Guest guest Posted February 4, 2002 Report Share Posted February 4, 2002 Xena, as always, you have a helpful knack of asking questions that get completely to the heart of the matter and help to unravel the confusions. 1. The reason why health visiting first embraced nursing as a pre-requisite for entry to the training was because, in the 1950s/early 1960s, there was real concern that health visitors would be overshadowed by the (then) new, graduate profession of social work. Health visiting did not seem very academically credible, so they latched on to nursing as a respected practice qualification (Maura Hunt, 1972 and Jane 1982, were the researchers who documented this). It is fascinating that so many current discourses accuse (as in last week's Nursing Times/anti- Houston letter!) health visitors of being 'elitist' when so many health visitors still rely on nursing to give themselves any claim to 'status' and credibility. 2. The problem with this approach, is that it means that you only have to develop nursing to retain any credibility. It doesn't matter if health visiting has no credibility, because we can always claim to be nurses. This is what has happened, especially since the UKCC took over health visiting regulation from the CETHV in 1983. Gradually, the emphasis has shifted from nursing being a good basis from which to develop, to being the only thing that is considered important. All the attention has moved to the entry points for training, so that now the learning outcomes/standards for the health visiting course (in the community health care nursing framework) are all optional; up to local arrangements. That is, of course, in line with other post-registration nursing courses, which are about developing nurses' skills for a local situation. It is not in line with other pre-registration courses (nursing and midwifery), where learning outcomes are specified in the statutory training rules and must be met because, once qualified, the registrant may move around and the qualification is a 'lifelong' basis for practice, so consistency (and thus credibility) are required. 3. The other confusion stems from the perception that, if health visitors don't spend three years on a pre-registration nursing course, they cannot/will not learn anything that nurses know. But if you shift to an 'outcomes-based' programme, then students have to learn everything they need for the job. So anything we think is relevant from nursing that is necessary to do the job of health visiting, would have to be learnt before a student could register as a health visitor. Drawing on my PhD, I think health visitors gain a great deal from the 'therapeutic caring' skills of nursing (also shared with humanistic psychology). So, taking your example of the LA community development workers: if they wanted to become health visitors (and I think it would be great to recruit some of them) I think students have to do enough nursing to learn about that. Probably they would need to learn a bit about 'the body' and physiology and a bit of pathology and a lot of health as well; other people would have their own 'wish list'. Nurses may know about those things already, but they need to learn about community development, group work skills, positive health and sustainable developments, that the CD wokrer already knows. Both would need some input about home visiting, forming relationships, normal childhood developments etc. 4. These days (unlike in 1962, when nursing became a pre-requisite for health visiting), we have lots of experience of modular courses and accrediting prior experience, so it is not really a problem to arrange different routes to a qualification. The key (which we have currently lost for health visiting) is that, in the end, all students have to have learnt the same things: what we think they need to do the job. That is what the UKCC consultation document, at the end of last year, was all about; trying to specify what those learning outcomes would be. My personal preference, once we have agreed what the standards based on those outcomes will be, would be to see two alternative routes to qualification: A) a three year, direct entry degree in health visiting for recruits that have no other academic qualifications: but just think of all the wonderfully suitable people that could be recruited, like nursery nurses, community mothers, community workers, bilingual link workers etc a two year, full time Masters programme as a multi-disciplinary entry for those who already have a 'relevant' degree (including nurses, who, especially among those who qualified in the last 10 years, are increasingly graduates). I would envisage a 2 day a week practice placement in the first year and giving service for 2-3 days a week in the second year, so that a CPT could lead a corporate caseload with at least one second year student contributing 'real' service under supervision. That would make it very affordable in workforce planning terms as well as giving the opportunity for a really effective education as well as opening up new ways of working in the practice situation; whereas our current programmes are far too limited and blinkered to do that. Thanks for asking the question! In November 2000, June and I debated the motion that 'You do not have to be a nurse to be a health visitor'. The transcript is available on /files/Debate in case anyone is interested. Best wishes Xena Dion wrote: > Can anyone explain the difference between direct entrance health visting and the community development workers who are doing all the public health work with the local authority. I am not purposefully trying to sound like an old luddite, but one wins a great deal of professional credibility with families coming from a nurse background. It also provides a great deal more conviction when discussing health issues when one has been exposed to nursing, again, I wonder if there needs to be a balance. > Xena > > >>> margaret@... 