On placement with the health visitor

Child nursing student Abbi talks about her placement in health visiting, where she worked in the community with babies and their families. Health visiting is just one career you might go into as a registered nurse.

During my second year studying Child Nursing, I had a placement with the health visiting team.

My role on this nursing placement was to work alongside a health visitor, observing how they support families and learning the normal developmental stages of children from birth. My shifts were different to the hospital: Monday to Friday, 9am-5pm. My mentor usually picked me up or asked me to meet her before going to the first visit of the day and would drop me off after the last visit. This meant that she could brief me before each visit during the care journey and debrief afterwards in a confidential way.

What do health visitors do?

Health visitors are professionals that work with children 0-5 years of age and their families. They ensure that children have the best start to their lives and that parents/family members are supported with their parenting.

Families are visited in their own homes, GP surgeries, children centres and clinics (the community) rather than in hospital.

There are many different types of visits that health visitors go on. Here are just a few of them.

Antenatal visits

This is a visit before the birth of a baby, with the families. The health visitor can see if there are any factors that could potentially affect the child when they are born, and means that they can put in early interventions in for the families which will make it easier for them to care for the child.

For example, some younger mothers may be very anxious about having a baby and may be worried about their financial situation, therefore a health visitor can provide them with information about local support groups charities that may support young mothers.

During antenatal visits, my role was about talking to the mothers and asking questions about their pregnancy, seeing if there was anything they were worried about and reassuring them throughout. I found this very interesting as it related to how I work within a hospital setting and taught me a different approach to supporting families.

New born visits

This happens after a baby is born, usually when they're 10-14 days old. Health visitors will weigh and measure the baby's height to ensure they have gained weigh since birth. They will also measure the baby's head circumference; all of these measurement will be plotted in the baby's personal health record or 'red book'. This is a book that all babies have in which health care professionals can write, to tell others about their development.

During new born visits, health visitors will also check if the family have any concerns about their baby and offer advice regarding any worries. They may also offer feeding advice such as breastfeeding support if they feel it is needed at this stage, as it is a vital growth stage for babies.

Lastly the health visitor will tell the parents how to register their baby, how to sign up at the GP, what immunisations the baby needs, give advice about safe sleeping, and advice about having a safe house (eg smoking guidance). They will then book in their next visit with the family.

As a student nurse my role in these visits would be weighing, heighting and doing the head circumferences, and again talking to families about their babies to see if there was anything they were concerned about.

Six-week check

When a baby reaches six weeks of age, health visitors will weigh them and measure their height to ensure they have continued to gain weight; once again this will all be plotted in the baby's red book.

They will ask the family again if there is anything they are concerned about and provide support if needed. This is also the stage where the health visitor completes a post-natal depression questionnaire with mothers to ensure they are getting the correct support.

My role was taking the weight, height and head circumference and also supporting families with their concerns.

One-year check

Next, the care of the baby is handed over to a Healthy Family Support Worker (HFSW) who completes further developmental checks with the family. It is a little while until the family is next seen, however they are able to contact their health visiting team if they need to during this time.

For the one-year check, HFSWs will ask families to fill out a questionnaire known as an Age and Stages Questionnaire (ASQ) before the visit. The questionnaire is about their baby's development and what skills they feel their child can and cannot do, eg movement skills, communication skills, fine motor skills. The HFSW will then check this to confirm and can make referrals if they feel the child has significantly delayed development in particular areas.

During these types of visits I got the chance to lead; this meant I got to speak to the families to see whether they felt their child was able to do certain skills and if they had any concerns about their child's development. I also got to interact with the child to check that they were able to do the skills on the ASQ that the families said they could do.

Two-year check

Two year-checks are also completed by Healthy Family Support Workers. It was a very similar visit to the one-year check, but looked at other skills that two-year-olds should be working towards.

I got the chance to lead some of these visits, checking that the children were developing the way they should be. I also got the chance to spend some time with the school nursing team with slightly older children. This involved doing their heights and weights and in some cases I got to observe the eye tests that children participate in during their school years. I found it very interesting how the communication changed between the different ages and depending on what the task was (eg eye tests).

Reflecting on my health visiting placement

Overall, I learnt a lot during my placement. Although this is not an area of nursing that I thought I would enjoy, I did really embrace my placement with the health visitor. I feel I would consider it in the future after working in a hospital setting.

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Study nursing at ARU

Find out more about our nursing degrees, and studying at ARU, at one of our Open Days.

We've been training nurses and other healthcare professionals for more than 25 years, and you can choose to specialise in adult nursing, child nursing or mental health nursing with us. We also offer a Postgraduate Diploma in Specialist Community Public Health Nursing (Health Visiting or School Nursing).