Careers in maternal and child health nursing
Caring for babies, children and expectant or new mums can be incredibly rewarding. We report on what it takes to work in maternal and child health nursing.
From looking after expectant mothers and their babies to supporting vulnerable teenagers, the field of maternal and child health spans a broad range of nursing practice. Some examples of registered nurse roles in maternal and child health include:
Children’s nurses
Also known as paediatric nurses, children’s nurses care for infants, young children and adolescents from birth through the early years to age 18. Child nursing can involve everything from perinatal nursing care, caring for sick newborn babies or providing immunisations to carrying out health promotion activities or caring for teenage road accident victims. Another key part of the work of children’s nurses is considering the care and support of the child’s parents, carers and wider family.
Children have very specific health needs compared with adults. That means that the nurses caring for them need to have a good understanding of healthy child development to minimise the impact of diseases and conditions on their patients’ path towards adulthood.
Infants and children communicate differently to adults. They can’t describe their feelings and what kind of pain they’re experiencing or how bad it is in the same way as adults, so nurses need to be sensitive to a child’s behaviour and reactions to interpret what they are feeling and what they need. Children’s nurses also require razor sharp observation skills to be able to spot when a child’s health declines, which can often happen very quickly.
As a children’s nurse, your patients could be in hospitals, day care centres, clinics and in their own homes, so they tend to work in a range of settings.
Children's nurses are part of multidisciplinary teams that look after patients, including doctors, hospital play staff, healthcare assistants, newborn hearing screeners, psychologists and social workers.
“The best part of the work is the impact you have on your patients and their families and the relationships you can build with them. Seeing a child leave the hospital in a better place and with a smile on their face is the most amazing feeling," says Ewout Van Sabben, a final year children’s nursing student in the NHS.
In Australia and America, children’s nurses are referred to as maternal and child health nurses (MCH nurses or MCNs).
Neonatal nurses
Premature or unwell newborn babies are known as neonates. Neonatal nurses are specialist children’s nurses who help provide round-the-clock care for them in intensive care, high dependency and special care baby units (NICUs, or neonatal intensive care units).
Premature babies can often have life-threatening problems such as difficulty with breathing or nutritional needs, and neonatal nurses are a vital part of the team responsible for treating them promptly and appropriately.
Some of the day-to-day tasks involved in the job include:
- preparing and checking medications
- managing a baby’s fluids
- recording observations and documenting a baby’s care
- initiating appropriate basic resuscitation in an emergency situation.
Neonatal nurses work closely with other health professionals such as paediatricians, dietitians, midwives and other children’s nurses to come up with care plans, and they support new parents through an anxious and stressful time.
“Depending on the type of unit you’re working on, you can expect to be changing nappies, administering feeds, giving medications, going to deliveries, or you could be out in the community or doing transfer to different hospitals, looking after ventilated or post-operative patients. It is really, really variable. But one thing I always say to people is that NICU nursing is more than just about cuddling babies,” says Neonatal Nurse Nicola Waife.
Children’s palliative care nurses
Paediatric palliative care is child health care for those who are terminally ill. A typical day for a children’s palliative care nurse (another specialism of children’s nursing) can involve home visits or working with a team of health service specialists to find out what is going on for the child and their family. This could include talking to hospice staff to ensure that respite care is going well; psychologists, to find out how the child’s parents are coping and whether they need more support; and play specialists to discover what they are working on with the child to help them express their anxieties and worries.
“My job is very special because of the uniqueness of the job. The personal challenge is getting it right with the family. I love working in the family’s home and I love the interaction you have with the children,” says Bernier Gorman, a children’s palliative care nurse with the Association of British Paediatric Nurses, an organisation committed to improving paediatric nursing through evidence-based information.
“There is a large element of emotional care. We often find that we’re the ones whom the parents can actually talk to because they don’t want to burden their family. You’re not going to stop the child dying, but what you can do is work to make it as good as it can be. So it’s about holding on to the positives. I find it a very rewarding job.”
Health visitors
A health visitor is a community health nursing role. In the UK, they are Nursing and Midwifery Council-registered nurses or midwives who have undertaken further training in community public health nursing to become specialist community public health nurses (SPCNs). The job involves working with families with a new baby through their early years to the age of five to spot any health needs as early as possible and ensure that young children have the very best start in life. Health visitors aim to improve the health and wellbeing of the under-fives by promoting health, preventing ill health and reducing inequalities.
Working with clinical and primary health care colleagues, they use their expertise and training to get the right support in place as soon as possible. Typically, health visitors work in people’s homes, but they also run clinics and parenting groups with early years practitioners, children’s social care professionals and family health services, GPs, school nurses, allied health professionals, and voluntary services to support the needs of children and families.
Everyday tasks include:
- supporting new and first time parents with postpartum care in the weeks after the birth of their baby
- providing breast feeding support and advice, as well as help with infant feeding and healthy eating for young children
- assessing children’s growth and development needs
- delivering health reviews to assess children’s growth and development
- promoting the best start in speech, language and communication
- supporting maternal and infant mental health.
- Spotting whether a child is at risk of harm and working with social healthcare providers and partners to safeguard and protect vulnerable children.
“I deal with any families from poor socioeconomic backgrounds who often feel vulnerable and isolated. By assessing their health needs, I can provide advice on accessing various services within the community or signpost them to specialist workers," says NHS Health Visitor Richard Montague.
"The positive contribution I make to a family's physical and emotional wellbeing is really satisfying, particularly when they need that extra support they wouldn't receive without us."
How to become maternal and child healthcare nurse
The main route into maternal and child health nursing in the UK is through a university degree course. According to the NHS Careers website, entrants will usually need a minimum of five GCSEs at grade 4/C or above, possibly in English language or literature and a science subject, plus two A levels or equivalent level 3 qualifications, such a T level or BTEC for an undergraduate degree.
It's also possible to enter child nursing through nurse degree apprenticeships and nursing associate apprenticeships, which are available with some employers.
A children’s nurse’s standard working week is around 37.5 hours on shift pattern which can include nights, early starts, evenings, weekends and bank holidays.
Once qualified as a children’s nurse, there are plenty of opportunities to specialise further, or move into management, teaching or clinical research.
To be a neonatal nurse, for example, you need to have a paediatric nursing degree and an adult nursing or midwifery degree. And registered nurses who want to become a Health Visitor need to undertake the health visitor training programme, known as the Specialist Community Public Health Nursing - Health Visiting (SCPHN - HV), which is offered at degree or Master's level.
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