered and that she should be highlighting this and how it should be something all parents should expect rather than to be dismissive of the whole profession.
So what to do? It’s been much said before, but we need to be loud and proud of what we’re doing – this whole blog started to both promote and reflect on health visiting and particularly on twitter I strive to raise awareness both professionally of best practice and among the public of what to do. Locally I’m trying my best to make a difference too, I’ve worked with colleagues to try new ways of working in clinics improving staff and family satisfaction, joined a shared governance council to help work on improving standards, and I’ve registered our team generic email to Bulletins from Public Health England to help keep us up to date.
I’m also going with fellow CPHVA members to the House of Commons on Wednesday, originally to lobby about health visiting and schools nursing, but with there now being a general election looming, now giving them an Election checklist with ringfencing of our budgets.
So…what can you do? Whether fellow HV, parent or other stakeholder in public health issues, please #loveyourhealthvisitor and be loud and proud of it – I’m Here on twitter 👍🏻
Having worked in Paeds A&E prior to my jump into health visiting, sepsis is something I’ve always been aware of, and how vulnerable babies especially can be.
Leah (who writes SCPHN’ing Along) has done a fantastic summary of today’s new guidelines – something we should familiarise ourselves with and be informing parents of at every opportunity.
Sepsis is a very rare conditional which can be life threatening condition which is caused by an infection which causes the immune system to go into overdrive.
Think sepsis aims to improve the diagnosis and early management of sepsis in primary care. There are an estimated 150,000 cases of sepsis per year in England, and around 44,000 associated deaths. However, with early identification sepsis can be avoidable and treatable.
Health Education England e-Learning for Healthcare (HEE e-LfH), in partnership with the Royal College of General Practitioners, has launched an e-learning programme for healthcare professionals about sepsis. Think Sepsis follows the recommendations of the new NICE guideline on sepsis recognition, diagnosis and early management. For further details please follow the link http://www.e-lfh.org.uk/programmes/sepsis/
More information can also be sought from the sepsis trust website http://sepsistrust.org/
Apologies for not posting more frequently, but starting and orientating myself to my new job/area, family birthdays and holidays have led to a lack of time/energy to post. Before I started this blog, I wasn’t a natural diary writer, so it is still a (relatively) new discipline!
New job feels like it’s going well, my team and managers are all very lovely, supportive and engaged which has helped me very quickly feel like a useful and effective team member. I’m unsure there is anywhere HV team within England that doesn’t have a long wish list of things they want to offer families and the wider community – while the contents may vary between areas, all are frustrated by what they aren’t able to do, and after the CPHVA conference this week, I am appreciating how fortunate my trust is compared to friends who are facing £10m cuts or question marks over redundancy of up to 50% of their teams. In his speech, Jon Ashworth MP spoke of how cuts to pharmacy budgets were set to disproportionately effect poorer areas, and fears among the conference delegates that the same will be true of HV/SN service cuts.
Su Lowe has been running the #loveyourhealthvisitor campaign, initially in Staffordshire, but hopefully reaching wider soon, a positive campaign inviting families to share what their HV has done for them, and the fantastic Forging Families have made this fantastic info graphic:
Health visitors do seem the hidden workforce, whether it’s that we don’t have the adrenaline of 24hrs in A&E or neat narrative of One Born Every Minute, our work just isn’t seen, to the point of there being no mention of a health visitor for Helen Archer during her domestic abuse storyline and even in Kay Mellor’s drama In the Club, the mum’s were still going to midwives/the maternity unit for advice when their children were nearing a year old!
There was a definite feeling of fighting the cuts and lots of talk of empowerment (some from me – more in next post!) and a feeling that many left conference with batteries charged and ready to try and raise public awareness. Am hoping that there’ll be more to report on this in months to come.
I’m just asking. Life is really tough at the moment. Really tough. This government is grinding down families, the vulnerable and those who care for them. There’s no funding for anything. This year has been a hard year in many ways. Resilience is low. Morale is low. I get it. So I’m just asking. But are we giving up on breastfeeding?
On the #MatExp Facebook group today we have been talking about the new fad for baby boxes. I am ready to be corrected on my understanding of these because it all seems about as clear as mud, but from what I can gather these boxes are provided by the Baby Box company, which is neither WHO code compliant nor UNICEF Baby Friendly. But they are being embraced up and down the NHS. And in many cases trusts are using them to put across the message that bedsharing is…
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Last year I did an alternate placement day with Dave Munday, and he spoke of the then top secret plans to have a week celebrating Health Visiting and promoting what we do. It sounded fantastic, but was still to receive official approval, and wasn’t going to happen until Sept 2016 – ages away, I mean, I had three more university modules to complete (with three essays, a portfolio, plus a spreadsheet demonstrating my awareness of child and family needs over several different ages and twenty domains), consolidation was still several months away (completed in early August), thoughts of my future employment were still distant (and I definitely wasn’t even considering winning any awards!!).
