One of the main attractions of becoming a public health nurse for Micheal Power was the opportunity to look after patients in their own homes and communities.
“Public health nursing gives you an opportunity to work as an autonomous practitioner with the support of your nursing colleagues and the primary care team (PCT),” the Swords-based nurse explains.
“My caseload consists of is a combination of child health and clinical nursing and I work within a geographical region in North County Dublin CHO 9/Network 2. Swords health centre is a large healthcare centre where members of the PCT are based and where we hold our team meetings on a monthly basis. I’m very lucky here in Swords as I have access to great support from a number of specialities.”
Being based in Swords with a large population of young families in the area, much of his time is spent visiting families in the home to carry out birth notifications and core development screening. “If the child is not meeting developmental milestones, there is a noted physical abnormality, or a parental concern, I will reassure parents, advise accordingly within my own scope of practice, and, if required, will refer onto the appropriate service such as Area Medical Officer or speech and language. A care plan will be written up which shows the problem/issue, goal/outcome, action/intervention and evaluation date, and recorded in the child health records,” he explains.
The PHN service works closely with the Child and Family Health Agency, Tusla, to ensure children and families who are experiencing difficulties have the supports and mechanism to help them manage the difficult times with the supports of the multidisciplinary team, such as family support workers, GPs, teachers and the gardaí.
Micheal also highlights the fact that he has several young patients with sensory and physical disabilities. He ensures that their particular nursing and social care needs are met through the close liaison of the provision of services from the HSE, private and voluntary organisations. “Mostly, parents are these client’s primary carers and provide the majority of their needs,” he says.
“My work also includes visiting clients at home in particular older persons to carry out holistic nursing assessments and clinical nursing.”
During his practical exposure while doing the PHN nursing course, he did practice placement in Kilbarrack, where you will find one of the oldest populations in the Dublin area, and the majority of work centres on clinical nursing and caring for the health needs of over 65s
“As a public health nurse, it is important to embrace the role of an advocate for your clients and families as many require assistance in accessing support and services, ie respite, home care packages, allied health support and this is part of the job is very rewarding,” says Micheal. “I have the advantage of working within an urban area where I may be able to access more services than some of my colleagues working within a rural environment where distance may limit a patient’s ability to access those services.”
The PHN team meet each Wednesday to discuss the schedule of care planned for the week ahead,taking into consideration the staff availability for the week’s work. There are three health centres within network 2 and, on occasion, it is necessary to help their colleagues if they are short-staffed.
Micheal says checking his diary, clinical and child health registers on a daily/weekly basis is a vital part of being a caseload holder.
“My diary is vital for planning the days and weeks ahead, whether it is for birth notifications, developmental clinics, weekly dressings, meetings etc. At the beginning of each month I utilise my register to allow me to plan appointments and clinics for the month ahead.”
He is full of praise for the diversity of the new skills that public health nursing presented to him. He explains that it is important to keep learning and up-skilling.
“We are regularly meeting new clients with a variety of new and different health and social care needs, and we need to keep our knowledge and skill base up to date to provide the proper care and support required. Our Practice Development Coordinator is very proactive, ensuring all our policies, guidelines, and individual training needs are met to ensure all nursing staff is working within their scope of practice. Within Swords health centre, we facilitate breastfeeding support groups, diabetic foot clinics, wound care clinics and child health clinics.”
The job is continuously changing and presents new challenges on a regular basis. And after a decade of shift work and night duty, Micheal is now enjoying the traditional working week.
“I had put in a decade of shift work and I felt ready for a different experience and challenge. For me public health nursing presented a rare opportunity for an interesting, challenging and diverse role in the provision of care to all clients within the community setting.