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The challenges in child health


We need to look after ourselves too if we are to properly safeguard children


School nurse


Safeguarding is a term used in the United Kingdom and Ireland to denote measures to protect the health, well-being and human rights of individuals, which allow people — especially children, young people and vulnerable adults — to live free from abuse, harm and neglect.

I guess one could say I’ve lived and breathed this all my life; as an older sibling, as a St John’s youth first aider, as a teenage daughter of a housebound sick dad, become a nursing student, becoming a foster sister, becoming a carer and advocate for sick family, volunteering, fundraising and much more.

It wasn’t by coincidence then that I’ve also gravitated to our most vulnerable throughout my nursing career; the ‘homeless’ ward, the ‘dementia’ ward, the ‘schizo’ unit, the travellers midwife, the ‘jumbulance’ nurse volunteer, the nurse for ‘incarcerated’ young people, the designated nurse for safeguarding/looked after children, the foster panel, the charities, etc

The past months have been overflowing in professionally and personally doing even more and, like you, it seems, it’s never enough.

In terms of the school and public health nursing workforce I feel like I’ve been on sentry duty with eyes on stalks, ever alert, marshalling, observing, absorbing, representing, advocating, challenging, disbelieving, appreciating, celebrating, despairing, interrogating, accepting.

Coronavirus, this most awful destructive global pandemic, has shown true colours over our country’s lack of ability to safeguard our most vulnerable. In our areas of highest deprivation, in our black and ethic minorities, in our learning/disabled in our voiceless and in those most in need we have struggled to deliver fair, equal and consistent services. This not a blame situation, rather a fact and indeed, to a point, a shared responsibility.

Many of our children already abused and neglected have suffered even more sustained and unimaginable; many more have become victims. Many plunged into new poverty; many already in poverty reaching new depths of desperation. Our paediatric acute hospital beds are reportedly over 80% occupied with children and young people crying out for help through self harm, eating disorders, suicidal ideation/attempts, anxiety, depression, loneliness-awaiting non-existent beds in CAMHS inpatient units.

Our exploiters are having a field day with child sexual exploitation/child criminal exploitation affecting more than ever before; the gang and knife crime becoming an almost daily occurrence in some areas of the UK.

During this same period Everyone’s Invited movement, a place for survivors to share their stories’, was established and now hosts over 50,000 harrowing testimonies. OFSTED’s resulting rapid review of sexual abuse in schools and colleges makes clear the sheer scale of sexual abuse, harassment and online sexual abuse experienced by our children and young people, reinforcing the serious issues raised by the thousands of testimonials submitted via the Everyone’s Invited website.

Is this a bleak picture? A resounding yes!

And yet also during this blasted global pandemic I have witnessed and tenaciously played my part in trying our utmost to reach in and reach out. The innovation, the service redesign, the extra miles, the access to the Child Protection Information System (C-PIS), the weekly partner and safeguarding huddles, the learning events, the training, the supervision sessions, the dissolving of previous, and often bureaucratic/power based, multi agency barriers, the ‘wartime’ effort has and continues to be so very supportive, humbling and, importantly, affirming.

The constant cuts to the public health grant by the Treasury has seen repeated cuts to school nursing (and other public health services) and right now, we are seeing proposals for more. How can we, in all humanity, even consider doing this to our children and young people, never mind it’s amazing, skilled and uniquely placed workforce? I’m told by erstwhile decision makers that humanity doesn’t pay the bills – I get this, truly I do, but I also know that loss of it now places our children as some of the saddest and loneliest across Europe; not a crown I’m happy for us to have. I also know that for every £1 invested in public health, there is a £16 saving.

Hampshire County Council currently have a proposal out to decimate their HV/SN and other services; it absolutely lacks humanity. And is very concerning indeed in relation to the safeguarding role of school nursing. Read our joint response with the iHV.

We trust you too will feel empowered to respond and to also add your name to our – SAPHNA’s – petition, demanding investment, not cuts, to our services.

‘Huminatis’ is at the very heart of nursing and should be shared by all of the children and young peoples workforce, ‘the quality of being kind to people …by making sure that they do not suffer more than is necessary..’ (Oxford dictionary).

We are at a critical crossroads in our children and young people’s health and wellbeing, they, and we, have suffered varying degrees of trauma as a result of Covid. We all need to be safeguarded because of that, from the short and long term impacts and our vulnerable must be further protected from and against the abusers, the exploiters, the neglecters, and, sadly, also decision-makers.

Cross-roads bring opportunity, albeit they may be scary.

The total ‘we’ are tired, weary, burnt-out, fearful. Acknowledging and accepting this is key to what we can/will be able to do going forward. I’ve been harping on about supervision, team get togethers, time out and away, treats, exercise, fresh air, sleep…a ‘broken record’, throughout Covid; I maintain this messaging. That’s because I firmly believe, and know from academic and personal evidence that one cannot pour from an empty cup; we are not superhuman. The culture of ‘it’s ok not to be ok’ that we, as professionals, constantly pedal also and equally applies to us. ‘Heal thyself’ is an absolute must if we are to safely safeguard.

As school nurses a call to harness our immense humanity, our integrity, our abundant wartime spirit and step up front and centre. We know and understand our pivotal role in safeguarding and in child protection; we also know that alongside great leadership we can and do bring added value. Now is the time to magnify and maximise this and, on behalf of our children, young people and families, become political with a very large P.