But here we are – #HVweek… and with events over the last year, it is very much needed, both to promote our work and efforts, and to raise moral in what has been a very challenging year.
The move to local authority commissioning feels that it has brought with it huge uncertainty, and with the door of “Call to Action” barely shut, HV numbers are dropping again and the foundations that were laid of what could be achieved for families and communities don’t seem to be given chance to prove our efficacy at reducing future spending.
In my own career, this means having qualified (with a merit 😀👏🏻), I’ve started working in a new trust, rather than being retained on the team/area I’d worked with for two years. Luckily, my new team are lovely and I’m really looking forward to the new challenges I will face, but it is strange having to orientate to a new area and different ways of working – we’re based in a children’s centre and do our clinics there rather than in GP surgeries. On the plus side, we can work remotely with laptops, this worked to my benefit last week when Mr A was poorly – mandatory e-learning was completed while he rested with CBeebies!
Being so new, I haven’t been able to organise any local events, but am lucky enough to be participating in the national virtual conference on Wednesday and am trying to promote as much as I can via social media using #HVweek and my own friends and family – if you’re reading this please join in too, also if you haven’t already look and sign my friend Su’s HV petition.
Even today (a “mummy” day) I’ve bumped into the GP I collaborated with in my student post and at the park bumped into a Mum and her two children who’ve moved locally to me from where I was working – both of whom had such positive things to say about health visiting it gave me a huge sense pride – something I hope all my colleagues feel this week, and hopefully can help us all stand up and make some noise about our work.
Almost every night I do bedtime stories for at least one of my children. Mr A at 2.5yrs is in a bit of a Peppa Pig funk at the moment (well, tbh he thinks he’s George!) – We normally read three books together at bedtime. I try and pull out a few stories first to offer a bit of variety and to charm him away from the very familiar texts, and over the years, would like to think I’ve quite an eye for picking out good stories on our visits to libraries and bookshops, and it fills me with pride that Miss E at 5.5ys is now reading to me books that I’ve read to her many times over the years. With the current #bathbookbed campaign and recent CPHVA Twitter Tuesday chat with Bookstart it was great to be able to get involved. Continue reading →
So way, way back last year, I read with interest about the CPHVA awards… I wonder what you have to do to get one of those, and read with interest the citations on the winners and felt proud to be entering a profession with such dedicated colleagues.
Little did I think a year later I would be there, let alone coming away with an award, but last Friday that’s exactly what happened.
It still feels a bit unreal – the afternoon went by in a blur, and I’m looking forward to reading about it in the next Community Practitioner! I was allowed to bring a colleague and so asked my Specialist Practice Teacher if she would like to attend as she’s been so supportive and encouraging during my training.
I was also fortunate to have my SCPHN course leaders Lynn Sayer and Mary Malone attending as they had been shortlisted in the Lecturer of the year category.
Luckily I didn’t have to make a speech when collecting the award, although I was then whisked out to speak to the lovely Alice and Helen from Community Practitioner who asked me how I was feeling which was overwhelmed!! I must admit, I got a bit teary as it struck me how much the award meant – hopefully I can explain it better here than I did at the time!
Part time places for SCPHN courses are really rare – even in the cohort of 60 that I started in, there were only 5 part time students. It is a shame there aren’t more part time places available. I hope by winning the award I can draw attention to how important it is to both offer these part time places, and how much we can bring to the role.
By training over 2 years, I was able to plan my alternate practice days particularly my #adaywithdave and attending the CPHVA conference. Also, my confidence has built up working with my SPT on the same caseload for 18mths means I’m entering consolidation already knowing many families on the caseload, and am now doing the 8-12 month reviews of babies I first met as newborns or even bumps last year!
The second point is that it isn’t an academic award – I have loved my SCPHN course, and have thrived on our modules and what they have taught me, allowed me to debate and reflect upon. But, my results are mid-range at best, I’m definitely a talker rather than a writer and so it has blown me away that me being me, and being enthusiastic, keen and supportive of my fellow colleagues and students has been recognised.
Finally, I hope that by winning this I can act as an ambassador. As health visitors, our role is still something many are uncertain of and am still regularly explaining what we are and what we do, something I hope that #hvweek will help with and maybe even some opportunities before September.
Also, for the awards. Nominating my course leaders and having them shortlisted was as exciting to me as being shortlisted myself – there are so few opportunities to celebrate our work and the huge achievements many of us make while “just doing our job” that I really hope (keeping up my Jennifesto pledge to encourage positivity!) that more of us make to effort to honour our colleagues and big up our profession!
Apologies – it’s been a while. What can I say, Christmas, coursework, new kitchens and no wifi all have contributed to towards this – as you can imagine, they all pop up at different points in the fun to definitely not fun continuum, with both the new kitchen and coursework making several entries at varying points!
All seems to be progressing really well, with September seeming both miles away (when thinking of family time) and amazingly close (when thinking of future employment!).
