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CYP children's nursing

Pauline Nelson

Name: Pauline Nelson

Job title: Primary Mental Health Practitioner

Speciality: Specialist Child & Adolescent Mental Health Nurse

Organisation: Southern Health & Social Care Trust

What is your current role?

I currently work in Step 2 Child and Adolescent Mental Health Service where my role is early intervention and prevention.  I undertake assessment of  individuals and families  and provide appropriate therapeutic approach and interventions. The preventative aspect is carried out through a community development approach focused on awareness of emotional and mental health through parent psycho education in community groups like parent & toddler groups and for children & young people through programmes such as Active for Life and school sessions.

I also provide training programmes to Step 1 professionals  for example, Health Visitors, Community Paediatric Nurses, School Nurses  and teachers.  Also included is provision of consultations to Step 1 professionals such as Paediatricians, Nurses, Social workers .

What was your route to this role?

I think that my route began with my interest in people and I completed my Degree in  Psychology . I researched many careers and each was eliminated, not fitting with the person that I was until I was impressed by the compassion and enthusiasm when I asked nurses about their career Having completed general and mental health nursing I worked in Southern Trust NI and Riverside Trust, London.

At this time, AIDS was a new illness so I sought further understanding so that I could be better at providing care and completed EMB specialist AIDS Nursing and provided care in GI Surgery. Throughout this I reflected on how many illnesses were preventable & researched prevention in nursing and was drawn to Health Visiting & completed this diploma. 

What prompted you to do this role?

In the course of working with a wide range of families in the community and with an age range from birth to end of life I became more acutely attuned to the need to develop emotional and mental health I felt that people were frequently aware of the importance of the latter but I was struggling to support their efforts to make changes in their attitudes or interactions to develop emotional literacy in the family. I sought help and found it in a foundation course in family therapy which changed my way of having conversations with families and supported them to consider how they can promote emotional and mental health from birth.

I found myself spending increasing time on this aspect of health in the new born and child as the need was uncovered. The need was such that it was necessary to establish a specific clinic  which we called 'The Behaviour Support Clinic' & came to be provided by a number of Health visitors  & was additional to our role. We had to acknowledge that we had insufficient time within working hours to provide this service. I counted the number of hours in direct clinic provision and suggested making a business plan to request extra Health Visiting hours in order to provide the service, outlining the need, the aims and the outcomes.

We were initially declined but in the course of a year a new report was launched outlining the need for this type of service. The report was 'Together We Stand' 1995. My excitement was uncontainable and the business plan was re submitted with supportive references from this report. The outcome was positive. We had requested an additional 8 hours of Health visiting time but we were granted 37.5 hours (1 WTE) in the first instance with potential to be increased and this was the birth of Step 2 CAMHS SHSCT.

What education/courses/modules have you undertaken to equip you for the role?

The post was advertised and one of my health visiting colleagues and I were successful in obtaining it as a shared post as we were both already part time balancing work and family. I completed the Specialist Practice in Child And Adolescent Mental Health. In addition I pursued family therapy to the next level and completed the intermediate family therapy qualifying as a systemic practitioner.

How do you see yourself developing your skills?

I use an eclectic mix of skills in communicating with families and children and young people individually. I use the skills of establishing therapeutic  engagement through the language that I use the type of questioning and curiosity that creates therapeutic conversations through neutrality. This supports the capacity for change, paving the way for incorporating additional interventions such as solution focused therapy, psychological therapies, cognitive-behavioural therapy or social learning theories.

What is your long-term career plan?

I have to be honest in saying that I have never planned my career but I realize that my career developed as a result of continuous reflective practice. 

'The best place to succeed is where you are with what you have' C.M. Schwab.

What advice would you give someone thinking about moving to work in your area of practice?

I would advise all nurses to be true to themselves in following what commands them to pay attention and to respond to need in service users and seek to address that need through the use of their skills and if necessary seek information and education to give the best to those who come to us. Be inspired  to reach wider horizons of thought and action. I would say that if they wish to work to make a difference to the emotional and mental health of children, young people and their families then this is one care service in which to do that. I would add that therapist neutrality is essential.

'The things that constitute real success is not in learning as much as you can but in performing as well as you can something that you consider worthwhile, whether it is healing the sick, giving hope to the hopeless or adding beauty to the world' - W. Raspberry.

What do you most enjoy about this area of care?

To return to my inspiration for nursing - I love working with people! What I find most enjoyable is that every individual is unique and so also the family. I become part of that system for a period in supporting the challenge of change, peeling back the layers of struggles experienced. I like the element of surprise when they come to realize that they are the experts of their own selves or family and together we can discover how they can make things different and have emotional and mental health through healthy interaction and relationships.

Also the sense of achievement in an individual child/young person in developing skills to manage emotional and mental health challenges. The greatest job satisfaction that I feel is that I have made a difference in the lives of families.

CYP case studies

Children and young people: career stories and case studies