01/31/02 08:36pm >>> > Hi Bev > > There are a number of us who are Sennate meembers who have pushing direct > entry health visiting for some time. > > There is a lot of resistance from nursing and unfortuneately the CPHVA also > who see health visiting as part of the family of nursing. We lost the > argument to have health visiting in the title of the NMC because of that. > > We did have a debate last year and I will find it on the computer and e-mail > it directly to you - you will I am sure find it interesting. > > Margaret > Re: HV priorities > > > > > > Sounds to me (again!) like a good reason for getting rid of the > restrictive practice that says only nurses can enter health visitor > training! We have so much to lear from other disciplines; the public health > profession is embracing multi-disciplinarity, but health visiting is not > being allowed to. > > > > Xena Dion wrote: > > > > > As an aid to help HVs pool workload a little, we did an exercise to > identify what work was considered high, medium or low priority (based on > around 25 HVs' choice). This is attached as it may interest some of you. > These are health visitors who are moving well towards the 'new ways of > working' coming together with other agencies and disciplines etc. and > generally quite well informed about current events in the health agenda. > However, it shows how, despite knowing where we are going, the everyday > reality is that when we identify need within families or groups that is > where our priority lies - the immediate 'crisis' or problem. I think we get > very sucked into people's problems, and as I have said often before, are not > provided readily with the skills to help people move on and sort their own > problems out. It is still the nurse in us that wants to help people and > 'make things better'. essentially this is why we come into the profession > though, and I think that needs to be remembe > > > > > > red as it may be a barrier to moving into more general public health work. > > > Just a thought, Xena > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 5, 2002 Report Share Posted February 5, 2002 et al, I totally agree with you all, I just feel compelled to be the devil's advocate and promote the questions that the health visitors are asking, which is no bad thing. This is a critical time to review the longterm direction health visiting is going in, and I think the balance has to be exactly right between maintaining the family centred public health role and the wider community population groups focused role. I, like many others, believe you are right on track, Xena >>> sarah@... 02/04/02 10:28pm >>> Xena, as always, you have a helpful knack of asking questions that get completely to the heart of the matter and help to unravel the confusions. 1. The reason why health visiting first embraced nursing as a pre-requisite for entry to the training was because, in the 1950s/early 1960s, there was real concern that health visitors would be overshadowed by the (then) new, graduate profession of social work. Health visiting did not seem very academically credible, so they latched on to nursing as a respected practice qualification (Maura Hunt, 1972 and Jane 1982, were the researchers who documented this). It is fascinating that so many current discourses accuse (as in last week's Nursing Times/anti- Houston letter!) health visitors of being 'elitist' when so many health visitors still rely on nursing to give themselves any claim to 'status' and credibility. 2. The problem with this approach, is that it means that you only have to develop nursing to retain any credibility. It doesn't matter if health visiting has no credibility, because we can always claim to be nurses. This is what has happened, especially since the UKCC took over health visiting regulation from the CETHV in 1983. Gradually, the emphasis has shifted from nursing being a good basis from which to develop, to being the only thing that is considered important. All the attention has moved to the entry points for training, so that now the learning outcomes/standards for the health visiting course (in the community health care nursing framework) are all optional; up to local arrangements. That is, of course, in line with other post-registration nursing courses, which are about developing nurses' skills for a local situation. It is not in line with other pre-registration courses (nursing and midwifery), where learning outcomes are specified in the statutory training rules and must be met because, once qualified, the registrant may move around and the qualification is a 'lifelong' basis for practice, so consistency (and thus credibility) are required. 3. The other confusion stems from the perception that, if health visitors don't spend three years on a pre-registration nursing course, they cannot/will not learn anything that nurses know. But if you shift to an 'outcomes-based' programme, then students have to learn everything they need for the job. So anything we think is relevant from nursing that is necessary to do the job of health visiting, would have to be learnt before a student could register as a health visitor. Drawing on my PhD, I think health visitors gain a great deal from the 'therapeutic caring' skills of nursing (also shared with humanistic psychology). So, taking your example of the LA community development workers: if they wanted to become health visitors (and I think it would be great to recruit some of them) I think students have to do enough nursing to learn about that. Probably they would need to learn a bit about 'the body' and physiology and a bit of pathology and a lot of health as well; other people would have their own 'wish list'. Nurses may know about those things already, but they need to learn about community development, group work skills, positive health and sustainable developments, that the CD wokrer already knows. Both would need some input about home visiting, forming relationships, normal childhood developments etc. 4. These days (unlike in 1962, when nursing became a pre-requisite for health visiting), we have lots of experience of modular courses and accrediting prior experience, so it is not really a problem to arrange different routes to a qualification. The key (which we have currently lost for health visiting) is that, in the end, all students have to have learnt the same things: what we think they need to do the job. That is what the UKCC consultation document, at the end of last year, was all about; trying to specify what those learning outcomes would be. My personal preference, once we have agreed what the standards based on those outcomes will be, would be to see two alternative routes to qualification: A) a three year, direct entry degree in health visiting for recruits