Anyhoo, last night was a lovely change from the typical. Mr-Darcy-like-man (aka my husband) was on post-work parenting duty, and I got to finish work and skip off to the Southbank, eat dim sum with friends, and go to see the rather amazeballs Caitlin Moran with a group of 10 other ladies including my very, very lovely friend Claire (more on her in a post soon).
Caitlin did some readings from and discussed her new book Moranifesto, and as the night
progressed, I found it more and more relevant to health visiting and the revolutions we are going through and how we need to have confidence in ourselves to speak up and be heard.
Like Caitlin, I’m very likely to bring humour (and sometimes a silly face!) to situations, and I’m not the most well read on all matters political. But over the last 18mths, I have become much more aware of the waves created by wider political decisions.
It got me pondering what my manifesto would constitute and here are my top three:
- The full adoption of the 1001 critical days manifesto with the proviso that its funding was maintained for at least 10yrs to give the services chance to prove their efficacy and enable the savings to outweigh running costs.
- Increased investment in training and infrastructure for school nurses & maintained training and recruitment for HV’s
- An increase in positive input to team meetings.
1001 days is an issue that’s been very close to my heart since my day out with David Munday and while unable to attend recent meetings, via Twitter I can still be up to date (Storify for most recent meeting here). It’s vital that as health visitors we continue to talk about this at every opportunity. While the government’s members of the APPG are fully accepting and supportive of the importance of (and cost saving potential of) early intervention, they are at the same time towing the party line regarding austerity and don’t acknowledge the critical effects local authority budget cuts are having, demolishing the established foundations needed to build these services on (we only have to look here for examples).
In a similar vein, with the call to action ending and the rapidly shrinking budgets, it’s already evident that maintaining even existing quotas of HV’s and SN’s is going to be difficult. School nurse numbers are critically low, families benefiting from the increase in HV numbers are going to be hit by the overstretched provision offered and it’s horrifying to hear of boroughs planning to withdraw school nurses when expansion could yield so much more.
Even in HV services, less than 6 months after transfer there are job freezes and invitations to retire in full knowledge the posts will be left vacant. Tensions are high among students realising posts may be more limited than expected and among those desperate to join the profession wondering when or if student positions will be advertised. The financial investment of the last 5yrs was so welcome, but without continued investment in recruitment, training and retention where will the next 5yrs take us?
So to my final point. We need to continue to see and celebrate the positives, and despite this being something that is free, quick and requiring no further training or qualification, we’re not very good at it.
Every day in practice we have a positive effect on someone, whether colleague, parent, student or even child – even if we don’t see it as anything special it might have made that person’s day, helped make something easier or helped start a useful collaboration.
By celebrating these and sharing them we can build team spirit, share best practice and recognise how amazing our service is. I’m going to try and suggest this to my team and with #HVweek coming in September, it seems a very good to start practicing praising and celebrating our profession.
It really should be the very best of times at the moment for health visitors, the Call to Action concluded this year, having increased our numbers to nearly 12,000. Our workforce buoyed by newly trained enthusiastic, evidence based practitioners.
But, the air is full of uncertainty… with every move the government gives with one hand while swiping away with the other. Tax credits saved but student nurse bursaries threatened, ongoing claims that NHS funding is safe, but responsibilities and budgeting for public health services moved to Local Authorities to manage on an every shrinking cash flow. If only we all had a Dave to write to the council for us.
So, what can be done?
Well, professionally there is much talk of how to prove our worth – internal auditing, KPI’s, friends and family tests to show we’re upholding the HV service specification.
Health visiting suffers from huge image problem – when we’re working well with parents, we can appear like graceful swans… gliding in and working so seamlessly that parents may not realise the amount of cogs whirring and thoughts processing and future planning in our heads as our evidence based advice is shared. When it isn’t so seamless, we can end up being perceived as clumsy and at worst belligerent – ignoring what parents are telling us or appearing to push on with our own agenda.
We’re never going to have the wow factor of 24hrs in A&E or even OBEM (as controversial as it is)… having worked previously in A&E (and v nearly appearing in 24hrs) I’ve had plenty of “Ta-dah” nursing moments, and the satisfaction of having instant results/relief. Health visiting is often a slower burn, a long game impossible to quantify into a perfect soundbite. Often recognising the earliest signs of problems and intervening to ensure the risk of harm is reduced and only measurable by long-term improvements in child and family health.
My original #MatExp pledge was to try and raise more awareness of the role of health visitors. Without the wider public knowing how much is offered to them at the moment, they won’t know what could be lost in a few years. Cuts are more difficult to make when there is outrage rather than whimpers – there have been whispers abound that there’ll be a National HV Week this year which would be amazing. Ensuring client confidentiality makes sharing about days on placement difficult; but maybe as health visitors we do need to share more about what we do, how we’re doing it and enable parent’s to sharing their stories too – I half joked in a tweet a while back:
The title of this post came to me really quickly (v rare for me!), and I knew it was a Dickens quote but was unsure which it came from, a quick Google told me it was from A Tale of Two Cities, but I did wonder if it was with some irony in the précis of the story… Vive le Revolution?!