Guest guest Posted June 26, 2001 Report Share Posted June 26, 2001 Well said Gill, you are right we have been through many changes not least the public health debate, now finally re-surfacing, and hvs the profession who always believed in it in the first place. Many hvs including myself are of an age where we welcome a resurgance of these important issues and don`t want a wilderness experience before being re-invented. It is better to build on something rather than demolish and then re-design only to discover you have lost the skilled workforce in the process.Jeanette > I have been following the HV/SN/nursing/not nursing etc debate with great >interest. What a pity that many practitioners will not see it because they >don't choose to log on to senate. On the subject of practitioner >complacency I think Toity and are right about people being bogged >down by workload and -as percieved by many - yet more chnages in the >pipeline. I am concerned that this complacency really disempowers >practitioners. If you think back to what we have lived through during the >last 10 or so years HVs in particular have been so ground down by stuff >like GP attachment, then GP fundholding where things got so ridiculous in >Glos that one practice actually succeeded in preventing their attched HVs >from taking part in any public health work. Other GPs were instrumental in >shaping HV practice development to suit their own agenda so that some HVs >were forced into doing more and more medical model work, becoming glorified >handmaidens. These changes were achieved by some sharp negotiation with the >Trust(nurses in managers suits) whose sole motivation, it appeared, was to >keep GPs happy. This treatment of a skilled and unique workforce served to >bring morale to rock bottom, where it remains, despite the more recent >pro-HV/SN noises from Tony et al. > >When we add to this mess the handicap (and I do mean this) of being nurses, >the end result is a disempowered, stressed out and utterly fed up group of >practitioners. Can you imagine any other professional group letting this >happen to them? Take our esteemed colleagues the GPs - would they have >stood for other professionals, not even similarly qualified and whose >practice was based on a different model, deciding how they were to work? I >believe that our nursing background has socialised us into doing what GPs >ask and accepting changes to practice imposed by managers and others >without questioning it ; and because we are seen as submissive caring types >we are conditioned to follow the script although we grumble amongst >ourselves. Internal grumbling is pretty harmless and eventually subsides >because people become engulfed by the demands of the job. > >But now we need to do something bold and uncharacterstic of nurses: we need >to assert ourselves and tell politicians and those who make policy >decisions that actually HVs (AND SNs) offer a unique and irreplacable >service to the well population and we want to retain our professional >integrity and autonomy in order to protect both the service and its >consumers. I weclome my colleauges from school nursing to join the action, >if they can free themselves from nursing and align themselves with their >public health allies. > Digest Number 326 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 26, 2001 Report Share Posted June 26, 2001 Hear hear Gill. What would it take to convince practitioners to spare a few hours from their busy, ground-down lives to regain pride in and control of their profession? Gill Newell wrote: > I have been following the HV/SN/nursing/not nursing etc debate with great > interest. What a pity that many practitioners will not see it because they > don't choose to log on to senate. On the subject of practitioner > complacency I think Toity and are right about people being bogged > down by workload and -as percieved by many - yet more chnages in the > pipeline. I am concerned that this complacency really disempowers > practitioners. If you think back to what we have lived through during the > last 10 or so years HVs in particular have been so ground down by stuff > like GP attachment, then GP fundholding where things got so ridiculous in > Glos that one practice actually succeeded in preventing their attched HVs > from taking part in any public health work. Other GPs were instrumental in > shaping HV practice development to suit their own agenda so that some HVs > were forced into doing more and more medical model work, becoming glorified > handmaidens. These changes were achieved by some sharp negotiation with the > Trust(nurses in managers suits) whose sole motivation, it appeared, was to > keep GPs happy. This treatment of a skilled and unique workforce served to > bring morale to rock bottom, where it remains, despite the more recent > pro-HV/SN noises from Tony et al. > > When we add to this mess the handicap (and I do mean this) of being nurses, > the end result is a disempowered, stressed out and utterly fed up group of > practitioners. Can you imagine any other professional group letting this > happen to them? Take our esteemed colleagues the GPs - would they have > stood for other professionals, not even similarly qualified and whose > practice was based on a different model, deciding how they were to work? I > believe that our nursing background has socialised us into doing what GPs > ask and accepting changes to practice imposed by managers and others > without questioning it ; and because we are seen as submissive caring types > we are conditioned to follow the script although we grumble amongst > ourselves. Internal grumbling is pretty harmless and eventually subsides > because people become engulfed by the demands of the job. > > But now we need to do something bold and uncharacterstic of nurses: we need > to assert ourselves and tell politicians and those who make policy > decisions that actually HVs (AND SNs) offer a unique and irreplacable > service to the well population and we want to retain our professional > integrity and autonomy in order to protect both the service