to want a fully qualified health visitor?

[MisselthwaiteManor]

I had an unannounced visit from a HV today, I'm 36 weeks pregnant with my first baby. She was an unaccompanied student.

I don't think she knew what she was doing and I didn't know what she was supposed to be doing either so it was all very awkward.

Are students normally accompanied by fully fledged HVs?

I'm annoyed, I am probably being precious but it's my first born and I have no family to ask for advice so I was actually looking forward to having a health visitor. Disappointed that the one I got was more bemused than me.

Her obvious discomfort whilst there, means that she is far from ready to carry out solo visits.

I agree with this I do think the Op should phone the health centre all the same and say how awkward it all was ,

Our area is the same as twas, you see your hv before and after birth. The visit is alwaus prearranged though.

Student hv are qualified nurses, doing an extra qualification, so they should not be inexperienced at communicating etc. Ring tge maon offoce and speak to someone to clarify the situation.

Ime though, the student hv are often more up to date, research based and have more time for listening and support. They are not so jaded/cynical/patronising as some old time hv (most of whom have to prioritise child protection cases anyway). So, I wouldn't rule out students entirely.

Meant to say as well that if the hv team are short staffed then perhaps their student is being pressured to take on work before she is ready - providing feedback may help her out.

Bird- they have already done 9 months of training which includes 50% practice working alongside a qualified HV before working alone

It is in the core HV programme to see all women antenatally in the region where I am. Many regions do not offer this yet for many different reasons but it is the ideal.
All HV students are qualified nurses, maybe even midwives, usually with loads of experience. I am very surprised that the student came unannounced. It is standard practice to at least ring first, usually with plenty of notice and often to confirm by letter.
A student HV will have been accompanied and observed on many similar visits before being released on the public unaccompanied.
I feel it should be brought up with her team as she is near qualifying. If that is the case than I fear for her in situations where she is discussing less than ideal parenting, drugs, alcohol and domestic violence and other more challenging parts of the bread and butter of the job, never mind facing aggrieved parents at case conferences and review meetings.
I would be inclined to follow it up, chances are she will come out again once baby is born and you obviously failed to hit it off.

Those of you who have had prenatal HV visits, what happened at yours? Was it any more than an introduction? Maybe my expectations were too high at this stage.

Yes I think it was the awkwardness that bothered me more than her being 'unqualified', I worded my OP badly. I have no idea what to expect from a health visitor so want them to be able to take the lead and know what they're doing here.

OP - whether it's normal in your area or not for an HV to visit pre-natally, I think it's worth a call to that health visiting team and discuss your experience with her supervisor so that he/she is aware that the appointment wasn't booked as it may have been the student's responsibility to do that, but she obviously didn't. Her supervisor also needs to know that she didn't exactly instil you with reassurance or confidence, especially as she didn't even seem to know what her own role was.

Whether she was fully qualified is neither here nor there at this stage for you as the midwives are still the bosses antenatally, and her interventions have no real bearing on you or the baby at this stage. But the fact that she's a crap student needs to be flagged up to her supervisor before she becomes a crap professional! If she is out on her own, she will be at the advanced stages of training so should be a lot better than that.

If her supervisor is any good, she'll take your feedback and deal with it from there, without involving you in any awkwardness. I'm an AHP who has supervised many students and would welcome (and urge) that sort of feedback from a patient.

If I phone in with feedback will they not tell her and make it even more awkward next time?

Luckily you keep your midwife until 6 weeks post birth in my area so I won't be totally alone if I never get on with the HV.

not at all they will just make sure she is better next time, TBH even if she was last on her placement or nearly qualified I still dont think she should have been out on her own, I know she has to learn and on the job is the best way but that doesnt help expectant parents, phone them and tell them she was lovely and all that but didnt put you at ease at all

I had a HV visit abouut 2 weeks before DD's birth (3 years ago, East Sussex). No reason at all other than it's standard here or was at the time

Sorry, I should have clarified the purpose of the antenatal visit.
On the whole it is about relationship building, introducing the role of the HV and the core programme, ie standard visit/HV contact schedule, clinic availability. The role of the childrens centres is also outlined.
Vital information such as safe sleeping, SIDS, shaken baby, what to do if baby ill, breastfeeding advice, expressing, or bottle feeding if indicated is also on the agenda. The midwives will possibly have touched on some of this but to be honest many women either don't get the relevant info or are overwhelmed by such a vast amount of stuff they aren't able to take it in.
The AN visit is really valuable to be honest.
OP really sorry yours wasn't great. Pleas ring up and let them know. I doubt they will tell her you rang, I'm sure it will be handled sensitively.

Just another one chiming in to say I met a HV before baby was born and it was to just have a chat about any previous pregnancies, any concerns I had and a bit of background about me and the dad.

I've also have a student HV (she still sees me at the moment). On the first visit she was accompanied by her mentor person and now she sees me alone. She's really good though and it definitely feels like she knows what she's doing. There was only one time she was unsure about something but she was confident with it if that makes sense and was honest and said she'd have to get back to me with it and she did. I think yours sounds like she's not really at that level yet.

