Guest guest Posted June 25, 2001 Report Share Posted June 25, 2001 Pippa I have so enjoyed the debate, I'm going on holiday so other people might like to carry forward this interesting topic. Just to add to you comment about me being unclear. I often felt as a practitioner that my nurse colleagues responded as they had been trained to the single symptom that arose. Using the previous example the behaviour problem of the child. The strength of health visiting I always felt was in working closely with the family over a long time to build a therapeutic relationship that will allow the real problem - the root cause if you like to be reached. Thus it is work of a more preventive style and method. In the previous example that I used the symptom was merely the behaviour problems of the child the root cause was the substance misuse of the mother compounded by the situation of the father. In a sense the parents were the ones with the real problems for good measure you might never discover those problems if you didn't spend time in home visiting. I will stop trying to be clear and go off on holiday now - Salut! >From: " P Bagnall " <p.bagnall@...> >Reply- >< > >Subject: Mid-summer's debate >Date: Mon, 25 Jun 2001 21:44:27 -0700 > >SENATE has dsiciplined me to be a regular email user, if I leave it too >long I feel out of touch and behind the times! > >In response to alot of interesting comments (from HVs but few from SNs) I >have the following to add: > >I am totally in support of building on the contribution of health visiting >in the modern world of complex health and social needs. Health visitors >have continued to respond to perceived and identified needs in a flexible >and increasingly evidence based way. But I remain unconvinced that this >cannot continue in isolation of other nursing developments. If HVs are to >have a role with all age groups where does this leave all other nursing >specialists and can HVs cope? > >Ruth, perhaps we need to be spending time on unravelling the skill-mix >issue? Whilst I am protective of clinically graded nurses I do see a world >of devolution where we have an ideal balance of skill and ability. Too >often I hear very experienced and qualified nurses complaining about the >lack of admin support. I sometimes wonder whether an investment in IT >might have a longer term value than lower grade A & C staff. Not that I >think all admin should be done by nurses, of course. > >, I welcome your suport for of collaboration. I really do believe >this has to be a team effort reflected across all boundaries. > >, I have really appreciated your regular contributions to SENATE. >Howver, your example of an holistic approach seems to align HVs with other >community nursing groups but your final point is unclear. Having worked >closely with SNs and CPNs you still seem to perceive the HV role as the >lead role. There will be other times when the CPN and SN take the lead. >Yes, HV may be unique but so too are other professional groups. > >Betty, I still maintain that nursing registration is integral to school >nursing practice which means I have a problem with the notion that this is >not necessary for health visitors. I would be really interested in your >reasons for perceiving health visiting qualitatively different from nursing >and midwifery. And where does school nursing belong? If health visiting >is needed by the public is there a separate case for school nursing? > >I am by no means an anti-HV activist. Quite the contrary, I am seeking to >build on their history in order to benefit the public. > >Coincidentally, I have been commissoned to write a book on " Succeeding as a >Nurse " . Each chapter will be different but I really want to include a >health visitor! Should I? >Pippa _________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 25, 2001 Report Share Posted June 25, 2001 SENATE has dsiciplined me to be a regular email user, if I leave it too long I feel out of touch and behind the times! In response to alot of interesting comments (from HVs but few from SNs) I have the following to add: I am totally in support of building on the contribution of health visiting in the modern world of complex health and social needs. Health visitors have continued to respond to perceived and identified needs in a flexible and increasingly evidence based way. But I remain unconvinced that this cannot continue in isolation of other nursing developments. If HVs are to have a role with all age groups where does this leave all other nursing specialists and can HVs cope? Ruth, perhaps we need to be spending time on unravelling the skill-mix issue? Whilst I am protective of clinically graded nurses I do see a world of devolution where we have an ideal balance of skill and ability. Too often I hear very experienced and qualified nurses complaining about the lack of admin support. I sometimes wonder whether an investment in IT might have a longer term value than lower grade A & C staff. Not that I think all admin should be done by nurses, of course. , I welcome your suport for of collaboration. I really do believe this has to be a team effort reflected across all boundaries. , I have really appreciated your regular contributions to SENATE. Howver, your example of an holistic approach seems to align HVs with other community nursing groups but your final point is unclear. Having worked closely with SNs and CPNs you still seem to perceive the HV role as the lead role. There