Staying visible throughout a global pandemic
Published: 10 August 2021 to 31 December 2098
It’s been a challenging year for everyone. When the pandemic erupted over one year ago, no one quite imagined what would be to come for our NHS services.
Providing high standards of care to those in the communities we serve is at the heart of all that we do. This meant that, even in the most unfamiliar of times, our teams stepped up, innovated and adapted their ways of working to ensure that their services could still be offered, albeit in new ways.
While this wasn’t always possible, our Integrated Specialist Public Health Nursing (ISPHN) teams knew that the need for their services was too great to stand down.
There were several core areas that were greatly affected during this time, but our Health Visitors and School Nurses were among the teams who needed to change their services the most, due to rules around isolation, social distancing and school closures.
School Nurse – case study 1
“As a School Nurse team in the local area, we go in the schools to do drop in sessions. Before the pandemic, students could access our team members at specific times and just turn up to our area within the school for support when they needed it. Guidance around social distancing and school bubbles mean that the way we worked needed to adapt quickly, and throughout this process it was important that we worked closely with Teachers to ensure our support was still open to those who needed it.
Some young people used our Chat Health app during this time. This helped us to further identify students who may be struggling and how we could offer the kind of support they required. In one instance, we learned of a young female who contacted the app describing feelings of anxiety and low mood, we also learned that she didn’t feel she had a support system in place to help her with this, and in response we set up telephone support.
The young person documented a really lovely piece about their appreciation, for the level of support they received both inside of school and when they were sent home when schools were closed.
It later transpired that this young female was a carer, and that she had little to no support. We have worked with the individual for months now, ensuring she is a supported young carer and that she feels more comfortable to take on this responsibility with the correct support in place.
It’s moments like this that show how important that first contact is, which is why we know it’s so important to continue to reach out and show that we are open and available to young people, even in these ever-changing circumstances. We therefore must be flexible and innovate, with new ideas to help us along the way.”
“During lockdown and strict covid regulations I was really worried about not being able to access any support networks, or accessing them and not finding them helpful due to the lack of face to face connection. I got to a really low place and decided to reach out and was allocated a wonderful school nurse called [staff member]. Luckily, covid regulations had relaxed just enough that we were able to have a few in person drop in sessions which were more helpful to me than I could ever put into words. She helped me out of my darkest place and continues to help me now as I’m still not where I need to be. I'm not often in 6th form due to the same personal reasons I'm seeking support for and I am still able to be supported with phone calls from [staff member]. The phone calls have been just as helpful as our in person sessions. They've provided useful plans, self care tips and connections to over emotional support networks. They are consistent and still feel personal enough that I can be really open. Overall, I have never been short of support during the Covid period, the support has felt overwhelming in the nicest way possible and I am so thankful for all of it, and for [staff member].”
- Student 1
“Talking to [staff member] has helped me a lot. She has checked in on me a lot to see how I'm doing and helping me look at things in a more positive way and find small positives in big negatives. She asks about the small things that can make such a difference and I really appreciate the help from her. She always helps find a solution to any problems I'm having and she is really good to talk to about anything on my mind. Thank you :)”
- Student 2
Health Visitor – case study 2
“During the pandemic it was particularly important to us that we ensured that mothers in our local communities knew we were still open and available for support, albeit in different ways.
Becoming a parent in the pandemic will have been particularly challenging for lots of people, in lots of different ways. From restrictions at appointments and visitation, to support in those first few weeks with things like breastfeeding and home visits.
We needed to ensure that parents knew where they could go for support with these things.
As part of our change in services, I think one of the most practical and helpful things we did was introducing regular phone calls with our health visitors and breastfeeding specialists. We also continued to offer home visits as often as we could.
A good example of how we went the extra mile for our service users was when a woman contacted me [Health Visitor] to say that she had recently moved into the area from York with her 13 week old baby, and was seeking support for breastfeeding.
I reached out to the individual on the very same day to find out more about the support she required, and to arrange an appointment for her and her baby.
The lady reported multiple problems with breastfeeding, including pain. Due to the severity of her symptoms, I rearranged my diary to ensure that I could see her as soon as possible, and visited her at her home within a few days. Before my visit, I had pre-empted the need for a referral to our breastfeeding specialist, and made an appointment for the earliest time available.
