Embedded Files
Working with the multi-disciplinary team
For many school nursing teams, communication with professionals from other disciplines improved during the pandemic. This was driven by:
· safeguarding concern
· online multi-disciplinary and strategic meetings
· a willingness to share information across disciplines in the best interests of the child.
With the need to travel for meetings removed as many continue to be online, school nurses are able to attend more meetings. This results in increased presence and visibility of the school nurse within the multi-disciplinary team. The SN specialist knowledge has been increasingly appreciated within the multi-disciplinary team. New partnerships have emerged through creative working during the pandemic. For example, conducting joint home visits with social care, or working closely with the home education team.
However, the expanded workload arising from the increasing safeguarding needs and health issues for CYP, particularly in mental well-being, is notable. This has been exacerbated by specialist services ‘closing their doors’, during the pandemic or currently having long waiting lists due to demand. This leads to SNs holding an increasing, and increasingly complex and acute caseload. In addition the relentlessness of 'back-to-back' online meetings also contributes to 'the hamster wheel of managing' with 'no head-space to reflect'.
The suggested activities take the group from considering the challenges for the team related to multi-disciplinary working, to considering the role of the school nursing team in a changing health landscape, and how to communicate the school nurse team role to other professionals.
Activities
Multi-disciplinary collaboration
‘It was always very difficult to get police, always difficult to get education involved, and school nurses, all in one area, but actually I think the new way of working really helped. I think using the online facilities really, really helped. And that’s something that I really want to continue with.”
. Show this quote via powerpoint or read it out. Give space for any general reaction.
What happened?
Ask the group whether they would agree with this? Can they give examples of successes and challenges of working with any other professional groups?
How do you feel about this?
Note down examples given on a whiteboard/flipchart and add any emotional aspects of the group response alongside – i.e. frustration, really pleased etc. Consider prompting where necessary.
If there is a general focus on challenges, ask specifically whether there have there been successes in collaborative working, and explore these in the same way.
(15 mins)
4. Look at the following quotes via powerpoint or read out. Give space for any general reaction.
What happened?
5. Ask the group whether this reflects their experience.
How do you feel about this?
6. Note down examples given on a whiteboard/flipchart and add any emotional aspects of the group response alongside – i.e. frustration, really pleased etc. Consider prompting where necessary.
The aim of this section is to encourage reflection on how school nursing teams tend to absorb increased workload and whether, and how, this should be boundaried.
Reduced availability of specialist support services
“We started to pick up the slack from other services, because we were on the frontline, we were back in the schools, we were available. CAMHS were not, their doors were shut. The GPs [general practitioners] were not, their doors were shut… People couldn’t access any other services, so started to come to school nurses, which we took on, because that’s what we do.”
Safeguarding role
"We are good at not losing sight of the child in the safeguarding process, being the voice of the child. But we should be in those meetings for a clearly defined purpose. The best health agency should attend, it shouldn’t always fall on the school nurse if there is another agency in more regular contact with the child."
Understanding the role of the school health service
“The council think of some new initiative – we’re already doing that… Even our commissioners don’t know what we do. Managers don’t really understand the school nurse role; there are not enough managers with school nurse experience. As we are no longer based in schools – teachers, parents and the children are not aware of the school nurse. We need to resell our service, re-educate people about the role. We need a national promotion of the school nurse role."
7. Look at this quote via powerpoint or read out. Give space for any general reaction.
What happened?
8. Ask the group whether this reflects their experience.
How do you feel about this?
9. Note down examples given on a whiteboard/flipchart and add any emotional aspects of the group response alongside.
The aim of this section is to encourage the group to think about how to effectively communicate the SN and school nursing team role to other professionals.
(15 mins)
Does anything need to change?
Did the previous activities identify a need for action? Listen out for where this may have been mentioned in the previous activities, and make a note for consideration at this point.
10. Ask the group as a whole to identify one area where there is a need for action.
11. Workshop a plan of action according to the SMART criteria – specific, measurable, achievable, realistic, timely. Ensure that this incorporates a forum when this will be formally reviewed i.e. an agenda item in a team meeting and a named person who will take this forward. It is helpful to write the plan on flip-chart paper for reference.
(15 mins)
If your session ends here the evaluation form is here.
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