Emma Visca
Senior Health Visitor
NHS Dumfries and Galloway
I grew up in a council house scheme and I’ve always loved that sense of community. All your neighbours looked out for you, and it was like a big family, the sense of a diverse group pulling together to help one another. It was the nursing I wasn’t sure about initially! I’m so glad this is the way things turned out though. As a young mum, I was really inspired to get into nursing by my own health visitor. She made me realise that the real skill is identifying what someone wants out of life, what they want for their family. Everything about a person becomes connected and real in those conversations. I was inspired by her professional nursing skills and how she used them to create this beautiful, holistic life plan that suited me as an individual. Outside of nursing, I am also an artist and I share that skill with my community, whether providing lessons or exhibiting. My goal is to extend help to those that are isolated without medicalising every interaction. I want to open a space where they can be with other people or just spend time experimenting on canvas. In terms of health visiting, it creates such a candid atmosphere to discuss where a family is in their journey. There is no checklist or set purpose, you’re helping a family to recognise what they want for themselves as a new family unit by starting with the catalyst of a new baby. It’s exciting to create a vision for community values with those who previously might not have known their neighbours. I am inspired to promote a sense of community working alongside new families who haven’t experienced it during their own upbringing.
When I was a single parent with my newborn daughter, my health visitor was really involved in my life. She registered that I was asking her a lot of questions about her job and asked if I was interested in nursing. She supported my application and we even walked together to post the paperwork. Sometimes you need to assess a family and quite literally take them by the hand. I’m really passionate about how we pull all these things together. The service needs to work towards constant improvement, so I promote the trying and testing of new methods, even if something doesn’t quite fit, I’ll encourage the team to adapt it and test it again. I’ve always had that kind of mindset, the confidence to keep going. I don’t ever need to stop having conversations that focus on improving the wellbeing of those I care for.
When I was a health visitor, I wanted to make changes, but I didn’t have the authority to implement those improvements. Being a senior charge nurse gives me the authority to make changes, influence policy and directly evolve the service. My job now gives me more scope to be the change maker. I am also part of the Excellence in Care working group and can influence standards of care. Looking at the quality of the service being delivered, asking what do the families want and what is crucial for these parents and young people, is both engrossing and inspiring. One of my recent studies tapped into the young people in high schools, I was curious about whether they wanted IT solutions for mental health concerns. Many of us assume that young people are not only tech-savvy but more comfortable communicating using technology. The results of the survey showed that these teens were worried about their phone footprint and concerned about who might have access to their device history. My CAHMS colleagues wanted to initiate NearMe or phone conversations, but the survey showed young people prefer to text. We all make assumptions but even this small example shows it’s crucial to push for the real, evidenced views of those you care for. Every new dataset I read prompts me to challenge, make changes and test things. I think I keep my colleagues on their toes with the amount of change I’m pushing for. My curiosity and questioning are for good reason though, I have to make a difference.
It’s been huge. I have tried hard to put it into words before and always struggle. The programme has woken me up to everything that’s happening around me. Instead of overthinking and over-analysing to the point of panic, I lead myself into a space where I can calmly think about the next steps. We have huddles on MS Teams and Clare Cable is my role model for that format. Starting with simple breathing and peaceful grounding creates a group environment that promotes honest sharing. I used to think of myself as having an NHS hat and an arty hat. Those two parts of me were very separate, and I didn’t know how to throw them together. Now I feel free to combine them, to wear both hats simultaneously. It makes me feel more authentic and connected to myself. Coaching sessions have been incredible. When we started, she asked me to look into my core. I was picking up this essence of deep red, the sense of something burning inside me. There was a physical sensation of warmth, I envisaged red lava filling me from my toes to my head, a latent strength that I hadn’t realised as an internal protector before.
Following that session, I took a mindful walk to my next job interview and felt like a warrior. The programme has allowed me to step up but with authenticity, not bluster. At that job interview, I believed in myself, in my preparation and that I belonged in that room. Before the Queen’s Nurse programme, if I think of that first day of residential, I could be quite anxious. I have always been supportive, a genuine people person and as a leader completely available but I was never aware of my own power. I hated being the centre of attention until I realised that self-belief is not bravado.
The programme also introduced me to the work of Otto Scharmer and Theory U. I have since attended a two-week summit and ended up in sessions with like-minded others who believe in ‘being here’ and ‘being present’ as a human being. From racism to sexism to environmental health, all these social constructs started to boil in me. I have become so passionate about everything. By engaging with a critical eye there is so much we can do to create a newer and more inclusive world.
Initially, the Scottish Government wanted to reduce the health visiting service during COVID, so we were getting guidance that we should upskill staff for the acute sector. I had to manage my teams, think about who could be redeployed and what level of service their redeployment would leave behind. I created COVID teams and made lists of the most vulnerable families. I chair the GIRFEC Locality Group and shared work across agencies to best support families. After planning revealed impossible sacrifices, we challenged the government decision, stood up for our service and won. We were able to prove that this is a crucial service that must be supported. Things changed so often and so rapidly that it was hard to cascade the information in a timely way. Understandably there was anger, fear and grieving amongst the staff. The barriers of using PPE and missing out on direct communication made building relationships more difficult. There were limitations on visits, and we had to think outside the box. From garden visits to the introduction of IT solutions and agile working – the things we did worked really well and have shaped how we will move forward post-pandemic. Pausing and reflecting I can see the benefit of addressing these unexpected challenges.
To get by I do lots of yoga and I’m studying mindfulness. My yoga teacher set up Zoom classes so that we could keep connected whilst apart and my mindfulness practices are daily. Taking time for myself with a little glass of something doesn’t hurt either. Just slowing down and telling myself – what has been happening is crazy, but we did it, we should be proud of that.