We began our day at BCU by speaking with a community public health nurse specialist. We learned about the role of a school nurse in the United Kingdom. In the states, school nurses are largely based within the school building to deal with health issues that arise during the school day. In the UK, school nursing is more of a public health role. School nurses are based in a community center, and have special field proficiencies they must learn. School nurses must continue on to complete specialist community public health nursing (SCPHN) training. School nurses work with children and their families to ensure they are healthy so they can succeed in the classroom. School nurses focus on proportionate universalism, providing more care to those in higher risk areas or situations to ensure an equitable surface. They also educate students on issues like sexual health, stress management, and hygiene.
The focus of school nurses is summarized by the healthy child program, which targets areas that may be health deficits in school aged children. They focus on the phrase MECC: Make Every Contact Count. Along with this, we discussed some of the downfalls of the NHS and subsidized health care. Although healthcare is free, minor issues can heave incredibly long wait times. For example, dental care is free until 18, but there is a large dentist shortage. As a result, there is a large oral care deficit in school aged children. The BCU speaker said it is not just a health or a school issue, but working together to provide care.
I was interested in the transition of healthcare to virtual format. We learned that since covid, public health nursing had moved online. Yesterday at the Children’s Hospital, we noticed that the majority of charting was on paper, whereas in the US hospital records are mostly digitized. The BCU public health nurse informed us that public health nursing is mostly digitized because the profession is so collaborative. This gives limited access to GPs, school nurses, and social workers. She said this strategy does work, but a downside is that different areas use different programs, so if the child needs support from another area it is hard to access their records. She feels the system should be standardized, but it is not due to funding shortage from the Nursing and Midwifery Council NMC. This council sets the standards for all nurses and midwives in core (general) field (specialty specific) skills. I felt this session was very beneficial, and a great example of the essential overlap in the fields of nursing and education.
Later in the day we spoke with a mental health nurse from the BCU staff. As we learned earlier this week, nurses have to choose their specialty upon entering nursing school. I didn’t realize until this discussion that mental health is one of the options for specialty, along with adult (general), child, and learning disability. We began by discussing the history and diversity of Birmingham. Birmingham is the first city in the UK to have the majority of their population identify as ethnic minorities. They have an incredibly high immigration rate from countries such as India, Pakistan, and Hong Kong due to prior colonization by the Uk, and opioid trading ties during the time of Queen Victoria. The mental health nurse speaking informed us of Birmingham’s history, specifically involving drug trading, to show that mental health problems are largely influenced by social context and external circumstances. A common misconception is that mental health problem is a genetic lottery, or randomly one is every so many people will suffer from a mental illness. In reality, these illnesses are impacted by external circumstances. He pointed out that Mental Health nurses, therefore, must be educated on these social situations at the root of the problem.
We discussed three different authors in this section, a nurse, a psychologist, and a psychiatrist. Each presented new ideas about mental healthcare. The author who stuck out to me the most was Joanna Moncrieff, a psychiatrist who publishes works to educate the public about psychiatric drugs. She attempts to challenge the disease centered model of prescribing these drugs, the idea that these medications reverse the underlying disorder. In actuality, there is not sufficient evidence to support this theory. Instead, Moncrieff promoted the drug centered model in which we recognize the adverse effects that drugs can have on the body and brain. This demedicalises the person, and helps us to look at other routes of treatment before medication to prevent the negative side effects of overprescription. This idea also led us to discuss forced medication and forced treatment. Our lecturer said that the UK Mental Health Act that allows for forced treatment of such illness is underlying almost all care he provides. This was a new perspective of mental health nursing I hadn’t thought about. This was an important idea because, if we focus on a drug centered model of prescription, healthcare staff can force patients to take medication that may have adverse effects.
At the end of the day we took a Black history tour. We discussed the cultural history of Birmingham as an industrial city, and learned about the impact of the Windrush generation on the city’s prosperity. We heard from a woman who can over to the UK from Jamaica during this time. She told us about the discrimination she faced as an immigrant and a nurse of color, and encouraged us to pursue our goals in the field of nursing. On our walking tour, it was very eye opening to hear about how much exploitation and slave labor contributes to our everyday privileges. It was so interesting to hear from our tour guides and learn about the rich culture of the city we’ve been staying in. I feel I learnt a lot about both nursing and education, as well as the cultural history of Birmingham.
Repping some BCU merch from the school shop
On the Black History walking tour of Birmingham