will be other times when the CPN and SN take the lead. Yes, HV may be unique but so too are other professional groups. Betty, I still maintain that nursing registration is integral to school nursing practice which means I have a problem with the notion that this is not necessary for health visitors. I would be really interested in your reasons for perceiving health visiting qualitatively different from nursing and midwifery. And where does school nursing belong? If health visiting is needed by the public is there a separate case for school nursing? I am by no means an anti-HV activist. Quite the contrary, I am seeking to build on their history in order to benefit the public. Coincidentally, I have been commissoned to write a book on "Succeeding as a Nurse". Each chapter will be different but I really want to include a health visitor! Should I? Pippa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 30, 2001 Report Share Posted June 30, 2001 I have read this debate with great interest over the last few weeks and have seen very valid points raised on both sides. I have to admit though to being a little alarmed at the fervour with which health visiting is seeking to distance itself from nursing. I qualified as a health visitor 26 years ago after an integrated training (SRN - yes, I am that old!, DN and HV). It was never my intention to be a nurse as I entered the training with the sole ambition of being a health visitor. However, out of that 26 years, I spent approx 10 years as a school-based school nurse, employed by the education authority. As a school nurse I would say that about half my time was spent doing "nursing" things ie. looking after children when they became ill in school or had accidents etc. A good deal of my time was also spent in the classroom teaching a wide variety of topics such as nutrition, accident prevention, hygiene, sexual health, smoking prevention, drug awareness, to name but a few. I also did a lot of one-to-one counseling, especially with young panic stricken girls who found themselves pregnant, and I did well-person clinics for the stressed out teachers after school had finished. My nurse training was invaluable to my role as school nurse and I could not have done the job without it. I can hear you all thinking - yes, but health visiting is DIFFERENT. Well, I suppose the job I do now as a health visitor is very different from my job as a school nurse, but I still use my nursing knowledge every day of my life (I can almost hear the gasps of horror coming towards me!!). Maybe I have a different vision of health visiting to the rest of you but I have always seen my role as providing HOLISTIC health care to a client/ family/ community. As we provide a universalist service it is inevitable that at any given time a certain proportion of the people we visit will be ill. We may not be visiting a person because they are ill, but if we are providing an holistic service then we cannot "ditch" them when they do become ill. Because of my training I can move quite happily from the medical domain to the nursing domain to the public health domain, as and when it becomes necessary. I consider health visiting to be a unique profession because of this - there is no other profession in health that has the ability to do this and we should be proud of it for that reason. Just like most other health visitors I feel very frustrated at times that I do not have the time to do the pro-active public health work that is so valuable, because I'm completely bogged down with routine surveillance work. I do not believe though that distancing ourselves from nursing will change that, and I do believe that a health visitor without nurse training will not be able to offer the same quality of service that can be offered today. How often have you visited an elderly person who has been prescribed medication by a GP who has not bothered to explain what they are for? How are you going to help an elderly person maintain their mobility and independence if you do not have an understanding of the illness that ails them? How are you going to help a young mother with cancer explain to her children what is happening to her without that nursing knowledge? Illness is a part of life and helping people cope with it has to be a part of our role or we cease becoming holistic carers. The answer to becoming more public health focused does not depend on what we are called or how we are registered, but on what we DO. We need to start documenting what we do in order to compile evidence of our effectiveness in the public health arena. We need clearly defined, irrefutable outcomes of clearly defined interventions that address clearly defined health issues. We need to compile caseload and locality profiles that are benchmarked so that we can "seek out health needs" and provided effective interventions to meet those needs. As I have mentioned on the SENATE previously, we have been doing this work in Swansea through our use of the Omaha System and I am convinced that it is the only way to change our role for the better. It is not sufficient to simply say that we are the best people to deliver the public health agenda - we have to PROVE it. -----Original Message-----From: P Bagnall [mailto:p.bagnall@...]Sent: 26 June 2001 05:44 Subject: Mid-summer's debate SENATE has dsiciplined me to be a regular email user, if I leave it too long I feel out of touch and behind the times! In response to alot of interesting