My HV is a student, she's been to my house once and was great. I haven't heard from her since though, she kept referring to LO as 8 weeks when he was 12 weeks and I'm sure I should have had more visits/contact than nothing (this contradicts what ive just said about her being great but she gave me loads of advice!). My LO is now 6 months. I think it's usual practice for them to visit unaccompanied, my HV is a trained nurse and we had a conversation about her training etc. I was a bit worried but after all the midwife visits (10 different ones pp) she was a relief! I'd check with the health centre just incase but I wouldn't have thought you have anything to worry about. Like the pps have said, different areas do things differently.

The op said tat she did not have a clue what she was supposed to be doing, does not sound like someone about to qualify or professional

They might not tell her it was you who phoned, OP. They might just say 'one of the patients you saw'. Also, if you say when you give the feedback that you don't want things to be awkward for her, but mainly you when you've just had a baby, you can request that they not send her out to you again. A decent supervisor will not have a problem with that at all.

It may be that she's already known to be a weak student who they are desperately trying to both support while allowing her independence. As an introductory visit doesn't really have implications for the health of mother or baby, they may have thought it was a 'safe' way of letting her out on her own. She didn't do well at all with just the basics. They really need to know. Looking at worst case scenario, it's a lot easier to fail a crap student than de-register an incompetent professional who may have done some real damage by the time disciplinary procedures creak into motion.

To be honest, the qualified ones I saw were rubbish. Student ones couldn't be much worse.

We had an antenatal HV visit and she was a student as well, although the appt was booked in advance.
Ours was crisp though and started the conversation with " so any issues of domestic violence, rape, incest or sexual assault". "Er no" was our answer and there was a long silence before I showed her out. Really wished I'd complained at the time.

Ours was crap rather!

Well it's a whole lot of unknown. Health visiting is a really great career move for a qualified nurse/midwife. It's highly competitive and interviews are demanding. HV interpersonal skills, values, ethics and academic ability are scrutinized and the training is intensive.
Students have to learn. You might even find that a student will be better. She/he is likely to have a smaller caseload, be working reflectively to develop their skills and will want to give you a bloody good service!

I have also had a letter for my first meeting with my Health visitor. (again, surprised that the visit is before due date!) She is also a Student. I will be extra nice to her and will actually feel more confident as I'm sure she will be more open to questions and listening to any worries i've got that a 'dyed in the wool' practitioner.

good luck. I hope it goes well. If you are not sure about anything or are worried, just ask her/him! They will be glad that you are open and honest about worries you have and it will facilitate a better relationship.

Saying that though, i am also miles away from my family and didn't get on with my first midwife...she didn't have very good interpersonal skills and I didn't feel able to talk to her. She also got dates wrong and my 20 week scan was booked for 3 weeks late. I am having a high risk pregnancy and had i not followed my gut that she wasn't for me, could have had problems later. I cried after my 1st appointment.

If you are not happy after the first meeting, just request a change. Good luck

Never had a single one tell me anything I didn't know already (or that I didn't know was actually wrong). You didn't miss much. I'm just astonished they visited you at home. Ours won't even come to the local surgery.

Sorry OP. Just read the post again. Give her one more chance then ask for another one?

She ought to be clear about the purpose of the visit at least. If she can't be clear about that then that's a bit rubbish.

My health visitor first visited me at home at 37ish weeks. She also held one of our ante natal classes observed by a student HV.
Both my HV and the student visited shortly after DS was born but the student lead the visit while the qualified HV sat back and observed.

The student was due to visit me alone at 7/8 weeks but that particular day wasn't convenient so my usual HV visited instead. I would have had no problem with the student carrying out the visit by herself as she seems pretty competent.
the student also holds the baby clinics (with the qualified HV hovering in the background) so I've seen her frequently and I feel as though I have more a relationship with the student than my actual HV.

My HV turned up as the midwives signed off, really don't think I'd bother next time though.

I also live in Kent and saw my HV at home before the birth, they tend to work hand in hand with the midwives here, I got to keep my midwife for the full 21 days and HV visits at the same time because I had twins, twas bliss.

on the fact she was clueless, phone your HV and discuss your concerns, as others have said she/he will be a qualified nurse or midwife and should not be visiting unless they are competent to do so.

Maybe she got a message to see you not why and assumed you had asked for the visit, this happens to me all the time at work, told X has asked for a appointment, see x to find they had been told to ask for a visit but not why, very awkward.

If you're going to give feedback, it might be a good idea to mention that the visit was unannounced as well. I'd think it's good practice to let people know when to expect them?

I didn't see the HV until after DS was born and I'd been signed off by the midwives, but she turned up unannounced.

It was a bit awkward really, because she turned up first thing in the morning, saying that she was HV X, here to see baby, etc - and I had to say, sorry, but you can't see DS, because he's still in the neo-natal unit at the hospital on account of being premature and we're not really sure when he'll be discharged...

If they'd bothered sending a letter / phoning in advance, it would have stopped them wasting their own valuable time like that!