I'm a health visitor, AMA

[KittyMcAllister]

Just as it says really!

I know we're not exactly the most well liked group on here but happy to answer any of your questions...

Apologies for typos the seeing mothers blossom really annoyed me. Who the chuff do you think you are?

Totally unnecessary @OhTheRoses - what a nasty post.

Whatever your feelings about your own HV, there's plenty of people, myself included, that's appreciated the support from their HV in those early days.

If you don't like the content of a thread then I suggest you don't read it instead of weighing in with a poorly spelt tirade against the well meaning OP.

*Ohtheroses
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Sorry for your experience.
I do use evidence based practice when asked for advice and hope it doesn't come across as patronising.
People are of course free to not have our services. For those that do, and get a positive outcome, especially when things have got off to a rocky start or when they have asked for our advice, well I'm happy for them.

@ohtheroses
Bee in your Bonnet much? Lots of people appreciate having a health visitor.
Bet your hv enjoyed coming to see you just as much as you enjoyed seeing her..

My HV was great in the early days.

Oh I have a question

Why did my health visitor look behind my baby’s ears on a few of her visits? Was she looking for cheese ?!

*Cutyourshakehole
*
No idea on that one!

Can I ask. What training you did and how long did it take to become a health visitor? Also if it's not too cheeky ( I understand if you would rather not answer this) what is the money like?
It's something I've thought of doing a few times but never properly looked into it .

I had a rocky start made rockier by an hv who didn't have the courtesy to make an apt, couldn't ad ise re immunisations, couldn't advise re bf except to tell me bf mothers put their babies first and ff mothers put themselves first.

I complained and her boss told me her role was to see if i talked to my baby enough for him to develop speech! The trust upheld my complaint.

Never saw a hv again and declined when my dd was born. Because they can't force you to use the service. My hv could tell me nothing a good book couldn't and expected me to queue up in a drs nexf to the sick people. If she ordered me to attend a clinic entirely reasonable in my book to make me an apt.

My eldest is now 23. The disempowsrment is still with me. Perhaps my really experienced 20 somerhing hv really thought she could make a woman in her mid 30s blossom.

To be a health visitor you have to be a trained midwife or nurse first (3 years) then do 1 year's postgraduate training at master's level. Like most of my colleagues I worked as a nurse first (for about 8 years) but you can go straight from nurse training to HV training and I know people who've done that. You can be any type of nurse first - adult, child, mental health or learning disabilities.

The pay is NHS Band 6 (£28k to 34k depending on experience).

Thanks 😊

I have a premature baby and, although my HV is lovely, neither her nor her team have a clue about the differing needs etc for prem babies.

Do you think that there should be specific people/teams who deal with development of prem babies?

I used to work on a neonatal ward and we had a dedicated "outreach" team that supported families post discharge with home visits often for a few months after babies came home, as the baby's needs are often complex and differ from term babies. Was anything like that offered to you?

Why can't the hv say "this is my role, if you feel i can support you, here are the i ic times and my contact details, we are here if you want us".

*Ohtheroses
*
I suppose we don't offer it as an "opt in" service as you describe because we feel it is important that everyone can access support in the early days of being a parent and that not everyone who needs it would reach out. For example in my area we visit a lot of immigrant families who may be isolated, not be aware of what services are out there or not be able to access them due to cultural or language barriers.

Of course, offering visits as we do to everyone means there are people who don't need or want our service. But there are important public health messages to deliver which are key to our role (safe sleeping for example) and which we feel everyone has the right to be aware of.

Again I'm sorry that such a poor experience has stayed with you. When I used the word "blossom" I didn't mean I necessarily had any part in the families' development, just that it was a nice thing to witness. I am not a 20 something and had my own children before training to be a HV, so I know how tough those early days are.

The outreach team visited occasionally for a couple of months, but prem baby needs differ for a lot longer than that.

The 1y and 2y checks for example should be carried out at corrected age not actual (when I pointed this out they moved the appt, but scored us against the checklist for the next age up ), they are likely to be much smaller for a while, be developmentally delayed in some areas. It's really important for HV looking after prem babies to understand the journey they've had, the experience and view them in the light of this, not suck through their teeth if your prem baby isn't on the growth chart/doing xyz.

It's very frustrating for parents to go through this with the HV and come away feeling as if their child is a failure. If it wasn't for the experts we already see (physio, dietician, speech therapist) assuring me that considering the history, things are looking just fine, I'd be wringing my hands constantly.