comments (from HVs but few from SNs) I have the following to add: I am totally in support of building on the contribution of health visiting in the modern world of complex health and social needs. Health visitors have continued to respond to perceived and identified needs in a flexible and increasingly evidence based way. But I remain unconvinced that this cannot continue in isolation of other nursing developments. If HVs are to have a role with all age groups where does this leave all other nursing specialists and can HVs cope? Ruth, perhaps we need to be spending time on unravelling the skill-mix issue? Whilst I am protective of clinically graded nurses I do see a world of devolution where we have an ideal balance of skill and ability. Too often I hear very experienced and qualified nurses complaining about the lack of admin support. I sometimes wonder whether an investment in IT might have a longer term value than lower grade A & C staff. Not that I think all admin should be done by nurses, of course. , I welcome your suport for of collaboration. I really do believe this has to be a team effort reflected across all boundaries. , I have really appreciated your regular contributions to SENATE. Howver, your example of an holistic approach seems to align HVs with other community nursing groups but your final point is unclear. Having worked closely with SNs and CPNs you still seem to perceive the HV role as the lead role. There will be other times when the CPN and SN take the lead. Yes, HV may be unique but so too are other professional groups. Betty, I still maintain that nursing registration is integral to school nursing practice which means I have a problem with the notion that this is not necessary for health visitors. I would be really interested in your reasons for perceiving health visiting qualitatively different from nursing and midwifery. And where does school nursing belong? If health visiting is needed by the public is there a separate case for school nursing? I am by no means an anti-HV activist. Quite the contrary, I am seeking to build on their history in order to benefit the public. Coincidentally, I have been commissoned to write a book on "Succeeding as a Nurse". Each chapter will be different but I really want to include a health visitor! Should I? Pippa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2001 Report Share Posted July 1, 2001 Dear thanks for your comments concerning the link with health visting and nursing. Like you I trained as a SRN. I was a committed nurse for a while but then as a ward sister on a medical ward I began to question why people were in hospital in the first place and became disallusioned with a purely curative approach. I wanted to know more about prevention and families. I had a long gap from health visiting and returned having gained skills in counselling, education, voluntary work, being a parent and helping run a business. I felt these skills proved more valuable than my rather outdated nursing knowledge, and enabled a holistic approach to supporting families and communities. I am not concerned about updating on medication, wound management,and cancer treatments. If I need to know something of a medical nature then I can research it or ask colleagues. I believe famlies have benefitted as much from my `other skills` as from nursing knowledge and believe that direct entry into health visitng would provide a diversity of skills that could be both challenging and exciting. Many consumer groups challenge the medical model on its exclusiveness on knowledge and become just as expert. My years out of health visitng made me realise how much health visitng gets caught up in its nursing background to the detriment of communities. Another point of view . Jeanette > I have read this debate with great interest over the last few weeks and have >seen very valid points raised on both sides. I have to admit though to >being a little alarmed at the fervour with which health visiting is seeking >to distance itself from nursing. > >I qualified as a health visitor 26 years ago after an integrated training >(SRN - yes, I am that old!, DN and HV). It was never my intention to be a >nurse as I entered the training with the sole ambition of being a health >visitor. However, out of that 26 years, I spent approx 10 years as a >school-based school nurse, employed by the education authority. As a school >nurse I would say that about half my time was spent doing " nursing " things >ie. looking after children when they became ill in school or had accidents >etc. A good deal of my time was also spent in the classroom teaching a wide >variety of topics such as nutrition, accident prevention, hygiene, sexual >health, smoking prevention, drug awareness, to name but a few. I also did a >lot of one-to-one counseling, especially with young panic stricken girls who >found themselves pregnant, and I did well-person clinics for the stressed >out teachers after school had finished. > >My nurse training was invaluable to my role as school nurse and I could not >have done the job without it. I can hear you all thinking - yes, but health >visiting is DIFFERENT. Well, I suppose the job I do now as a health visitor >is very different from my job as a school nurse, but I still use my nursing >knowledge every day of my life (I can almost hear the gasps of horror coming >towards me!!). Maybe I have a different vision of health visiting to the >rest of you but I