Real-life story - Denise Ward
Denise is a specially trained public health nurse who delivers a structured home visiting programme which is offered to first-time parents under the age of 20. She visits the mother regularly from early pregnancy until the baby is two years old.
How I got into the role
I was working as a Health Visitor (HV) when I read an article about the Family Nurse Partnership (FNP) and knew family nursing was something I would like to do. The training programme was gradually being extended across the country (following earlier introduction) and I had colleagues who had trained in the first wave who suggested it might interest me.
My previous professional qualifications as registered general nurse and registered health visitor, as well as my experience and knowledge of working with communities and families, meant that I was eligible to apply. This next stage of professional development was attractive to me as the family nurse role was fairly new and I knew it would challenge and develop my clinical practice.
What I do
Overall my role as family nurse is aimed at transforming the lives of vulnerable young parents and their babies. I deliver a structured, evidence-based parenting programme to first-time parents between the ages of 13 and 19. The overall aim is to help young women to have a healthy pregnancy and to feel confident about supporting their baby to grow and learn.
The FNP programme originated in America and is gradually being rolled out in the United Kingdom. The programme itself is highly structured and involves a home visiting pattern from early pregnancy through to the child’s second birthday. Once I have recruited clients to the programme (it is voluntary), I work with them using a mixture of clinical methods and specific activities, and my style has to be one of guiding rather than directing. The programme is evaluated and I have a certain amount of data collection to manage, so I spend time on this in my daily duties.
Since successfully applying for the role, I have undertaken intensive training and had to ‘un-learn’ some of my previous work methods. The FNP training programme has supported me through my first year and helped me gain the skills and knowledge I need to deliver the programme and to work effectively with the target group. I also have the support of a supervisor and regular supervision sessions.
I work part time and have a caseload of 15 families. The work is quite intensive and I build a strong, trust-based relationship with clients. FNP goals include promotion of healthy lifestyles (such as reducing smoking and alcohol consumption) for the mother, as well as longer term economic benefits for the family through increased employment and education. My role also aims to improve child health and development and reduce child abuse and neglect.
The best bits and challenges
I really like that my work is based on a therapeutic relationship built on trust between myself and my clients. The work is both challenging and highly rewarding. Working with young people in itself may require compromise; I have to accept that they may prioritise other things over keeping an appointment with me, for example. Some of my clients have very unstable home environments and I have to accept that they don’t always see the value of the programme or professional input into their lives.
Some clients may be suspicious of authority and it can be a challenge at times to maintain their commitment to the programme once they have been recruited. It is hugely rewarding however when I see a client’s confidence grow and they begin to make appropriate choices for themselves and their child. Seeing them believe in themselves and reach for their aspirations makes my job so worthwhile. A client once said to me that in the past, all they bothered about for their baby was ‘every designer label’ but now realised that a baby needs nothing but a loving mum and that she knew she could now provide everything. This sentence from a 14-year-old mum really showed me the value of the FNP programme.
Life outside work
I recently decided to work part time because I also care for my disabled mother. I love gardening and family life in general keeps me busy.
Career plans and top tips for others
At this time I feel I am only just consolidating my learning and consider myself a fairly new family nurse (I’m just coming to the end of my first cohort of mums). I have no plans to change my career at the moment and just want to do my job really well.
Working with vulnerable young people can be intensive and demanding but very rewarding. You need to be prepared to take forward existing knowledge and skills but to leave some traditional client-based approaches behind and embrace new ways of working. You need to be comfortable with delivering a structured programme of care.