Public health nurses working for all
There is no better time to remind people why immunisations matter. Finding and deploying a vaccine in response to the coronavirus (COVID-19) pandemic will be a critical factor in protecting lives in this country and across the world.
Many diseases are preventable through comprehensive population immunisation programmes, and reductions in the incidence of illnesses such as rubella, whooping cough, diphtheria and measles in England are directly attributable to this preventative approach.
World Immunisation Week has highlighted the vital role nurses and midwives play in championing this critical public health intervention. We should be incredibly proud of the work that continues every day in community health settings to prevent future widespread outbreaks that can kill or cause long term health problems for children, young people and adults. Acting now and ensuring parents and families continue to immunise their children during these unprecedented times will help reduce the risk of other disease outbreaks months and years after the current coronavirus ‘lockdown’ ends.
The importance of the continued immunisation programme is just one example of the vital and far-reaching role public health nurses have. Health visitors and school nurses will play a dynamic role, both at this time and when we begin to rebuild services to address the longer-term impact of this pandemic.
Children, young people and families are under immense strain. Nursery and school closures, social isolation, and virtual and digital services, in place of usual face-to-face services, all add to the complexity of family life, particularly for the most vulnerable families. It is crucial for parents, children and young people to continue to have access to support and advice in such uncertain and rapidly changing times. The NHS guidance about community services prioritisation sets out the services children and families should receive, including health visiting and school nursing services.
For children aged 0-5 the priority will be antenatal, new birth contacts and 6-week check for health visiting services, with a shift from face-to-face to virtual contacts using the phone or via video calls, unless there is a safeguarding or clinical need. Many health visitors and school nurses have been finding and adjusting to different ways to carry out their vital work within social distancing rules. We have worked with the Institute for Health Visiting (iHV) to develop new guidance to support this new way of working for health visitors.
For many parents the first few weeks of parenthood can be difficult and stressful. Having a crying baby can be worrying and difficult to cope with, even under normal circumstances. We have worked with ICON to develop a short animation focussing on preventing shaken baby. Please do share this with colleagues and families you work with. Health visitors can use their contacts to support new parents and to signpost to additional support if this is required.
We know children and young people appear to be less affected directly by coronavirus. However, there have been some concerns that children with underlying health conditions are presenting late. The Royal College of Paediatrics and Child Health have developed information for parents to help ensure they know when to seek help and get the right support for them and their children.
School nurses are used to working with technology to provide services, however the current challenges have made this even more important, particularly as young people struggle with anxiety and mental health issues. This will mean more virtual contacts to support children and young people, particularly the most vulnerable, including young carers. Responses so far show how incredibly adaptable school nurses have been and how committed they are to providing excellent care in new and unfamiliar circumstances. Please do direct children and young people to the Rise Above materials, where they will find useful tips on dealing with anxiety, sleep disruption and mental health issues.
Both health visitors and school nurses maintain their vital safeguarding role, using clinical judgement to determine when a face-to-face visit is required. Still carrying out universal contacts, while many services have paused, they are the eyes and ears for vulnerable children and families – protecting and safeguarding children. Where families do need to be seen, following an assessment, colleagues are rising to the challenge of community-based practice while observing social distancing and using personal protective equipment. Meanwhile, family nurses are also following guidelines to ensure that families can safely receive home visits, where needed, or virtual ‘visits’, ensuring that clients and their children are protected. Health visitors, school nurses and family nurses can use the NHS England safeguarding resources to support their practice.
COVID-19 has meant we have to change the way we lead our lives and the way we work. We are in unprecedented times. We face new challenges daily. It has never been more important to pull together, and we are all truly grateful for the way in which health and social care professionals and local communities, including businesses and voluntary sector organisations, have risen to these challenges.
Health visitors, midwives and school nurses are skilled in assessing and seeking out health needs; the scope of their work spans immediate response and long-term prevention. To all our public health nursing colleagues: your contact and support with children, young people, parents and carers at this moment is essential to ensure they are safe, healthy and supported. We will continue to work with partners to provide updates and revised guidance to support you to give the best support possible. We are immensely grateful for all you are doing to support families to be safe and healthy while staying at home, protecting the NHS and saving lives.