have always seen my role as providing HOLISTIC health care >to a client/ family/ community. As we provide a universalist service it is >inevitable that at any given time a certain proportion of the people we >visit will be ill. We may not be visiting a person because they are ill, >but if we are providing an holistic service then we cannot " ditch " them when >they do become ill. Because of my training I can move quite happily from >the medical domain to the nursing domain to the public health domain, as and >when it becomes necessary. I consider health visiting to be a unique >profession because of this - there is no other profession in health that has >the ability to do this and we should be proud of it for that reason. > >Just like most other health visitors I feel very frustrated at times that I >do not have the time to do the pro-active public health work that is so >valuable, because I'm completely bogged down with routine surveillance work. >I do not believe though that distancing ourselves from nursing will change >that, and I do believe that a health visitor without nurse training will not >be able to offer the same quality of service that can be offered today. How >often have you visited an elderly person who has been prescribed medication >by a GP who has not bothered to explain what they are for? How are you >going to help an elderly person maintain their mobility and independence if >you do not have an understanding of the illness that ails them? How are you >going to help a young mother with cancer explain to her children what is >happening to her without that nursing knowledge? Illness is a part of life >and helping people cope with it has to be a part of our role or we cease >becoming holistic carers. > >The answer to becoming more public health focused does not depend on what we >are called or how we are registered, but on what we DO. We need to start >documenting what we do in order to compile evidence of our effectiveness in >the public health arena. We need clearly defined, irrefutable outcomes of >clearly defined interventions that address clearly defined health issues. >We need to compile caseload and locality profiles that are benchmarked so >that we can " seek out health needs " and provided effective interventions to >meet those needs. > >As I have mentioned on the SENATE previously, we have been doing this work >in Swansea through our use of the Omaha System and I am convinced that it is >the only way to change our role for the better. It is not sufficient to >simply say that we are the best people to deliver the public health agenda - >we have to PROVE it. > Mid-summer's debate > > > SENATE has dsiciplined me to be a regular email user, if I leave it too >long I feel out of touch and behind the times! > > In response to alot of interesting comments (from HVs but few from SNs) I >have the following to add: > > I am totally in support of building on the contribution of health visiting >in the modern world of complex health and social needs. Health visitors >have continued to respond to perceived and identified needs in a flexible >and increasingly evidence based way. But I remain unconvinced that this >cannot continue in isolation of other nursing developments. If HVs are to >have a role with all age groups where does this leave all other nursing >specialists and can HVs cope? > > Ruth, perhaps we need to be spending time on unravelling the skill-mix >issue? Whilst I am protective of clinically graded nurses I do see a world >of devolution where we have an ideal balance of skill and ability. Too >often I hear very experienced and qualified nurses complaining about the >lack of admin support. I sometimes wonder whether an investment in IT might >have a longer term value than lower grade A & C staff. Not that I think all >admin should be done by nurses, of course. > > , I welcome your suport for of collaboration. I really do believe >this has to be a team effort reflected across all boundaries. > > , I have really appreciated your regular contributions to SENATE. >Howver, your example of an holistic approach seems to align HVs with other >community nursing groups but your final point is unclear. Having worked >closely with SNs and CPNs you still seem to perceive the HV role as the lead >role. There will be other times when the CPN and SN take the lead. Yes, HV >may be unique but so too are other professional groups. > > Betty, I still maintain that nursing registration is integral to school >nursing practice which means I have a problem with the notion that this is >not necessary for health visitors. I would be really interested in your >reasons for perceiving health visiting qualitatively different from nursing >and midwifery. And where does school nursing belong? If health visiting is >needed by the public is there a separate case for school nursing? > > I am by no means an anti-HV activist. Quite the contrary, I am seeking to >build on their history in order to benefit the public. > > Coincidentally, I have been commissoned to write a book on " Succeeding as >a Nurse " . Each chapter will be different but I really want to include a >health visitor! Should I? > Pippa > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2001 Report Share Posted July 1, 2001 on 1/7/01 7:51 pm, j.e.clifton@... at j.e.clifton@... wrote: I felt these skills proved more valuable than my rather outdated > nursing knowledge, and enabled a holistic approach to supporting