Think Sepsis

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.

SCPHN'ing Along

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/

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Bit invisible?

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.

Are we giving up on breastfeeding?

Heart Mummy Musings

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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It’s #HVweek!!!!

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.

Choosing books with Bookstart

 

bookstart

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 →

Oh my…!

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!

 

The Jennifesto

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

Moranifesto

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:

  1. 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. 
  2. Increased investment in training and infrastructure for school nurses & maintained training and recruitment for HV’s
  3. 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 was the best of times, it was the worst of times…

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.

Yesterday came news of cuts one London council were looking to make and the threat that the 5 universally offered visits may be dropped once the legislation expires in 2017.

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.

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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:

  But wonder if we do need this (or a similar hashtag – don’t want to tread on toes 😉) to start to highlight what we do and families experiences of us and wider promote what we actually do.

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?!

What a journey!

As I mentioned in my last post, my week has been dominated by the CPHVA conference – I’m going to blog more about it when I’ve got the time, but am still in a bit of a whirl!

I spent 2.5 days (having been able to attend the National Meeting the previous night) there and had a fantastic time. 

The only downside was missing meeting Helen (@heartmummy – blasted trains!) Could easily have cloned myself a few times over such was the wealth of masterclasses and interesting speakers and it was amazing to properly meet many of the CPHVA team I’ve chatted with on Twitter in the #CPHVAtt’s and especially the lovely @frustrated_HV who as well as inviting me out for dinner, ensured I got back to Manchester Picadilly in time for my train (and was ready to help when more transport chaos struck!).

The professional colleagues I met were all so friendly and left me feeling hugely motivated and with lots to consider and reflect upon with regard to practice and my future intentions with regard to where I want to go within the vocation.

I felt able to ask questions and contribute to sessions and having been invited to be part of the “Social Media A-team” I enjoyed practicing my Twitter skills and don’t think I’ve ever tweeted so much (felt bit odd yesterday not keeping the world up to speed with Mr A’s soft play session 

“@loftyjen still in ball pool; Mr A unsure which colour ball he prefers #toddlers”

 I didn’t meet any other students during conference which saddened me and I wonder if more could be done to enable students/newly qualified SCPHN’s to attend and get involved. 

It wasn’t until I was (finally) on a train home that it dawned on me; in interactions with parents, fellow professionals and colleagues I often find myself saying I’m “just a student HV…” with an almost apologetic tone. 

Over the course of the conference, it seemed no one was bothered that I was a student – they were still keen to hear my thoughts and experiences. It’s helped clarify my interest in leadership (good timing given its my current module!) and I’ve been able to make some useful contacts for the future.

Being such a huge chunk of CPD, I’ll reflect and blog on further sessions…following the speech from Jackie Smith and with my CPHVA information pack on revalidation, can ensure it’ll all be useful when my time comes!

CPHVA Conference 2016

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So, I’ve left the confines of the M25 behind (not to mention Hubbie & two kids!!) and (despite best efforts of the 14.40 train) have made it to Manchester for the CPHVA conference (yay!).

I’m going to be tweeting (@loftyjen if you don’t follow me already) on the hashtag #CPHVA15 as will many others over the next couple of days as well as blogging about what happens.

There’s a jam packed schedule and I’m already struggling to work out what I’ll be happy to miss (unless cloning is an option!!).