that have no other academic qualifications: but just think of all the wonderfully suitable people that could be recruited, like nursery nurses, community mothers, community workers, bilingual link workers etc a two year, full time Masters programme as a multi-disciplinary entry for those who already have a 'relevant' degree (including nurses, who, especially among those who qualified in the last 10 years, are increasingly graduates). I would envisage a 2 day a week practice placement in the first year and giving service for 2-3 days a week in the second year, so that a CPT could lead a corporate caseload with at least one second year student contributing 'real' service under supervision. That would make it very affordable in workforce planning terms as well as giving the opportunity for a really effective education as well as opening up new ways of working in the practice situation; whereas our current programmes are far too limited and blinkered to do that. Thanks for asking the question! In November 2000, June and I debated the motion that 'You do not have to be a nurse to be a health visitor'. The transcript is available on /files/Debate i n case anyone is interested. Best wishes Xena Dion wrote: > Can anyone explain the difference between direct entrance health visting and the community development workers who are doing all the public health work with the local authority. I am not purposefully trying to sound like an old luddite, but one wins a great deal of professional credibility with families coming from a nurse background. It also provides a great deal more conviction when discussing health issues when one has been exposed to nursing, again, I wonder if there needs to be a balance. > Xena > > >>> margaret@... 01/31/02 08:36pm >>> > Hi Bev > > There are a number of us who are Sennate meembers who have pushing direct > entry health visiting for some time. > > There is a lot of resistance from nursing and unfortuneately the CPHVA also > who see health visiting as part of the family of nursing. We lost the > argument to have health visiting in the title of the NMC because of that. > > We did have a debate last year and I will find it on the computer and e-mail > it directly to you - you will I am sure find it interesting. > > Margaret > Re: HV priorities > > > > > > Sounds to me (again!) like a good reason for getting rid of the > restrictive practice that says only nurses can enter health visitor > training! We have so much to lear from other disciplines; the public health > profession is embracing multi-disciplinarity, but health visiting is not > being allowed to. > > > > Xena Dion wrote: > > > > > As an aid to help HVs pool workload a little, we did an exercise to > identify what work was considered high, medium or low priority (based on > around 25 HVs' choice). This is attached as it may interest some of you. > These are health visitors who are moving well towards the 'new ways of > working' coming together with other agencies and disciplines etc. and > generally quite well informed about current events in the health agenda. > However, it shows how, despite knowing where we are going, the everyday > reality is that when we identify need within families or groups that is > where our priority lies - the immediate 'crisis' or problem. I think we get > very sucked into people's problems, and as I have said often before, are not > provided readily with the skills to help people move on and sort their own > problems out. It is still the nurse in us that wants to help people and > 'make things better'. essentially this is why we come into the profession > though, and I think that needs to be remembe > > > > > > red as it may be a barrier to moving into more general public health work. > > > Just a thought, Xena > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 5, 2002 Report Share Posted February 5, 2002 Thanks Xena. Although if people don't agree, that's alright too; we need the debate and that doesn't mean insisting that everyone has the same viewpoint. Xena Dion wrote: > et al, I totally agree with you all, I just feel compelled to be the devil's advocate and promote the questions that the health visitors are asking, which is no bad thing. This is a critical time to review the longterm direction health visiting is going in, and I think the balance has to be exactly right between maintaining the family centred public health role and the wider community population groups focused role. I, like many others, believe you are right on track, Xena > > >>> sarah@... 02/04/02 10:28pm >>> > Xena, as always, you have a helpful knack of asking questions that get completely to the heart of the matter and help to unravel the confusions. > > 1. The reason why health visiting first embraced nursing as a pre-requisite for entry to the training was because, in the 1950s/early 1960s, there was real concern that health visitors would be overshadowed by the (then) new, graduate profession of social work. Health visiting did not seem very academically credible, so they latched on to nursing as a respected practice qualification (Maura Hunt, 1972 and Jane 1982, were the researchers who documented this). It is fascinating that so > many current discourses accuse (as in last week's Nursing Times/anti- Houston letter!) health visitors of being 'elitist' when so many health visitors still rely on nursing to give themselves any claim to 'status' and credibility. > > 2. The problem with this approach, is that it means that you only have to develop nursing to retain any credibility. It doesn't matter if health visiting has no credibility, because we can always claim to be nurses. This is what has happened, especially since the UKCC took over health visiting regulation from the CETHV in 1983. Gradually, the emphasis has shifted from nursing being a good basis from which to develop, to being the only thing that is considered important. All the attention has > moved to the entry points for training, so that now the learning outcomes/standards for the health visiting course (in the community health care nursing framework) are all optional; up to local arrangements. That is, of course, in line with other post-registration nursing courses, which are about developing nurses' skills for a local situation. It is not in line with other pre-registration courses (nursing and midwifery), where