families and > communities. I am not concerned about updating on medication, wound > management,and cancer treatments. If I need to know something of a medical > nature then I can research it or ask colleagues. I believe famlies have > benefitted as much from my `other skills` as from nursing knowledge and > believe that direct entry into health visitng would provide a diversity of > skills that could be both challenging and exciting. I would agree with this point of view - the best training i have ever done was with the CAB and I feel it equipped me better for the work of health visiting than the health visitng course itself. I feel that the information I have from my nursing background has been useful but the attitudes and values that go with that really get in the way sometimes. I certainly do not think I'd be a worse health visitor without the knowledge and experience of being a registered nurse and the knowledge and skills I have brought to health visitng have been those aquired in working outside of the NHS. Interestingly a friend who is nurse and social work and CAB trained is in agreement with my views re the CAB training. I think that nursing has a long way to go before itcan reach what I learned there about working with people from where they are..... phoebe Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 2, 2001 Report Share Posted July 2, 2001 This whole debate is fascinating, and resonates closely with things I am trying to say in my research MA looking at health visitors concepts of postnatal depression. Would any of those who have contributed so far mind if I used your comments in my thesis? (referenced of course) Regards Jane Jane Research Assistantc/o Division of General Praticetel. ext 66927 (prefix with 0115 84 if external line)>>> klm@... 1/7/2001 20:09:12 >>>on 1/7/01 7:51 pm, j.e.clifton@... at j.e.clifton@... wrote:I felt these skills proved more valuable than my rather outdated> nursing knowledge, and enabled a holistic approach to supporting families and> communities. I am not concerned about updating on medication, wound> management,and cancer treatments. If I need to know something of a medical> nature then I can research it or ask colleagues. I believe famlies have> benefitted as much from my `other skills` as from nursing knowledge and> believe that direct entry into health visitng would provide a diversity of> skills that could be both challenging and exciting.I would agree with this point of view - the best training i have ever donewas with the CAB and I feel it equipped me better for the work of healthvisiting than the health visitng course itself. I feel that the informationI have from my nursing background has been useful but the attitudes andvalues that go with that really get in the way sometimes. I certainly donot think I'd be a worse health visitor without the knowledge and experienceof being a registered nurse and the knowledge and skills I have brought tohealth visitng have been those aquired in working outside of the NHS.Interestingly a friend who is nurse and social work and CAB trained is inagreement with my views re the CAB training. I think that nursing has along way to go before itcan reach what I learned there about working withpeople from where they are.....phoebe Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 2, 2001 Report Share Posted July 2, 2001 on 2/7/01 9:37 am, Jane at Jane.@... wrote: This whole debate is fascinating, and resonates closely with things I am trying to say in my research MA looking at health visitors concepts of postnatal depression. Would any of those who have contributed so far mind if I used your comments in my thesis? (referenced of course) Regards Jane course not - you're welcome regards phoebe Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 3, 2001 Report Share Posted July 3, 2001 I don't think HV would necessarily want to distance itself from nursing, but the problem at the moment is for nursing to recognise that HV has many points in common with nursing, but is not a subset of it. Getting recognition for that means that at present it is the points of difference which are being emphasised rather than the commonalities. As Betty said in her excellent letter (which have copied to Beverly Malone and Cumberlege) 'HVs are nurses, but health visiting is not nursing'. < > From: " Christensen " <jean@...> Date sent: Sat, 30 Jun 2001 21:16:45 +0100 Send reply to: Subject: RE: Mid-summer's debate [ Double-click this line for list subscription options ] I have read this debate with great interest over the last few weeks and have seen very valid points raised on both sides. I have to admit though to being a little alarmed at the fervour with which health visiting is seeking to distance itself from nursing. I qualified as a health visitor 26 years ago after an integrated training (SRN - yes, I am that old!, DN and HV). It was never my intention to be a nurse as I entered the training with the sole ambition of being a health visitor. However, out of that 26 years, I spent approx 10 years as a school-based school nurse, employed by the education authority. As a school nurse I would say that about half my time was spent doing " nursing " things ie. looking after children when they became ill in school or had accidents etc. A good deal of my time was also spent in the classroom teaching a wide variety of topics such as nutrition, accident prevention, hygiene, sexual health, smoking prevention, drug