What is the role of a Health Visitor? Guest Post.

Health Visitors – Oh groan! Mine was useless, never saw her, busybody, what does she know? Twin set and pearls, interfering, will report you to Social Services. I am sure you have heard all the stereotypical comments. Where do they come from? The giving and receiving of advice isn’t always easy, it’s difficult to embrace change and modify behaviour, especially when you receive conflicting advice from not only family and the media but health professionals too. Sometimes there is a way of saying things without causing offence or anxiety.  I like to think I was diplomatic but maybe I wasn’t always. In all professions there are the good and bad but on the whole I worked with some lovely ones.

One new client who answered the door to me, in response to my “Hi, I’m Jan your Health Visitor” responded with “What the Fuck do you want?” Admittedly they were a family with lots of issues, I never really managed to address them all, but eventually I was more warmly welcomed.

So what did I want? Basically to help a family achieve better health and offer support in difficult times. I passionately believe our biggest role after health promotion, early detection of ill-health and child abuse, should be support for mothers. All mothers, but particularly those with post-natal depression, baby loss and mental health problems. Some can be prevented, some can’t, but a lot can be helped with timely support and interventions which can ultimately lead to a better experience  with subsequent babies.

I spent half my 43-year career as a hospital based nurse, where I was highly respected and valued, the other half in the community as a Health Visitor, I was the same person but I had to work a lot harder to gain that same respect.

I worked as a Health Visitor at a time when we actively sought out mothers who were struggling by home visiting, as and when required. I have sat with mothers with tears in my eyes as they showed me photos and mementoes of their stillborn and poorly neonates and sudden infant death babies. I allowed them time to talk and grieve to enable them to work through the tragedies they endured. I visited for as long as they needed me. I can say that now as I am retired! I fear that we didn’t, and still don’t, support those who suffer baby loss and battle with infertility so well.

Times change and working practices do too, mainly due to financial restraints but sometimes it’s a false economy. Prevention will always be better than cure and in a nutshell that’s what Health Visitors do. Try to prevent ill-health, physical or mental. Politicians take note, it’s not a tick box exercise to show that we are tackling the issues of the day, because we are not. It is far cheaper and more humane to try to prevent.

Our role has changed slightly because of these constraints, a lot of our work is done brilliantly by Nursery Nurses and the development of Children’s Centres that offer support, drop-ins and play times for the under 5’s. I was privileged to be on the working group that helped launch our first Baby Cafe locally to support breast-feeding mothers. I was however mindful that whilst breast feeding is brilliant there are mothers who were unable to or didn’t wish to breast feed and they must not be made to feel second-rate or failing, because they are not.  What I do mourn is the loss of our autonomy, deciding who we think needs help.

My first Health Visiting job after training was based in a GP surgery and all his patients were my patients or clients as they are now called. I saw them at ante-natal clinic, ran ante-natal and post-natal groups and classes, visited after birth, did the developmental checks and ran baby clinics. I helped with the usual difficulties of feeding, sleeping, tantrums, toilet training, rashes and speech delay. I was a constant in their lives and in a good position to identify any mother who was struggling adapting to the steep learning curve that motherhood can be and able to nurture, advise and support without criticism or stigma.

Although times have changed and pressures increase, people don’t. They all need help and support from time to time and maybe the lack of familiarity of having the same Health Visitor or Nursery Nurse who knows you in good times and bad is missing. Nonetheless they still want to help you, so seek them out, don’t be afraid to ask, you shouldn’t be criticised, they won’t be trying to take your children away, they just want to help you reach better health and for your children to reach their potential. If they don’t they are in the wrong job and maybe you should ask to see a different one!



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