At the appointment, I discovered that one of her main reasons for being so determined to breastfeed, despite the challenges, she had chosen not to give her baby immunisations, due to religious grounds, and therefore she wanted the baby to develop an immune system through her milk.
Luckily, the woman was happy to be referred to the breastfeeding specialist and was also advised to contact the children’s centre for further support. The lady has since been receiving ongoing support in this way.
By receiving timely contact from our team, the service user’s needs were assessed quickly and referral was made as soon as possible, with support provided in a timely fashion. Following this initial contact, the woman feels confident and able to contact her named Health Visitor for support, and is delighted to report that several months later, she is still exclusively breastfeeding her baby.”
“After recently moving to Beverley from York, I quickly registered with the Health Visiting team and was located (named staff) as my health visitor, she was quick to come visit me at home as I was struggling quite badly with breastfeeding and my mental health due to the lack of support I received in York. I can’t thank her enough, she referred me to a lactation specialist which saved my breastfeeding journey as I was about to quit, my mental health has massively improved and I’m still breastfeeding nearly 8 months later! Throughout this period, (named staff) also supported me by calling me once a week and was always quick to respond when I messaged her about any queries I had. She has also supported me with my sons allergies and eczema by referring him to a dietician. The service I have received has been outstanding, the best post-natal care I have received, it’s made me feel confident knowing that I have the support in place for my son and future children.”
- Service user 1
Health Visitor– case study 3
“Earlier this year, I was contacted by the head of a school to support a young boy in returning to school. The child had very severe allergies and asthma, and had been out of education for almost a year due to the pandemic.
I contacted the head as requested and I was informed that they needed a health care plan in order for the child to return to school safely. It was confirmed that mum wished for the child to return to school for the benefit of his social and emotional needs, as well as his academic needs. The child was also keen to return to school, along with his siblings and to be among his peers.
I visited the mother and child at home at the earliest opportunity, to find out more about his complex care needs and to develop a health care plan. Once complete, with mum’s consent and approval, I shared this with his two consultants in Sheffield the very same day.
One of the consultants replied the following day, agreeing to the management plan and proposals in place regarding the management of his severe allergies, and his asthma in principal, with a couple of additional recommendations.
As I did not get an immediate reply from the second consultant I forwarded the reply email from the first consultant, seeking feedback again within a few days.
The child has frequent medical appointments, and his mother spoke positively about their relationship with his consultants. I asked if she was able to discuss with the consultant about the proposed health care plan in order to enable its progression, as I had not received a reply, which she agreed to do, meanwhile I liaised with school to keep the progress going.
However, the child was due to have immunotherapy which would mean more time in hospital and a potential delay for returning to school. As time passed while I awaited updates on his treatment, I learned that delays had been experienced and that the young boy was also dealing with some other medical concerns. As a result, his consultant had advised that at this time he should not be attending school, and was best supported at home with his education.
Throughout all of the weeks that passed, I maintained contact with mum, school and the consultants. When the child’s treatments seemed to be complete, an appointment was set up so that we could develop a plan for his phased return to school. The plan described information about his complex medical condition, safe storage of medication, what constitutes as an emergency, when to call an ambulance, how the child may present and when, and how, to give him his prescribed medication.
On approval from the consultants, the child was indeed able to commence his phased return to school, and after discussion with mum, I was pleased to report that he was coping well and that the plan met his needs.
Thanks to the support from our team, the child will benefit from being in school with his peers. Although he has siblings, he will benefit from being among his own peer group, which is important for the development of his emotional wellbeing and social skills, in addition to supporting his academic needs.
We continue to support mum and child with his education health care plan moving forwards, which mum is supportive of and has expressed her gratitude for. School and mum both feel safer knowing that there is a robust plan in place, in the event of a clinical emergency for this child.”
“The medical professional involved with our son went out of her way to get him sorted with a health care plan and back to school. Worked well with all my son’s medical professionals and school to get him back to school safely during such difficult times.”
- Service user 2
As needs have risen, so has what the team have offered. The team recognised that this was no time to step down, and instead stood up and did everything they could.
We would like to take this opportunity to thank our ISPHN service teams for all that they have done and continue to do. Your work does not go unnoticed and these case studies are perfect examples of how much your roles are needed in our communities. Thank you.