awareness, to name but a few. I also did a lot of one-to-one counseling, especially with young panic stricken girls who found themselves pregnant, and I did well-person clinics for the stressed out teachers after school had finished. My nurse training was invaluable to my role as school nurse and I could not have done the job without it. I can hear you all thinking - yes, but health visiting is DIFFERENT. Well, I suppose the job I do now as a health visitor is very different from my job as a school nurse, but I still use my nursing knowledge every day of my life (I can almost hear the gasps of horror coming towards me!!). Maybe I have a different vision of health visiting to the rest of you but I have always seen my role as providing HOLISTIC health care to a client/ family/ community. As we provide a universalist service it is inevitable that at any given time a certain proportion of the people we visit will be ill. We may not be visiting a person because they are ill, but if we are providing an holistic service then we cannot " ditch " them when they do become ill. Because of my training I can move quite happily from the medical domain to the nursing domain to the public health domain, as and when it becomes necessary. I consider health visiting to be a unique profession because of this - there is no other profession in health that has the ability to do this and we should be proud of it for that reason. Just like most other health visitors I feel very frustrated at times that I do not have the time to do the pro-active public health work that is so valuable, because I'm completely bogged down with routine surveillance work. I do not believe though that distancing ourselves from nursing will change that, and I do believe that a health visitor without nurse training will not be able to offer the same quality of service that can be offered today. How often have you visited an elderly person who has been prescribed medication by a GP who has not bothered to explain what they are for? How are you going to help an elderly person maintain their mobility and independence if you do not have an understanding of the illness that ails them? How are you going to help a young mother with cancer explain to her children what is happening to her without that nursing knowledge? Illness is a part of life and helping people cope with it has to be a part of our role or we cease becoming holistic carers. The answer to becoming more public health focused does not depend on what we are called or how we are registered, but on what we DO. We need to start documenting what we do in order to compile evidence of our effectiveness in the public health arena. We need clearly defined, irrefutable outcomes of clearly defined interventions that address clearly defined health issues. We need to compile caseload and locality profiles that are benchmarked so that we can " seek out health needs " and provided effective interventions to meet those needs. As I have mentioned on the SENATE previously, we have been doing this work in Swansea through our use of the Omaha System and I am convinced that it is the only way to change our role for the better. It is not sufficient to simply say that we are the best people to deliver the public health agenda - we have to PROVE it. Mid-summer's debate SENATE has dsiciplined me to be a regular email user, if I leave it too long I feel out of touch and behind the times! In response to alot of interesting comments (from HVs but few from SNs) I have the following to add: I am totally in support of building on the contribution of health visiting in the modern world of complex health and social needs. Health visitors have continued to respond to perceived and identified needs in a flexible and increasingly evidence based way. But I remain unconvinced that this cannot continue in isolation of other nursing developments. If HVs are to have a role with all age groups where does this leave all other nursing specialists and can HVs cope? Ruth, perhaps we need to be spending time on unravelling the skill-mix issue? Whilst I am protective of clinically graded nurses I do see a world of devolution where we have an ideal balance of skill and ability. Too often I hear very experienced and qualified nurses complaining about the lack of admin support. I sometimes wonder whether an investment in IT might have a longer term value than lower grade A & C staff. Not that I think all admin should be done by nurses, of course. , I welcome your suport for of collaboration. I really do believe this has to be a team effort reflected across all boundaries. , I have really appreciated your regular contributions to SENATE. Howver, your example of an holistic approach seems to align HVs with other community nursing groups but your final point is unclear. Having worked closely with SNs and CPNs you still seem to perceive the HV role as the lead role. There will be other times when the CPN and SN take the lead. Yes, HV may be unique but so too are other professional groups. Betty, I still maintain that nursing registration is integral to school nursing practice which means I have a problem with the notion that this is not necessary for health visitors. I would be really interested in your reasons for perceiving health visiting qualitatively different from nursing and midwifery. And where does school nursing belong? If health visiting is needed by the public is there a separate case for school