*Itscurtainsforyou
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It does seem like you have not HVs with the best understanding of your baby's needs. Reviews should always be carried out with an adjustment for prematurity precisely to avoid the feelings of failure you describe as it is unfair to assess a baby who was born 2 months' prematurely (for example) on the same lines as a term baby.

Op - unfortunately I don't think it's just me. Most if not all of the other mums of prem babies I know say exactly the same.

I believe that either everyone gets appropriate (better!) training on the differing needs of prem babies, or there should be specific recruitment of HV who specialise in looking out for premature babies.

I actually don't mind the HV system - I take/leave the advice or support as I see fit, but my latest experience has disappointed me a bit tbh as it feels like one size fits all, when it really doesn't.

This isn’t a question, just a comment to say that my experiences with HVs have been positive.

The HVs I’ve seen have all been friendly, helpful and supportive.
It’s just a shame that funding cuts are making it harder for them to be there to support families. Our local baby clinics were recently cut from weekly to fortnightly.

You can be any type of nurse first - adult, child, mental health or learning disabilities.

I'm not sure this is correct?

I was formerly (reg lapsed) a Mental Health nurse, on part 3 (was 13). I couldn't have got on to a Health Visiting course. As far as I understood, you had to be a general or children's trained nurse, or a midwife.

Why is it about what "you" feel though kitty and not something that is reached by discussion and mutual agreement with the family. It isn't a mandatory service
Whilst the hv service is obliged to offer visits families have no obligation to receive them. Why is that not made clear when it is absolutely the fact of the matter?

I am not deprived, English is not my second language. My babies were planned and wanted with marriage and a beautiful home coming first. Why wpuld a health visiter have tried to drag me down to the lowest common denominator? What wpuld have been wrong with congratulations instead of the dead pan mantra? What happened to we would like, may we offer, this is what is available rather than you will do. If I'm told I will or have to do something I will very reasonably ask why and expect an accurate answer. Not I can tell if you talk to your baby enough. How dare a hv say that when they are a visitor in my home, uninvited. Surely you see that?

I dont think ranting at one health visitor is going to change the whole service. If you feel strongly find a way to have your say. Don't make one person feel bad for their own profession!

Personally I had what I considered to be vague advice with my first but when the shit hit the fan with my second my hv (same one) stepped up and got me help and tbh if she hadn't just made the appointment and pushed it through there's no way I would have sorted it myself. Looking back I was confident and happy with my first, I also had huge family support so I can see why the hv just spent the bare minimum time with me.

I can't even remember my hv with my 3rd lol

Agree with curtains re prem babies. We had outreach out for 6w after the DTs came home from nicu. My HV is genuinely very nice but was not aware of TAMBA safe sleeping guides for multiples, Bliss guidelines for weaning premies or even who the Neonatal Outreach team were. She kept calling them midwives.

Just this week I was advised to think about weaning 20w old babies whose corr age is 15w!

Surely prematurity is not that rare??!

I've been really lucky and my HV has had great knowledge of having a premature baby. Everything has been done according to his corrected age not his actual and even if he hasnt met a corrected age milestone, she doesn't stress me out over it. She did three weekly visits for the first 6 months at home to weigh him and offer support and was brilliant when I was diagnosed with PTSD or when he had health issues. She helped me feel supported and confident so I definitely think that it is important for all HV's to have good knowledge of preemies and the effects of a premature birth on parents

We get it, OhTheRoses, you hate HVs, you can't believe they had the gall to not know you were special thanks to being married and middle-class and every one on earth needs to apologise to you for the actions of the one that visited you two decades ago. If you're still this upset about it 20 years later, then you need to talk to someone about it, preferably a professional, not on Mumsnet.

If there are no health problems, monthly is fine for the first 6 months but if someone chose not to come to clinic as they are happy their baby's growing/developing normally that's fine as well.

See, this isn't really a question but I find it interesting how few people read the guidelines about weighing in the red book. What it actually says is that, provided baby has regained birth weight and there aren't failure to thrive concerns, babies under 6mo should be weighed no more than once a month and babies older than that should be weighed no more than every two months. I've always been happy and confident that my two are growing well so I don't really bother, but I do see online a lot of mums who process this as "monthly is a minimum, more is better", get their babies weighed every week and wind themselves up terribly about every tiny fluctuation off a centile line.