and its > consumers. I weclome my colleauges from school nursing to join the action, > if they can free themselves from nursing and align themselves with their > public health allies. > Digest Number 326 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 26, 2001 Report Share Posted June 26, 2001 Gill Your words are very sad but oh so true. But there is hope - I have found going in and working with groups of HVs (and other staff in the community who are feeling the same), once they realise someone is there to support and guide them - empowerment comes back. It does not seem to take long before they are questionning again and thinking widely and feeling able to develop their idea. Maybe there is something about not encouraging us - maybe the managers as we refer to are frightened of the power once it is unleashed and developed. And it is powerful and it is for the client and for inequalities not against the Trust - this for me is what we need to encourage the power to empower clients and really do soemthing about the inequlaities and people's health. I have great hope when I see places that are hell to work in grow and shine. I am sure we will get there. Margaret Digest Number 326 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2001 Report Share Posted June 27, 2001 Like others I have been following the nursing /not nursing debate etc with interest. Gills letter has prompted this reply because I felt it summed up many of the issues facing health visitors at the moment. Where I work HV's have recently been advied they will be expected to take on more work related to medical models and pathologies rather than health - most staff are part time and have a workload which embraces 0-5 screening, baby clinics, parenting classes, bereavement care, continence assessments, medical housing assessments, + a variety other things requested by GP's (including zimmer frame measuring!) Fortunately for me I am not working as a HV at the moment! we are just moving into self managed nursing teams (based around a group of GP practices) and I fear that this moves health visiting ever closer to a nursing identity which denies the unique contribution of the health visiting role. School nurses are at present to remain outside of this system because they are allocated to schools rather than practices. GPs have been very instrumental in shaping the role of HV's . Other professions in the area se health visitors as baby weighers and only ever ask for 'medical ' information from HV's in case discussions/planning meetings etc requests for other kinds of information go to social workers, family support workers, teachers etc. The culture within the Trust is not supportive of innovation as people seem to feel too ground down on the whole to take any kind of risks (a frequently heard position statement from HV's is that they keep their heads down and keep out of the way, getting on with their job quietly! - Nut Island syndrome?) although I suspect management would not agree with this. It is nothing like the profession I thought I was entering when I did my training 6 years ago. On a more positive noteI have been really delighted by the things said here as I feel that whilst there is such passion and feeling there may be still hope that someone will be able to carry out public health work somehow. I feel very passionately about health visiting but couldn't cope with working the way my colleagues have to do. I have thought for a while though that maybe health visitng will need to disappear and be reinvented before that can happen as it seems to me that nursing culture has such a strong hold on the way health visiting is managed and understood by others Phoebe. > I have been following the HV/SN/nursing/not nursing etc debate with great > interest. What a pity that many practitioners will not see it because they > don't choose to log on to senate. On the subject of practitioner > complacency I think Toity and are right about people being bogged > down by workload and -as percieved by many - yet more chnages in the > pipeline. I am concerned that this complacency really disempowers > practitioners. If you think back to what we have lived through during the > last 10 or so years HVs in particular have been so ground down by stuff > like GP attachment, then GP fundholding where things got so ridiculous in > Glos that one practice actually succeeded in preventing their attched HVs > from taking part in any public health work. Other GPs were instrumental in > shaping HV practice development to suit their own agenda so that some HVs > were forced into doing more and more medical model work, becoming glorified > handmaidens. These changes were achieved by some sharp negotiation with the > Trust(nurses in managers suits) whose sole motivation, it appeared, was to > keep GPs happy. This treatment of a skilled and unique workforce served to > bring morale to rock bottom, where it remains, despite the more recent > pro-HV/SN noises from Tony et al. > > When we add to this mess the handicap (and I do mean this) of being nurses, > the end result is a disempowered, stressed out and utterly fed up group of > practitioners. Can you imagine any other professional group letting this > happen to them? Take our esteemed colleagues the GPs - would they have > stood for other professionals, not even similarly qualified and whose > practice was based on a different model, deciding how they were to work? I > believe that our nursing background has socialised us into doing what GPs > ask and accepting changes to practice imposed by managers and others > without questioning it ; and because we are seen as submissive caring types > we are conditioned to follow the script although we grumble amongst > ourselves. Internal grumbling is pretty harmless and eventually subsides > because people become engulfed by the demands of the job. > > But now we need to do something bold and uncharacterstic of nurses: we need > to assert ourselves and tell politicians and those who make policy > decisions that actually HVs (AND SNs) offer a unique and irreplacable > service to the well population and we want to retain our professional > integrity and autonomy in order to protect both the service and its > consumers. I weclome my colleauges from school nursing to join the action, > if they can free themselves from nursing and align themselves with their > public health allies. > Digest Number 326 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2001 Report Share Posted June 27, 2001 I was so sorry to hear the sorry state Phoebe's colleagues are having to work with. I enjoyed reading the contributions from Gill Newell and Hurley - that's what I understand by health visiting. I'm a health visitor by trade but have a peculiar job - but it involves looking at a large number of Part 8 Reviews of child protection cases where a child has ended up seriously harmed, usually dead. In so many of these cases the restrictions that HVs have accepted upon their role and the limited home visiting this has involved are a common feature. I think this is a research study for a health visitor with the inclination to wade through sad tales of things that went wrong. But I am so concerned that everywhere there are HVs constrained from their proper work and being unable to look at the family issues which underpin parenting going wrong, child protection systems failing and kids getting some of the worst outcomes. It's an abiding shame that so few HAs, GPFHs, whatever, actually managed to come up with a decent specification for HV services which reflected the real work. All that investment and fuss and for what gain? I fear these disabled jobs. I know there are practitioners out there living with the guilt we all feel when something goes wrong on our caseload. Cannot we ensure that some of the clinical governance lessons are learned by NHS trusts who are overcompliant with unreasonable expectations of GPs, etc? Can't we get some of the accounatbility for these failures recognised by those who hold so much power for what they do? I'm hoping somebody out there can email me a really good service spec. > Like others I have been following the nursing /not nursing debate etc with > interest. Gills letter has prompted this reply because I felt it summed up > many of the issues facing health visitors at the moment. Where I work HV's > have recently been advied they will be expected to take on more work related > to medical models and pathologies rather than health - most staff are part > time and have a workload which embraces 0-5 screening, baby clinics, > parenting classes, bereavement care, continence assessments, medical housing > assessments, + a variety other things requested by GP's (including zimmer > frame measuring!) Fortunately for me I am not working as a HV at the moment! > we are just moving into self managed nursing teams (based around a group of > GP practices) and I fear that this moves health visiting ever closer to a > nursing identity which denies the unique contribution of the health visiting > role. School nurses are at present to remain outside of this system because > they are allocated to schools rather than practices. GPs have been very > instrumental in shaping the role of HV's . Other professions in the area se > health visitors as baby weighers and only ever ask for 'medical ' > information from HV's in case discussions/planning meetings etc requests for > other kinds of information go to social workers, family support workers, > teachers etc. The culture within the Trust is not supportive of > innovation as people seem to feel too ground down on the whole to take any > kind of risks (a frequently heard position statement from HV's is that they > keep their heads down and keep out of the way, getting on with their job > quietly! - Nut Island syndrome?) although I suspect management would not > agree with this. It is nothing like the profession I thought I was > entering when I did my training 6 years ago. > > On a more positive noteI have been really delighted by the things said here > as I feel that whilst there is such passion and feeling there may be still > hope that someone will be able to carry out public health work somehow. I > feel very passionately about health visiting but couldn't cope with working > the way my colleagues have to do. I have thought for a while though that > maybe health visitng will need to disappear and be reinvented before that > can happen as it seems to me that nursing culture has such a strong hold on > the way health visiting is managed and understood by others > Phoebe. > > > > I have been following the HV/SN/nursing/not nursing etc debate with great > > interest. What a pity that many practitioners will not see it because they > > don't choose to log on to senate. On the subject of practitioner > > complacency I think Toity and are right about people being bogged > > down by workload and -as percieved by many - yet more chnages in the > > pipeline. I am concerned that this complacency really disempowers > > practitioners. If you think back to what we have lived through during the > > last 10 or so years HVs in particular have been so ground down by stuff > > like GP attachment, then GP fundholding where things got so ridiculous in > > Glos that one practice actually succeeded in preventing their attched HVs > > from taking part in any public health work. Other GPs were instrumental in > > shaping HV practice development to suit their own agenda so that some HVs > > were forced into doing more and more medical model work, becoming glorified > > handmaidens. These changes were achieved by some sharp negotiation with the > > Trust(nurses in managers suits) whose sole motivation, it appeared, was to > > keep GPs happy. This treatment of a skilled and unique workforce served to > > bring morale to rock bottom, where it remains, despite the more recent > > pro-HV/SN noises from Tony et al. > > > > When we add to this mess the handicap (and I do mean this) of being nurses, > > the end result is a disempowered, stressed out and utterly fed up group of > > practitioners. Can you imagine any other professional group letting this > > happen to them? Take our esteemed colleagues the GPs - would they have > > stood for other professionals, not even similarly qualified and whose > > practice was based on a different model, deciding how they were to work? I > > believe that our nursing background has socialised us into doing what GPs > > ask and accepting changes to practice imposed by managers and others > > without questioning it ; and because we are seen as submissive caring types > > we are conditioned to follow the script although we grumble amongst > > ourselves. Internal grumbling is pretty harmless and eventually subsides > > because people become engulfed by the demands of the job. > > > > But now we need to do something bold and uncharacterstic of nurses: we need > > to assert ourselves and tell politicians and those who make policy > > decisions that actually HVs (AND SNs) offer a unique and irreplacable > > service to the well population and we want to retain our professional > > integrity and autonomy in order to protect both the service and its > > consumers. I weclome my colleauges from school nursing to join the action, > > if they can free themselves from nursing and align themselves with their > > public health allies. > > Digest Number 326 > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2001 Report Share Posted June 27, 2001 This is very concerning and sad but not in many ways enfamiliar. I think however there is hope. 's thought about using clinical governance is very important. What you write Phoebe is as you say a very medical interpretation. Look at the policy agenda - Saving Lives, Making a Difference and so on - clear direction for helath visitng and school nursing and it is not a medical agenda. I have been able to use this in a number of places to push forward and develop both health visiting and school nursing. It sounds like your Trust is using hvs to fill gaps because they are nurses - I wander. We are hoping from Senate to involve thise in practice more and to perhaps do some study days for areas using the information we have about practice and how it is and should develop. Incidently - which area are you Phoebe - it would be useful to know. Don't despair there is hope - you should be pushing the agenda not the GPS - could your PCG/PCT nurse reps help? Margaret Digest Number 326 > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 13, 2001 Report Share Posted July 13, 2001 In a message dated 7/13/01 5:35:27 PM Pacific Daylight Time, writes: > Joni!!!!! > Was you looking, Sweetie? > Did he have anything to brag about?? > LOL, > Now I know I am in the wrong profession!! > Trude You are absolutly right. There are alot of people out there who look sane and aren't. The other night we had a dentist (sorry Bill) checking in at our ticket counter here in Seattle. The agent who was checking him in couldn't see over the counter. The guy looked perfectly sane, but he didn't have any pants on!! True story, happened last week. Joni Trude UNFORTUANATELY I was off that nite. However, no one said he had anything to brag about....he he Joni > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2001 Report Share Posted July 14, 2001 No problem Joni! I rarely wear pants, and when I do, it is something unusual....say a fishnet or fake fur. B Re: Digest Number 326 > In a message dated 7/13/01 5:35:27 PM Pacific Daylight Time, > writes: > > > > Joni!!!!! > > Was you looking, Sweetie? > > Did he have anything to brag about?? > > LOL, > > Now I know I am in the wrong profession!! > > Trude > > > > You are absolutly right. There are alot of people out there who look sane > and aren't. > The other night we had a dentist (sorry Bill) checking in at our ticket > counter here in Seattle. The agent who was checking him in couldn't see > over > the counter. The guy looked perfectly sane, but he didn't have any pants > on!! True story, happened last week. > > Joni > > > Trude > > UNFORTUANATELY I was off that nite. However, no one said he had anything to > brag about....he he > > Joni > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 19, 2003 Report Share Posted May 19, 2003 Thanks everyone for the messages. I am happy I found this group. You all seem to have a realistic and optimistic view. I will need that later on as I have the surgery. Having had one years ago, I am never going to lose the dread of the first days post op until I experience this. It was cruel. Well, I know that it will be different, difficult, and an education. Thanks once again. Oh, to answer the question about the dogs. I found two organizations that support home study certification of service dogs ( physical assistance and canine companions). http://www.petsandpeople.org/ Also, this link really has much information and opportunities http://www.vetmed.ucdavis.edu/CCAB/dogsorgs.html#T. They are excellent resources for the working dog. My dogs, Beau and Rickey are both rescue Labradors who are going to obedience school and learning to be courteous, car proof, and able to go into stores, restaurants, church, school, and maybe even work. They are learning to sit, stay, let me lean on them, pull, carry, guide, back up, help me over things, and be all around companions. The real reason I started was because of the depression. I started experiencing that about three years ago. I was getting blinders on about people. I could not take the confusion, lights, and people nearly running into me at the mall, and in stores. So, I stopped going out. Well, when I found that there was a way to use a dog because of ADA accessibility and that I could train one and now two to do this with me I started out. Now Beau goes grocery shopping and to the swimming pool. She assists me in crowds and even went across the country in the passenger cabin with me last fall on the airlines. As I write more later I will answer questions and send you information. Thanks once again. we promise to persevere bless you anne, beau, and rickey Digest Number 326 > > Quote Link to comment Share on other sites More sharing options...
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