learning outcomes are specified in the statutory training rules and > must be met because, once qualified, the registrant may move around and the qualification is a 'lifelong' basis for practice, so consistency (and thus credibility) are required. > > 3. The other confusion stems from the perception that, if health visitors don't spend three years on a pre-registration nursing course, they cannot/will not learn anything that nurses know. But if you shift to an 'outcomes-based' programme, then students have to learn everything they need for the job. So anything we think is relevant from nursing that is necessary to do the job of health visiting, would have to be learnt before a student could register as a health visitor. Drawing on my PhD, I > think health visitors gain a great deal from the 'therapeutic caring' skills of nursing (also shared with humanistic psychology). So, taking your example of the LA community development workers: if they wanted to become health visitors (and I think it would be great to recruit some of them) I think students have to do enough nursing to learn about that. Probably they would need to learn a bit about 'the body' and physiology and a bit of pathology and a lot of health as well; other people would > have their own 'wish list'. Nurses may know about those things already, but they need to learn about community development, group work skills, positive health and sustainable developments, that the CD wokrer already knows. Both would need some input about home visiting, forming relationships, normal childhood developments etc. > > 4. These days (unlike in 1962, when nursing became a pre-requisite for health visiting), we have lots of experience of modular courses and accrediting prior experience, so it is not really a problem to arrange different routes to a qualification. The key (which we have currently lost for health visiting) is that, in the end, all students have to have learnt the same things: what we think they need to do the job. That is what the UKCC consultation document, at the end of last year, was all > about; trying to specify what those learning outcomes would be. My personal preference, once we have agreed what the standards based on those outcomes will be, would be to see two alternative routes to qualification: > > A) a three year, direct entry degree in health visiting for recruits that have no other academic qualifications: but just think of all the wonderfully suitable people that could be recruited, like nursery nurses, community mothers, community workers, bilingual link workers etc > > a two year, full time Masters programme as a multi-disciplinary entry for those who already have a 'relevant' degree (including nurses, who, especially among those who qualified in the last 10 years, are increasingly graduates). I would envisage a 2 day a week practice placement in the first year and giving service for 2-3 days a week in the second year, so that a CPT could lead a corporate caseload with at least one second year student contributing 'real' service under supervision. That > would make it very affordable in workforce planning terms as well as giving the opportunity for a really effective education as well as opening up new ways of working in the practice situation; whereas our current programmes are far too limited and blinkered to do that. > > Thanks for asking the question! In November 2000, June and I debated the motion that 'You do not have to be a nurse to be a health visitor'. The transcript is available on > /files/Debate > i > n case anyone is interested. Best wishes > > > > Xena Dion wrote: > > > Can anyone explain the difference between direct entrance health visting and the community development workers who are doing all the public health work with the local authority. I am not purposefully trying to sound like an old luddite, but one wins a great deal of professional credibility with families coming from a nurse background. It also provides a great deal more conviction when discussing health issues when one has been exposed to nursing, again, I wonder if there needs to be a balance. > > Xena > > > > >>> margaret@... 01/31/02 08:36pm >>> > > Hi Bev > > > > There are a number of us who are Sennate meembers who have pushing direct > > entry health visiting for some time. > > > > There is a lot of resistance from nursing and unfortuneately the CPHVA also > > who see health visiting as part of the family of nursing. We lost the > > argument to have health visiting in the title of the NMC because of that. > > > > We did have a debate last year and I will find it on the computer and e-mail > > it directly to you - you will I am sure find it interesting. > > > > Margaret > > Re: HV priorities > > > > > > > > > Sounds to me (again!) like a good reason for getting rid of the > > restrictive practice that says only nurses can enter health visitor > > training! We have so much to lear from other disciplines; the public health > > profession is embracing multi-disciplinarity, but health visiting is not > > being allowed to. > > > > > > Xena Dion wrote: > > > > > > > As an aid to help HVs pool workload a little, we did an exercise to > > identify what work was considered high, medium or low priority (based on > > around 25 HVs' choice). This is attached as it may interest some of you. > > These are health visitors who are moving well towards the 'new ways of > > working' coming together with other agencies and disciplines etc. and > > generally quite well informed about current events in the health agenda. > > However, it shows how, despite knowing where we are going, the everyday > > reality is that when we identify need within families or groups that is > > where our priority lies - the immediate 'crisis' or problem. I think we get > > very sucked into people's problems, and as I have said often before, are not > > provided readily with the skills to help people move on and sort their own > > problems out. It is still the nurse in us that wants to help people and > > 'make things better'. essentially this is why we come into the profession > > though, and I think that needs to be remembe > > > > > > > > > red as it may be a barrier to moving into more general public health work. > > > > Just a thought, Xena > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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