nursing? I am by no means an anti-HV activist. Quite the contrary, I am seeking to build on their history in order to benefit the public. Coincidentally, I have been commissoned to write a book on " Succeeding as a Nurse " . Each chapter will be different but I really want to include a health visitor! Should I? Pippa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 3, 2001 Report Share Posted July 3, 2001 Dear , Agreed - Health visiting is much broader and encompasses so much more than just medical matters. My background in financial management consultancy and commercial management has been a great help to me. I has helped me think outside the NHS framework which I find is often based on precedence rather than strategy or logic. Regards, Ruth Grant MEERABEAU ELIZABETH wrote: > I don't think HV would necessarily want to distance itself from > nursing, but the problem at the moment is for nursing to recognise > that HV has many points in common with nursing, but is not a > subset of it. Getting recognition for that means that at present it is > the points of difference which are being emphasised rather than the > commonalities. As Betty said in her excellent letter (which have > copied to Beverly Malone and Cumberlege) 'HVs are nurses, > but health visiting is not nursing'. > > < > > From: " Christensen " <jean@...> > Date sent: Sat, 30 Jun 2001 21:16:45 +0100 > Send reply to: > Subject: RE: Mid-summer's debate > > [ Double-click this line for list subscription options ] > > I have read this debate with great interest over the last few weeks and have > seen very valid points raised on both sides. I have to admit though to > being a little alarmed at the fervour with which health visiting is seeking > to distance itself from nursing. > > I qualified as a health visitor 26 years ago after an integrated training > (SRN - yes, I am that old!, DN and HV). It was never my intention to be a > nurse as I entered the training with the sole ambition of being a health > visitor. However, out of that 26 years, I spent approx 10 years as a > school-based school nurse, employed by the education authority. As a school > nurse I would say that about half my time was spent doing " nursing " things > ie. looking after children when they became ill in school or had accidents > etc. A good deal of my time was also spent in the classroom teaching a wide > variety of topics such as nutrition, accident prevention, hygiene, sexual > health, smoking prevention, drug awareness, to name but a few. I also did a > lot of one-to-one counseling, especially with young panic stricken girls who > found themselves pregnant, and I did well-person clinics for the stressed > out teachers after school had finished. > > My nurse training was invaluable to my role as school nurse and I could not > have done the job without it. I can hear you all thinking - yes, but health > visiting is DIFFERENT. Well, I suppose the job I do now as a health visitor > is very different from my job as a school nurse, but I still use my nursing > knowledge every day of my life (I can almost hear the gasps of horror coming > towards me!!). Maybe I have a different vision of health visiting to the > rest of you but I have always seen my role as providing HOLISTIC health care > to a client/ family/ community. As we provide a universalist service it is > inevitable that at any given time a certain proportion of the people we > visit will be ill. We may not be visiting a person because they are ill, > but if we are providing an holistic service then we cannot " ditch " them when > they do become ill. Because of my training I can move quite happily from > the medical domain to the nursing domain to the public health domain, as and > when it becomes necessary. I consider health visiting to be a unique > profession because of this - there is no other profession in health that has > the ability to do this and we should be proud of it for that reason. > > Just like most other health visitors I feel very frustrated at times that I > do not have the time to do the pro-active public health work that is so > valuable, because I'm completely bogged down with routine surveillance work. > I do not believe though that distancing ourselves from nursing will change > that, and I do believe that a health visitor without nurse training will not > be able to offer the same quality of service that can be offered today. How > often have you visited an elderly person who has been prescribed medication > by a GP who has not bothered to explain what they are for? How are you > going to help an elderly person maintain their mobility and independence if > you do not have an understanding of the illness that ails them? How are you > going to help a young mother with cancer explain to her children what is > happening to her without that nursing knowledge? Illness is a part of life > and helping people cope with it has to be a part of our role or we cease > becoming holistic carers. > > The answer to becoming more public health focused does not depend on what we > are called or how we are registered, but on what we DO. We need to start > documenting what we do in order to compile evidence of our effectiveness in > the public health arena. We need clearly defined, irrefutable outcomes of > clearly defined interventions that address clearly defined health issues. > We need to compile caseload and locality profiles that are benchmarked so > that we can " seek out