Health service

Dupe Akinrinmade says: After completing GCSEs I wanted a job that was fun and exciting and that presented new opportunities and challenges every day. After completing a GNVQ level 2 in Health and Social Care, I was able to work in several placements involving children and the elderly in private, voluntary and local authority establishments. In one placement I was inspired by the playgroup leader. She had an excellent relationship with the children and parents in the group and really enjoyed her job. I then studied for the NNEB, which provided me with a good background in child development, which I regularly draw upon in my current work.

After finishing my NNEB course I worked as an agency worker in several inner London nurseries, before landing my first contract position in a social services family centre. After five years I had the option of applying to move up the career ladder or branch out into a different field of childcare. One day my attention was caught by an advertisement for a job that involved working with health visitors in a Community Trust in London. What attracted me was that it was still community-based and, unlike a managerial position, it would still give me direct experience with children.

I was successful in my application and began a three-month training programme within the Camden and Islington Community Health Services NHS Trust. I networked with different professionals and local agencies. I met speech and language therapists, child psychologists, social workers and voluntary outreach workers. All the professionals I met with were really keen that nursery nurses' skills and knowledge of child development were being implemented in the health visiting service.

Now, in a typical week, I work in two afternoon child health clinics based at the GP practice, where parents and carers can have a child weighed and measured by the clinic auxiliary. They can also discuss their child's health and development with a health visitor and nursery nurse. I also work two mornings a week with health visitors carrying out developmental assessments on two-and three-year-olds. This is a chance for the health visitor to observe the child and discuss any concerns the parents may have about their child's development.

My role in the clinical setting is to discuss with parents some ideas on play and stimulation at home and to consider nursery provision. Accident prevention in the home and safety issues when buying nursery equipment and toys are often a consideration. Other issues include toilet training, nutrition, tooth care, and how to deal with difficult behaviour. One afternoon a week I work alongside a National Childbirth Trust breastfeeding counsellor in a breastfeeding support group for new mothers.

The rest of my week is booked with home visits, which may involve short-term or long-term intervention with a family. A session with a family may be about the benefits of play and stimulation and ideas on how to introduce, for example, messy play with hands-on demonstrations. I may discuss different ways of managing difficult behaviour or sleep routines, or introduce new parents to local childcare facilities.

There is a lot of paperwork involved, making appointments for developmental assessments and so on, but training is offered to support this part of the job.

I would suggest that anyone interested in this line of work should be enthusiastic and friendly, work well in a team, have a sense of humour, be able to manage their own workload and have bags of energy!

The experience of working in a nursery has helped me give feedback to parents when discussing local childcare provision. I have been offered excellent training with the NHS Trust. Currently I am learning how to carry out Newborn Hearing Screening, for which the trust is a national pilot site. In the future I will be liaising with local groups to start a regular drop-in session for parents on child health issues such as glue ear, thread worms and head lice. I am always acquiring new skills and my role is constantly evolving.

A FURTHER STEP

Community nursery nurse Maureen Lajolie says: I left school quite early and I was already working in retail part-time, so I decided to work full-time. It was fun, and I was able to earn good money. But at the age of 21, I decided I needed a change. I spoke to a career advisor at the Job Centre , who discussed my interests, came up with working with children, and recommended the NNEB course.

After qualifying as a nursery nurse in 1990 I went to work in Canada as a nanny for two and a half years. There I volunteered at the Hugh McMalian Rehabilitation Centre for children who were learning how to walk, talk and feed themselves again after an accident or a major operation. I also studied and qualified there as an Early Childhood Educator, equivalent to the NNEB.

On my return to England I went to work in a family care centre that helped families who were living with terminal illness. After seven years there I was burnt out from working with families who are so needy, although I learned so much about life situations there. The centre sponsored me to do a hospital play specialist course, which came in useful in some of the work I was doing with children.

I had already thought about doing health visiting, but I knew I did not want to do nursing, so when I saw this job advertised in Nursery World I applied successfully.

I was a bit apprehensive at first, but the team I worked with at Camden and Islington Community Health Services NHSTrust were helpful, and I had a mentor who was very open-minded about skill mix, and knew what nursery nurses are capable of. At first it was work from the health visitors, things like addresses not known, checking if families still lived at their address, or giving advice to parents after their child had been at A&E.

Then I started getting work via six health visitors with families who had concerns about their child's behaviour or speech, feeding issues, nursery places, mother and toddler groups. In July last year the structure changed and I now work with a health visitor and community nurse on two caseloads.

A typical week for me is a Monday morning meeting with the health visitor and clinic auxiliary to make sure clinics are covered. In the afternoon I do some visits. Tuesday morning I help to cover the drop-in clinic giving all sorts of advice from weaning to behaviour, and Wednesday morning I do a newborn hearing screening clinic by myself; in the afternoons I do more visits. Thursday I am on day release at college, studying for the foundation degree in early childhood studies, which the Trust has funded. Fridays I usually do visits and tie up all my paperwork ready for Monday.

I am also involved in a project looking at the health needs of three-to five-year-olds. I attend two nurseries once a month and am available for parents if they have any worries. I discuss issues with the nursery teacher, and then speak with the parent to let them know what services are available. With their permission I make referrals to speech and language and clinical psychologists.

I feel my knowledge of child development is being used well. However, there is an issue around nursery nurses doing development checks that is still being looked into. I feel we are adequately equipped to do these checks because of our training and the plans we make for each individual child in nursery to promote their development.

I would recommend this position I'm in to other nursery nurses if they are interested in family-based work. The qualities you need for a job like this are to be really open-minded, and to take each family and their issues seriously even when you know the problem is something that will rectify itself eventually. That family at that particular time are experiencing difficulties and you can help ease the tension by giving some simple but important advice. There are some families with more complex needs who have to be referred on, so you must assess the situation and get other professionals involved.

There is some mixed emotion coming from the other professionals I work with. Some really welcome the skill-mix team and see its benefits. Others feel threatened that nursery nurses may end up replacing health visitors. However, since I joined the NHS 18 months ago there have been so many changes, with more on the way, that it is quite hard for people to settle.

The pay is not bad. Now more and more bits are being added to the job description - like any other job really!

Please note that Camden and Islington Community Services NHS Trust is a chosen national pilot site for the Newborn Hearing screening programme