Your qualifications and references have been scrutinised, criminal records checks completed and you are ready to be placed with a family and start looking after children. But are you really ready for any possibility? Would you know what to do in the event of accident and injury?
According to a shocking survey last year (see box), two-thirds of parents are unsure whether their childcarer would know what to do in a medical emergency. And parents themselves are even less clued up, with nine out of ten surveyed ignorant of basic first aid which could save their child's life.
Roma Felstein, a journalist and broadcaster, knows the true value of having a nanny trained in first aid. When her son Toby swallowed a coin and it got stuck in his throat, her South African nanny did not panic and knew exactly what to do to get it out. 'I was standing beside her in the kitchen when it happened and I was left open-mouthed in admiration,' says Roma. 'She lifted him up and slapped him across the back in exactly the right spot and it came out. It showed me how important first aid training is for anyone looking after children.'
But Roma now knows she was very lucky to have had a nanny who had up-to-date first aid training. Many who have obtained an NNEB or similar qualifications will have learned first aid, but that knowledge may be inadequate unless they have have updated their skills at regular refresher courses, while unqualified nannies may never have done a first aid course.
And the situation among au pairs is even worse, as Roma and her colleague Tina Lazarus discovered three years ago when they set up Safe and Sound - a company specialising in providing first aid training to childcarers and parents.
Tina first got an inkling of the scale of the problem when she accompanied her au pair to a first aid training course and realised immediately that there were acute language barriers to au pairs learning anything. As a former language teacher she decided to help by setting up pre-course glossaries and exercises to familiarise au pairs with the content of the paediatric first aid course. In close co-operation with a paediatrician and an accident and emergency children's nurse, she and Roma began to develop their own training materials.
Tina recalls, 'We ran a pilot course just for au pairs. We had 12 girls, and nine of them didn't know what number to dial for an ambulance and, in many cases, they were being left in sole charge. It was really shocking. Au pairs are often too scared to tell the parents they work for that they would not know what to do if an accident happened. As parents we tend to bury our heads in the sand and say "this will be fine".'
Such indifference to first aid training can have serious consequences. Tina knows of one case where a small boy collided accidentally with an au pair who was carrying a cup of coffee and he was badly burnt on the arm. 'The au pair's first instinct was to put the boy's arm under cold water - a correct response. However, his ten-year-old sister intervened and told the au pair to put hydrocortisone cream on the burn - completely the wrong thing to do.
If the au pair had been trained she would have taken the lead as the only adult there, and put the arm under cold water for ten minutes.'
Despite these risks, Tina says parents are reluctant to foot the bill for first aid training, even though at around 60 it's a small price to pay for peace of mind. As a result au pairs currently represent only 10 per cent of the participants on Safe and Sound's courses.
The courses, which all comply with British and European resuscitation guidelines and are written and edited by qualified medical professionals, including paediatricians and paediatric nurses, provide 'the basic life-saving skills that will enable anyone who is looking after children to know what to do in an emergency', says Roma. The Lifesaver course includes intensive practice in resuscitation and covers basic life support, shock, the recovery position, choking and drowning. The Essential First Aid course deals with bleeding, burns, scalds and electrocution, meningitis, febrile convulsions, allergies and stings, simple fractures, head injuries, treatment of shock and poisoning.
Claire Jackson, a London nanny who attended a Safe and Sound course in her employer's home, says she was impressed by the practical nature of the course and the close attention the trainers paid to ensuring all participants carried out procedures, such as resuscitation, correctly. 'It wasn't a case of someone looking out into a big room and saying to everyone "that's fine". We were watched one by one,' says Claire.
Oliver Black, a director of the Tinies chain of agencies which organises first aid courses, says, 'The key is to have a course which is paediatric-focused, very practical and which people are going to remember without feeling they have to keep looking things up in a booklet, and that means it must be interactive.'
Catherine Lennon, 29, who is currently a maternity nanny for a young baby, found that the course organised through Tinies allowed her to update her skills so that she could cope with the demands of looking after a newborn.
'With older children it tends to be plasters on knees, whereas working with newborns you have to know about resuscitation, because there are occasions when babies forget to breathe, there is the danger of cot death and you have to be particularly on the ball when they have their first immunisation,' Catherine says.
Safe and Sound now trains nannies, parents and schoolteachers. Agencies such as the London Au Pair and Nanny Agency and Platinum Nannies, whose management have done the first aid course themselves, are now committed to ensuring their nannies attend as a condition for obtaining work.
Maggie Dyer, who runs the London Au Pair and Nanny agency, attended the course when she had to look after a grandchild last year. She says, 'Recently qualified nannies will have resuscitation skills that are bang up-to-date, but there are many experienced, unqualified nannies, who are excellent at the job, but who do not know what to do in an emergency.'
Cressida Hoblyn of Platinum Nannies believes that proof of first aid skills should be among the essential prerequisites to getting a nanny job, along with references and criminal record checks. 'Since our agency is run by mothers, we are very hands-on over this issue,' she says. 'While there is no regulation of nannies, the first aid issue can only be regulated by agencies being responsible and insisting that their nannies update their first aid knowledge.'
Tricia Pritchard, professional officer at the Professional Association of Nursery Nurses, says, 'PANN believes that not only should a first aid certificate be a condition of obtaining insurance, it should be a condition of employment.' PANN, she says, urges its nanny members to 'become first aid-trained and to ensure that they regularly renew their training'. She adds, 'They not only need to be fully trained in first aid procedures, they need to be able to apply that knowledge in a calm way, often taking care of siblings at the same time as the emergency.'
Tricia has encountered instances where untrained nannies have failed to recognise the vulnerability of their position, acted inappropriately when an incident has occurred and then been summarily dismissed by parents who failed to check whether their employee had first aid training.
Sarah Barringer of the Aegis nanny agency says, 'In the past few weeks in my area of south-west London we have had three confirmed cases of bacterial meningitis. This brings home the necessity for everyone looking after children to be first aid-trained. Children can die of this form of meningitis very quickly unless the symptoms are recognised.'
She says her agency plans to organise courses with the St John Ambulance, and is confident that the Government will eventually introduce a nanny register and that this will be the key to ensuring nannies undergo proper first aid training.
ALARM BELLS.
* Every year more than half a million under-fives need to go to hospital accident and emergency departments after accidents in the home.
* Nine out ten parents in Britain do not know simple first aid procedures which could save their child's life.
* Two-thirds of parents think their child's carer would not know what to do in an emergency.
* Only 8 per cent of babysitters would know what to do.
* Two out of ten babies and young children have an accident while being looked after by a carer such as a grandparent, friend or childminder.
* Nineteen per cent of parents have watched their child choke and 69 per cent did not know what to do.
* Twenty nine per cent of young children have 'swallowed a chemical such as soap powder' and 91 per cent of parents did not know what to do.
* Fifteen per cent of babies and young children have fallen down the stairs through a stairgate and 75 per cent of parents had no idea what to do.
Source: The Mother and Baby Save a Life Campaign 2002, backed by Tesco and St John Ambulance
RESOURCES.
For details of first aid courses and other information contact: * Safe and Sound on 020 8449 8722D Tinies on 020 7384 0322D Aegis on 020 8392 658 Useful books: * Pocket First Aid, produced jointly by St John Ambulance, St Andrew's Ambulance Association, British Red Cross, published by Dorling Kindersley (4.99) (see our reader offer on page 4) * First Aid for Children: a step-by-step guide for giving first aid to babies and children (2001/2002), free from St John Supplies on 0207 2782779