health needs " and provided effective interventions to > meet those needs. > > As I have mentioned on the SENATE previously, we have been doing this work > in Swansea through our use of the Omaha System and I am convinced that it is > the only way to change our role for the better. It is not sufficient to > simply say that we are the best people to deliver the public health agenda - > we have to PROVE it. > Mid-summer's debate > > SENATE has dsiciplined me to be a regular email user, if I leave it too > long I feel out of touch and behind the times! > > In response to alot of interesting comments (from HVs but few from SNs) I > have the following to add: > > I am totally in support of building on the contribution of health visiting > in the modern world of complex health and social needs. Health visitors > have continued to respond to perceived and identified needs in a flexible > and increasingly evidence based way. But I remain unconvinced that this > cannot continue in isolation of other nursing developments. If HVs are to > have a role with all age groups where does this leave all other nursing > specialists and can HVs cope? > > Ruth, perhaps we need to be spending time on unravelling the skill-mix > issue? Whilst I am protective of clinically graded nurses I do see a world > of devolution where we have an ideal balance of skill and ability. Too > often I hear very experienced and qualified nurses complaining about the > lack of admin support. I sometimes wonder whether an investment in IT might > have a longer term value than lower grade A & C staff. Not that I think all > admin should be done by nurses, of course. > > , I welcome your suport for of collaboration. I really do believe > this has to be a team effort reflected across all boundaries. > > , I have really appreciated your regular contributions to SENATE. > Howver, your example of an holistic approach seems to align HVs with other > community nursing groups but your final point is unclear. Having worked > closely with SNs and CPNs you still seem to perceive the HV role as the lead > role. There will be other times when the CPN and SN take the lead. Yes, HV > may be unique but so too are other professional groups. > > Betty, I still maintain that nursing registration is integral to school > nursing practice which means I have a problem with the notion that this is > not necessary for health visitors. I would be really interested in your > reasons for perceiving health visiting qualitatively different from nursing > and midwifery. And where does school nursing belong? If health visiting is > needed by the public is there a separate case for school nursing? > > I am by no means an anti-HV activist. Quite the contrary, I am seeking to > build on their history in order to benefit the public. > > Coincidentally, I have been commissoned to write a book on " Succeeding as > a Nurse " . Each chapter will be different but I really want to include a > health visitor! Should I? > Pippa > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 3, 2001 Report Share Posted July 3, 2001 Jane - I would have no objections to you quoting my comments to SENATE, although it seems from some of the messages I have read there would be some methodological problems for you to overcome in doing so. I wish you the best of luck with your research. -Jean- -----Original Message-----From: Jane [mailto:Jane.@...]Sent: 02 July 2001 09:37 Subject: Re: Mid-summer's debate This whole debate is fascinating, and resonates closely with things I am trying to say in my research MA looking at health visitors concepts of postnatal depression. Would any of those who have contributed so far mind if I used your comments in my thesis? (referenced of course) Regards Jane Jane Research Assistantc/o Division of General Praticetel. ext 66927 (prefix with 0115 84 if external line)>>> klm@... 1/7/2001 20:09:12 >>>on 1/7/01 7:51 pm, j.e.clifton@... at j.e.clifton@... wrote:I felt these skills proved more valuable than my rather outdated> nursing knowledge, and enabled a holistic approach to supporting families and> communities. I am not concerned about updating on medication, wound> management,and cancer treatments. If I need to know something of a medical> nature then I can research it or ask colleagues. I believe famlies have> benefitted as much from my `other skills` as from nursing knowledge and> believe that direct entry into health visitng would provide a diversity of> skills that could be both challenging and exciting.I would agree with this point of view - the best training i have ever donewas with the CAB and I feel it equipped me better for the work of healthvisiting than the health visitng course itself. I feel that the informationI have from my nursing background has been useful but the attitudes andvalues that go with that really get in the way sometimes. I certainly donot think I'd be a worse health visitor without the knowledge and experienceof being a registered nurse and the knowledge and skills I have brought tohealth visitng have been those aquired in working outside of the NHS.Interestingly a friend who is nurse and social work and CAB trained is inagreement with my views re the CAB training. I think that nursing has along way to go before itcan reach what I learned there about working withpeople from where they are.....phoebe Quote Link to comment Share on other sites More sharing options...
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