I'm a health visitor AMA

[CosmicTeacup]

I'm going to regret posting this aren't I?

Is it true that a really tidy house would "be suspicious" to you? Or is that one of those urban myths people tell you to make you feel better for being a slattern?

What would you be looking out for with a mum who has a baby with health issues? As in would this mother be at higher risk from PND? Do you offer anything as standard? (For context my 5.5m old has a very rare genetic condition and global development delay and I can't recall every being asked by my HVs I tend to see different ones each time if I'm ok?)

I think that HV's should all admit on their first visit to every parent that they have no specialist knowledge of child development and all concerns should be referred to a GP at the very least. I think having a HV who doesn't acknowledge the limitations of their knowledge and experience is more dangerous than having no HV tbh.
Having a HV who still couldn't accept or acknowledge her limitations and was thrown out of my ds's multi disciplinary assessment by the paediatrician made me determined that no HV would ever lay eyes on my dd and funnily enough the GP supported me in this.
I'd prefer that HV's were done away with and the funding given to enable clinics run by GP's tbh.

I found my hv was brilliant when I had my first and worried about everything. She was incredibly patient with me when I phoned her on a very regular basis thinking my pfb had a terrible disease.

Op, when does HV involvement stop? My youngest is 4 and we haven't seen a HV for a year or so and the one we were seeing has left. I'm not sure if we still have one.

What have you been most shocked by in your work?

What are the real warning signs to you that parents aren't coping/are neglecting children?

What sort of mad things DO people add to bottles?!

I’d like to say thank you too. Mine were all little rays of sunshine. I was reading the kids’ red books recently and it made me want to cry, seeing how much support and help they gave me.

Can I ask....I had a tough time after my twins were born (in retrospect I think I had PND) and I got visited a LOT. With the next one all was well and although I had all the normal visits, I had v few compared to with the twins. Is it standard to see twin mums more? Would you try and visit a struggling Mum more even without a formal diagnosis? All 3 kids were growing reasonably well.

I understand why health visitors get reports from a&e/miu but do you find that it'll put some parents off getting their children checked?

A lot of the mothers I know expected their HV to have a level of knowledge and expertise around the various technical/medical aspects of parenting that HVs just don't have because that's not what their training is for

I'm a paeds student nurse. Health visitors do have to be qualified nurses but not necessarily paediatric nurses. Still, they do need to have knowledge about the medical side of things. They do specific health assessments for looked after children.

I agree though that on the face of it 'Health Visitor' is a bit of a misleading name for their role as people interpret 'Health' to mean individual health and the role is there to improve public health, which isn't only done by reacting to medical need. So they end up being a strange mix of social worker, nurse, midwife, counsellor, educator and advocate. A massive driver in their role is improving factors that we know feed into long term health.

Shapely - yes they have medical knowledge, being nurses, and know how to carry out health assessments, etc but IME for example they don't have much in the way of detailed knowledge about things that aren't to do with generic public health outcomes unless they have specialised in that area previously. That's not a criticism - it's not their role to be able to answer complex questions about genetic disorders for example, but parents don't necessarily know that and then can feel let down because the person they see as being a medical support worker doesn't seem to have the necessary knowledge.

Completely agree @Spaghettijumper. That's sort of why I don't believe the name fits as it creates an expectation that isn't realistic, or even a part of their role.

Maybe we need to call them Public Health Workers? I think that would give a better message.

It seemed to me that in a number of situations HVs I and my friends met simply made up an answer to the questions they were asked, making it seem like an 'official' answer when it was just what they did themselves or something they came up with off the top of their head. I think some of them did that because they needed to seem knowledgeable and didn't want to admit that giving that sort of advice wasn't really their role.

I don't blame HVs for that - I don't think it's any accident that women sent out to support other women are given inadequate training and support, because the whole thing is seen as not very important and not requiring any actual research or expertise.

To be clear, I think there is definitely a role for a health worker to visit families, ensure safety, monitor health etc, I just don't agree with the way in which that responsibility is given to relatively low-paid nurses after a short amount of training, given what they have to deal with and I think the way in which the whole thing is 'sold' to parents is ridiculous. There is so much misogyny going on in the whole thing,as mothers are usually the focus - and mothers can't be actually engaged with as credible humans, they always have to be soft-soaped and duped - and the workers are usually women. It's a totally underfunded, under resourced and undervalued service that ends up trying to do an enormous job under the cover of other goals. Totally unnecessary.

Marks place

Sorry for taking over and ranting on your AMA, @cosmicteacup!

Spaghetti HV's have to do an additional degree course focusing on public health issues child development maternal mental health amongst many other things- the training is absolutely intense so i object to you making it seem like we have no idea

Funny how this thread is going. Perhaps the OP can confirm what the health is in the title then? Had a HV go pissy on me over the fact that I saw a paediatrician behind her back.. saying, oh you did then, ok, what do I know about babies health... then explained in her way what the diagnosis was, as if the paed diagnosis needed validation if you know what I mean

Yes they do have an intense training course, I know that dontbe. Then they're not given the time, funding or resources to actually fulfil the functions they're supposed to fulfil, because so little respect is given to what they are trying to do (improve outcomes for the entire population of the country). Meanwhile parents expect them to be able to advise on problems that they haven't been trained in because their role isn't to act as a medical reference. It suits the patronising, ridiculous system to have people believe that they're there to advise on health because of the misogynistic belief that if mothers hear the words 'health surveillance' they'll get all scared and womany and won't submit.

IMO it's for similar reasons that SureStart failed to reach the populations it was supposed to reach - because their approach was patronising and controlling and misogynistic with a nice dose of class contempt thrown in.

@DreamingofSunshine I think there's a lack of support for breastfeeding mums. I always recommend breastfeeding support agencies to my families where the mum has chosen to breastfeed but the uptake is fairly low.

@Fluffykins2014 no, I presume parents are competent unless they demonstrate otherwise!

@EssentialHummus your HV doesn't sound great. I'm always open and honest with families about why I'm there and what I'm looking for.

@Crunchymum I love a tidy house! I'd be concerned about potential PND if I thought the mum was too concerned though, I'd worry about how much rest she was getting

Spaghetti the SureStart centres in my area absolutely did reach the parts of the population they needed to despite the fact that for the last 4 or 5 years they were chronically underfunded.
Now they're shut they reach nobody and the children are missing out.
My team of hvs are fab, they backed me up with the gp when dc4 had cmpa and reflux, and referred to paeds and a dietician when the gp wouldn't. They saw me on the Car park of the gp when I was poorly and came over for a chat to see if they could help me in any way. They are all absolutely lovely and I know if I needed any support they would all go above and beyond to provide it. So, no questions from me just a huge Thank you to the health visitors on here

@Crunchymum and in regards to parents of children with health issues, they should be seen every 6 months as a minimum because while the child often gets extra support from other agencies the support for parents is lacking. You can always contact your HV for extra support and this should be made clear to you. I have a disabled child myself so I'm always concerned with how the parents are doing in this situation though.

What is your favourite part of your job?

I have seen various hv over my three children, some good and some terrible.
I find it really sad that our Sure Starts are closed and the baby weighing clinic is now done in the library, I think it is detrimental to mums who might want a private chat for support.

Do you know the book Known to Social Services? If so, what do you think of it?