Parenting Rep - help needed!!

[susanmt]

I'm sure some of you will know I was asked to be parenting rep on our surgery patient group after I complained about our health visitor (an if you didn't and are interested it is on the thread 'I'm NOT a Gina Mum, but for those of you who are ....'.
Well - two things!
(1) The health visitor has resigned!! She is moving to be near her family. So they are looking for a new one
(2) Because they are looking for a new one they have decided to review the service. My remit is to find out what parents want from a health visitor. Mainly, I want to be left alone by the HV, so I'm not a good person to ask!!. I am going to do a lot of chatting at the playgroup and toddler group, as almost all the mums there are part of our practice (we are in a rural area), but I wondered if, through your great expertise and wisdom you could think of some good ideas - I'd like to spark off discussion and see if we could get what parents really want from a health visiting service. They are going to use any good ideas to write the job description!
Thanks for the help!!

Someone knowledgeable, fairly local and non-judgemental.

My first HV with DS1 was a matronly ogre. She dictated everything and scared me from doing things the way I wanted. Other HVs at our health centre are so slack and just can't make a decision. My current HV is great at offering advice and making suggestions without belittling you in any way. She is also a parent herself which I think is important. We have 2 drop in clinics each week but if you want to speak to a HV about a specific problem you have to ask them to come out to you.

Our old hv offered parenting classes over a 6/8 week period. They were pretty useful.

Batey - what kind of things did they cover? Sounds interesting, never seen anything like that offered round here.

We had postnatal classes too, they were really good, went when dd was about 7 weeks at first - 6 classes. Each week had a 'theme' - Postnatal depression (with local depression nurse), weaning (with hospital nutritionist), common illnesses (incl. vaccination), books (with local librarian) etc.

To be honest, a lot was about meeting other local mums and often the poor speaker had to struggle to be heard over the crying! But it was my first try at breastfeeding in public which was good, and definitely some useful tips.

I think HVs need to be available, helpful, perceptive, both hands-on AND hands-off as appropriate, reassuring, good at helping one mum while another baby is crying at baby clinic, down to earth, prepared to visit at home, knowledgeable.

A HV needs to be easy to get in touch with - there needs to be a clear and well-publicized way of contacting them.

I found the drop-in baby clinics a lifesaver when ds was tiny, because you could go along and get reassurance and advice about things that you suspected (as a 1st time mum) were too trivial to call the HV out for. Our local authority have really cut back on these recently and I think it's a bad thing.

HV should have good links with local baby clubs, toddler groups etc - our HV really encouraged me to go and again it was very helpful.

I would have gone to resuscitation classes too if they had been run at my surgery. Agree HVs should be non judgmental, friendly and available. Mine didn't have children and I didn't appreciate her advice about getting ds into a routine at 10 days old. Apart from that I'm not much help susanmt as I mainly wanted to be left alone too.

susanmt, another vote for the parenting classes run by our HVs at our local GPs. Six to eight weeks, sessions included teeth & gum health, weaning, baby massage, essential first aid, immunisation pros and cons (the HVs wisely acted as "facilitators" for that one and kept out of the hot debate, but a big thumbs up for acknowledging parental concerns on the issue), and a Christmas party, which was purely social and the last session. I am still in touch with one good friend I made through that group, and have nice reunions with about six others 2-3 times a year.
Also I think a good HV should offer:

A knowledge of the differing types of parenting book on offer, and a willingness to recommend a selection of titles (this was what sparked your involvement, wasn't it!)

A willingness to cut to the chase (off the record) as to which local GPs despise babies and which actually enjoy dealing with them and their parents

Local info such as where the best paed A & E is (assuming you are within 100 miles of one)

Lots and lots of URLs to pass on

A really fab HV would organise ongoing parenting sessions in the evening (as well as daytime, to reach as many parents as possible) on toddler taming, child development milestones, sibling rivalry, settling children in daycare/playgroup, etc. Aren't they responsible for the children until the age of five?

Good luck and well done you for carrying the cudgels. I hope they did not make you feel even 0.5% bad about your ex-health visitor leaving.

Wow, what a fab chance, Susan!

I think the ideal HV would firstly be one who knew where he/she was or wasn't wanted! They would not have their own agendas, which IME is quite common. They would offer wide-ranging proper research-based information, (especially WRT to breastfeeding) or be willing to refer on to others with information, so parents could make their own choices. They should support parents decisions, even if those decisions are against the 'party line', eg on MMR.

Education such as parenting classes is a great idea and I would also like to see something more 'woman oriented', such as a chance for mums to talk about how they themselves are doing. There are lots of issues after having a baby, maybe changed relationships with DH/DPs and other children, body image, if/when to return to work, coping with broken nights/crying and PND.

So many issues, so little time. Do let us know how it all goes - maybe this will be the first Mumsnet Approved HV!!

I would add to her job description some-one who is resourceful and is proactive (without being bossy and a bully !!!). Must be friendly, approachable and able to communicate. knowledgeable about ante-natal, babies and then toddlers, and the mother (remember they look after kids til they go to school, not just babies). Hope that gives you some ideas.

Susanmt ,good luck with this. I would just like to add that my HV was brilliant with prem babies but, most HV seem terrified by them which is not helpful to a new mum with a 3lb scrap at home ! THere needs to be far more training.

I think communication skills are especially important.

