Brenda Kirk has been working in child health for almost 30 years and is now a Clinical Nurse Specialist and Team Leader for the disability nursing team for Specialist Children’s Services in Renfrewshire. Regularly called on within the team for advice, she is also the key contact for other agencies because of her knowledge and skills related to child health and development.
I started off doing nursery nursing and it showed me that I really wanted to work within a caring role. After a careers chat, I was advised I would probably be well suited to nursing and that is what set the ball rolling.
After qualifying, I worked in a surgical unit in Glasgow for three years before going to train as a paediatric nurse. I then worked in the general surgery and ENT ward at Yorkhill children’s hospital, working part time as my own children were small.
I did the old modular training and went to university in the evening to upgrade my qualification to degree level. In the course of doing that, I became more interested in not just seeing the sick child in hospital but seeing the sick child out in the community. I worked for a short time as a staff nurse with the health visiting team while I was doing the health visiting course. I then worked as a health visitor in Erskine for five years before taking the post of specialist health visitor providing care for children with additional support needs. I’ve been in that post since 2007 but three years ago, due to a service redesign, my title changed and I had the team lead role added to my role.
My current role is in assessing, care planning and providing support to children with additional support needs within Renfrewshire. I have an active caseload of families who I work with. I could be going out on home visits, undertaking developmental assessments or reviews with children who have complex neurological disabilities, developmental disorders, or long-term conditions with a developmental need.
I also manage and supervise a team of eight staff delivering disability nursing and children’s community nursing services.
I manage all disability referrals with the Consultant Community Paediatrician, liaising with partner agencies to ensure the health needs of children are met, and managing onward referrals. We work with a small team of three Community Paediatricians who specialise in child development
To ensure the service continues to meet the needs of the children I regularly review our work, completing audits and analysing data. I represent Specialist Children’s Services (SCS) at senior nurse meetings, management meetings and service steering groups to ensure that the wellbeing of children with developmental disorders and complex needs remains high on everyone’s agenda.
Over the past few years SCS have been working to embrace the ‘Team around the Child’ concept to meet individual needs and improve outcomes for children and their families. Two pathways of care have been developed – disability and vulnerability. My role, and that of the team, is key in the Disability Pathway, where the move to a Nurse Led Assessment is the foundation, with the aim to ensure a multi- disciplinary service in which children and young people are at the centre.
Within the disability pathway there is disability nursing and community children’s nurses sub specialties. Both nursing strands make enormous contributions to not only the health and well-being of children but also in empowering and supporting families.
By empowering families, we support them to manage lifelong conditions. The families do not always have to be seen on a regular timed basis, however the team is accessible at any times that they need us.
Our expertise and experience in working with children means that we can help families cope with the conditions they’re living with and provide the support they need. We can’t change the diagnosis that children have, it is about enabling the child to be all that they can be and building families’ confidence so that they know they are doing everything they can to support their child.
My vision is to improve the services provided to the families of pre-school children where there is a possible diagnosis of autism. The goal is to provide early support to families who are either awaiting a diagnostic assessment or who have received a diagnosis.
The waiting time for diagnosis can be extremely stressful for parents and we are committed to providing the care they need through uncertainty. Early advice and support should not solely be diagnosis specific, these very early stages can be important for developing a family’s coping mechanisms.
I am working with parents to hear their views on what pre and post diagnostic support they would like, whether this is in the form of direct individual work or group sessions. I feel very strongly that if families receive excellent support, advice and education as early as possible, this will have a positive impact. My plan is to listen to the type of support families feel would be of benefit. I aim to pilot a post diagnostic nursing contact, evaluating the impact to be able to improve services further within our locality.
The first point of contact for accepted referrals is our nursing team. We are a dedicated and experienced team of nurses and support staff who have excellent skills in assessing children’s development but as importantly supporting and working with families.
Sometimes it can be six weeks after diagnosis when parents come up with the questions they really want to ask. A conversation with an experienced nurse at that point would enable parents to understand clearly what support options are available and allow them to ask the questions which are important to them. For the nursing team, it would give us an opportunity to listen deeply to the concerns and anxieties which family members may have, to put them in touch with the available services and to carefully assess whether there are any ongoing issues for that family where additional support is required.
My years of experience in supporting children and families from uncertainty, through diagnosis to flourishing, mean that I am confident we can design an even better service for the future.