Health Visiting Placement

Abbi Jordan-Bland

Faculty: Health, Social Care & Education
Department: School of Nursing and Midwifery
Course: BSc (Hons) Child Nursing
Category: Nursing and midwifery

27 June 2018

During my second year, I had a placement with the health visiting team. 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 the hospital.

My role on this 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.

There were many different types of visits that health visitors go on including:

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 these types of 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 visit. This happens after the baby is born, usually when the baby is 10-14 days old. Health visitors will weigh and measure the babies’ height to ensure they have gained weigh since birth. They will also measure the babies’ head circumference; all of these measurement will be plotted in the babies’ personal health record or red book. This is a book that all babies have in which health care professional can write, to tell others about their development. They 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 very 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 (e.g. smoking guidance). They will then book in their next visit with the family. My role in these visits would be weighing, heighting and doing the head circumferences of the babies and again talking to the families about their babies seeing if there was anything they were concerned about.

6 week check. Health visitors will weigh and measure the babies’ height to ensure they have continued to gain weight which will all be plotted in their 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. Again my role was taking the weight, height and head circumference and also supporting families with their concerns.

1 year check. The care of the baby is then 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. At the 1 year check HFSW will ask families to fill out a questionnaire known as an Age and Stages Questionnaire (ASQ) before the visit regarding their babies development and what skills they feel their child can and cannot do e.g. 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.

2 year check. This is also completed by the HFSW and was a very similar visit to the 1 year check, but checked other skills that 2 year old 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 times 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 (e.g. eye tests).

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

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