There are some great HV's at my practice, but my assigned HV is the least helpful. You ask her for help, spend some time explaining the problem and she sort of sympathises and then starts talking about somethig else. There's very little advice on offer and when your concerned enough to go and ask for advice that's not very helpful. She's nice enough, she just seems more interested in chatting than dealing with the job in hand. TBH I very rarely go any more. I don't know if that's any help

This is great folks! Keep up the ideas, the meeting is a week on Thursday so I am going to the playgroup this afternoon to chat to other Mums about what they want from a HV. Our HV also has to look after old people and be involved in teenage health, so we are looking for someone who can do it all!!

Hi Susanmt - this is a great chance to get just want you want.

I've been lucky with my HVs - they did the legal visits, but didn't force themselves on me and dd. They run a drop-in clinic every Tuesday for checking weight, general queries, etc. They have set up a parents (well mothers) group on a Tuesday morning - with external visitors invited to cover everything from childcare provisions to household safety. They are open to suggestions. So I'd suggest more of the same and a willingness to get information for unusual or obsure requests.

Hope this helps.

Our hvs are great even though one of them advised us to wean dd too early. They run under-ones sessions once a month which covers subjects such as first aid, home safety, play and stimulation and childhood illnesses as well as regular weaning talks which can take place in your home. There is also a twice-weekly drop-in clinic. I've found the hvs most useful for advice on weaning and sleep and would suggest that an awareness of food intolerence is helpful. Also I do think it helps if they are a parent too. Another thing that my hv is good at is suggesting local baby-friendly places to eat or to visit - perhaps you could compile a list!

I'm amazed reading this how much some of your HV's provide. I've had very little from mine except the routine checks. Oh and I was given a list of play groups and mother and toddler groups when I moved. That's about it.

My HV came round once when dd was 2 weeks old and I have never seen her since (dd is 5 now). lucky I didn't have pnd I have always thought.

My experience with my first HV was just like yours, CAM. There I was, having just had my first child, living in a strange town miles away from family and friends with my husband away (he was in the Navy) for three months. She visited me once when dd was about two weeks old to introduce herself and at the end of the (brief) visit announced that she wouldn't be back, unless I specifically contacted her, because "she found it too difficult to turn out of our street onto the main road." I never saw nor heard from her again.

What I would like from a HV

Sympathy and understanding when I (who hates needles at the best of times) cry along with my baby after immunisations.

resources to allow me to make an informed choice about immunisations/weaning etc. I feel the most important thing is for a HV to be impartial in teh advice they give and suport the decisions I make - not to try and make them for me.

My good HV informaly puts Mums in contact with each other when she feels they have similar interests/issues (only after asking their permission)

What I really didn't want fom my HV was what I got. At my 12 week pregnancy check up she saw me for a preliminary chat at which she explained her job as "looking out for the welfare of children and making sure they are safe at home"!! No mention of providing support for me. She then proceeded to ask me about my relationship with my mother. She died when I was v. young and I have a stormy (but currently excellent) relationship with my stepother. This was v. exciting for her as she was then able to use her amateur phschology to induce a crying fit in me whch lasted all evening, and suggest that I should see a shrink to work out my obvious "issues" with my mother as they would make me unable to bond with my baby.
Since the birth of my baby she has constantly criticised me for following GF (she wrote REGULATED !! in big letters in my notes at the 6 week check) and for my intention of returning to a high pressure job when DD was 4 months. After reading your experiences susanamt I am now about to draft a letter of complaint to my practice manager. She cannot be allowed to make anybody else feel as awful as she did me.

Prufrock, that's terrible and I'm really sorry this woman was allowed to make you feel this way. Please do write the letter.

I can say what I like and don't like about my HV.

I like her helpfulness re. suggesting ways to meet other local mums, either through drop-ins or classes. I also like her attentiveness and perceptiveness when examining/assessing ds.

On the flip side, I don't like it when she identifies problems that aren't really problems. So ds mumbles when tired; it doesn't mean he needs speech therapy! He's 2! And the fact that he interrupted me several times when I was talking to HV can't possibly mean that I need to take parenting classes in order to learn to curb that kind of (normal, IMO) behaviour. I almost had the sense she was finding problems in order to justify her existence, and the existence of those parenting classes she was trying to push. But mostly I left feeling demoralised--and I was 8.5 mos pregnant with #2, not an ideal time for HV to imply that I don't know what I'm doing as a parent!

My HV was lovely, if a little patronising. She was in on our ante natal classes, and did these meditation sessions every week. We'd get the gen about looking after baby an then she'd play this "relax...pretend you are in a baloon" tape...for half an hour. She had the sing song voice of someone from Barbados (Ithink thats her origins), she had children herself, and she was lovely. But she also sounded like she thought I was in primary school, even when I tried to talk to her like an adult. I remember talking to my son when I was changing his nappy and calling it his pee pee, and her remonstrating with me and saying I should call it his penis.....durr...this really annoyed me.i did lke her though, bt just wished she'd let me get on with it.

i went through some university study about development as well, but suddenly felt paranoid after the third session. I just wanted to get on with it without being judged.

my experience of HVs is they are really nice but a bit dippy.I think some of them make things up as they go along.

Folks this has been brilliant. I am going to look so knowledgeable and wellresearched come Thursday! It is very interesting because what you have said ties in really well with what local mums are thinking - great minds think alike.
When we have a job descrpition I'll let you know what has been included!