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Working in school nursing teams
This section explores how school nurses and school nursing teams express pride in the role and frustration over the lack of recognition of their role in public health care. There is also a specific section on staff support, including redeployment. During the consultation and evaluation process of developing this resource, despite occurring several years ago, redeployment was raised as a specific, and extremely emotive area for reflection. It is recommended that if your team experienced redeployment that this activity is included. SNs also voice a need for specific support in relation to safeguarding caseloads, particularly when solely delivering safegarding and childprotection support.
There are two aims to this section - one to encourage a strategic view of school nursing , where it is important for the school nursing voice to be represented both at a local and national level; and two to consider what support might be needed for the team on an ongoing basis, including consideration of the impact of redeployment on indivudials and teams during the pandemic.
Pride in the role
During the pandemic the SN was increasingly recognised for their specialist public health role, with professionals turning to the school health service for expert advice.
CYP and family members were appreciative of the SN accessibility and expertise.
An increased presence at multi-disciplinary meetings and collaborative working such as joint home visits with social workers improved professionals’ knowledge of the SN role.
Some SNs voiced disappointment that whilst there had been a positive change in recognition of the SN public health role during the pandemic, as restrictions have lifted, there has been a return to pre-pandemic roles.
The aim of this guided discussion is to encourage the school nurse teams to think about how to raise the profile and respect for the school nursing service at a strategic level.
What school nurses say
“We’re on the map, it has put school nursing in (county) on the map, this Covid pandemic. Schools know who we are, because we’ve been contactable throughout the two years, and we have a lot more channels to be contactable now.”
and
“I would definitely say post-pandemic now, morale amongst nurses is dropping because of the way that we're now being treated. I would say… So, one of my team commented the other day, she said, “I feel like I've been told to get back in my box now.”
“Seeing in the media constantly [that] nobody’s caring about vulnerable children, and you are like, I did three home visits yesterday and then attended four virtual meetings and was working ‘til nine o’clock to make sure that I was able to document all of the stuff that I’d done. That's difficult because it really feels like we don’t exist. Like nobody actually realises how many school nurses are out there, what we’re doing, what's actually available, what's being done… You’re like I’m literally slogging my guts out to make sure that the children are seen.”
Activities
What happened?
Divide the room into two groups, give each group one of these quotes. Ask the groups to read and discuss their response to the quote they’ve been given (10 mins).
How do you feel about this?
Ask each group to think of a key word/ a few key words that summarise the feeling expressed within the quote/s and note this down. Then, in each group, whether this reflects their feelings (5 mins).
In turn, ask each group to read the quote to the other group (having this also viewable on a large screen could be helpful at this point), stating their key terms (they do not need to share their feelings in the wider group). Allow time for the other groups to respond and discuss. Make notes on flip-chart throughout the discussion. (10 mins for each group)
Does anything need to change?
4. Ask the group to consider whether the pandemic has impacted the strategic profile of the SN/school nursing team locally. Has this profile changed beyond the pandemic? What is the current picture? Is there a need for action? For example, is there a positive example of where the school nurse voice is now present that previously wasn’t? Alternatively, is there a forum where the group feels there should be a SN presence where there isn’t?
Again, listen out for possibilities in the discussions and make a note for consideration at this point. Ask the group as a whole to identify one area where there is a need for action.
5. 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.
Staff support
School nursing teams were quick to devise ways of supporting each other through the challenges of Covid-19 and beyond i.e. setting up Facebook and WhatsApp groups as a resource for real-time responses to the rapidly changing landscape.
Some felt extremely well-supported by their managers, and trust or local authority employers, with regular supervision, safeguarding supervision and team meetings; some felt completely set adrift.
Some were redeployed. This was often a difficult experience, in relation to nursing those with Covid-19, practicing in an area that was not their current area of expertise, no longer working with the CYP on their caseload, and an increased workload for those remaining in the service. One participant noted that this had left a considerable ‘fracture’ in their school nursing team. During the evaluation of this resource we found that where redeployment had occurred within the team that some strong emotions were expressed and members of the group were keen to share their experiences, although suprised at their response given the time since being redeployed. Most said, that is was the first time they had spoken about their experience of redeployment.
In addition depending on the school nursing team model further support may be required. For example, school nurses who are solely working in safeguarding voiced a need for regular CAMHS/psychology support in relation to case management, and role boundaries etc.
The aim of this activity is for the school nursing team to consider what support might be helpful in mitigating any negative emotional or psychological impact of their work.
Redeployment, yes that left us short. They were almost shoved… there was no choice, there were a lot of us that were redeployed with no notice, straight out into adult settings, we were paediatric trained, but into adult district nursing! And our skill sets didn't match what was needed, and that was very scary. We felt incredibly vulnerable. And that's left a big fracture within the service.
Some of the safeguarding cases are awful, harrowing. They are increasingly complex as the social work threshold is raised and school nurses are holding more difficult cases. We don’t have any follow-up or debrief regarding specific, particularly difficult, cases. We’re only human, and when you hear all that stuff… it has led to sickness. We have informal supervision with each other, peer support, but you need a one to one ideally, and with a clinical psychologist.
"I love the job.If we want to be valued we need to value ourselves."
Activities
What happened?
For teams where staff were redeployed during the pandemic:
As a whole group ask those who wish to, to their experience of redeployment within the team.
How do you feel about this?
Write key emotions down on a flip chart as they are verbalised.
As a facilitator reflect their experience back verbally.
Field and chair discussion as it arises.
Does anything need to change?
Ask the group whether anything needs to be done as a result of redeployment in the team. Listen out for possibilities during the listening stage above, and make a note for consideration at this point. It may be that the opportunity for an open safe discussion is enough. However if action is proposed:
Ask the group as a whole to identify one area where there is a need for action as needed.
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.
If your session ends here the evaluation form is here.
Activities
What happened? & How do you feel about this?
If redeployment did not occur in the team:
As a whole group ask if there are aspects of their work that have a negative emotional/psychological impact.
Field and chair discussion as it arises.
Does anything need to change?
Ask the group if there is any support that could be helpful to mitigate any negative impact. Listen out for possibilities during the discussion, and make a note for consideration at this point.
Ask the group as a whole to identify one area where there is a need for action as needed.
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.
If your session ends here the evaluation form is here.
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