Francine is a highly experienced nurse who has worked for different NHS organisations over her 20 year career, helping hundreds if not thousands of children and parents, including assisting health visitors going to see new mums in child and family teams.
As the lead nursery nurse, Francine’s been at the eight bedded Mother and Baby Unit – known as Ribblemere MBU – at Chorley and South Ribble Hospital for over four years, where she and her team of fellow nursery nurses see their role as being “the voice of the baby” who has recently been or are about to be born to a mother who is being treated there.
They’re on hand to support the child’s growth and development, referring them to other services, giving help and advice, ensuring that neither mother nor child are disadvantaged in their bonding, development and relationship building while in hospital.
It’s not always child’s play but Francine and her team thoroughly enjoy supporting mentally unwell mothers, and partners, along the road to recovery and being discharged from the unit. They really consider parents’ wishes and just recently, helped a mother who sadly ended up being moved to a psychiatric intensive care unit (PICU). She wanted to be able to breastfeed her baby.
“We had a patient who was unfortunately suffering with psychosis and initially wasn’t suitable for treatment at Ribblemere. She had expressed her desire to be able to do something that so many other mums do; breastfeeding. It was really important to her.
It’s hard enough for any mother, but for someone who isn’t physically with her child because she is poorly, it’s even more challenging. Thankfully, we were able to teach her how to express her milk, so it could be sent to dad to feed baby and we also trained the PICU staff how to help her express her milk too. She didn’t then have the guilt of not only being separated but not being able to provide her child with milk.”
So we have told you about the amazing work of Francine and the other nursery nurses, but we want to give you a real glimpse into what life at Ribblemere involves, so we spent the day with Francine on the unit…
5:15am - My day starts. I have an energetic, lover of life, 20 month old boxer who needs a walk before I leave for work. I am fortunate enough to live near to a canal and so to start my day walking, hearing bird song and very often wind and rain on my face. It sets me up for the day!
I arrive home in time for a shower and dressed for work. I leave home at 06.45 to be ready for a day shift starts at 07.30 with a handover from the night staff. The nursery nurse (NN) on the night shift feeds back information about the feeding pattern of the babies overnight, support needed to provide all the necessary care and the interactions between mothers and babies.
8.15am to 8.45am - Crèche time for the babies. This provides them with an opportunity to socialise with each other and staff. We have a well-resourced area which creates the right environment for play and stimulation. We provide the babies with a safe and secure environment to enable them to develop their curiosity about the world around them, this is vital for their development.
It also provides mums the opportunity to have some ‘me time’ which can be used to catch up on some rest, have a shower, prepare for the day or eat breakfast. There were three babies awake today and so I and other member of staff enjoyed encouraging the babies to reach for overhanging toys, to try and find the source of ‘rain maker’ sound and some tummy time. I then gave a bottle to a hungry baby before taking her back to mum, which was an opportunity to ask how her night had gone and her plans for the day.
9am to 9.30am - Morning huddle. This is when the multi-disciplinary team (MDT) have the opportunity to discuss the events of previous day and overnight for the patients, any appointments that need staff support, building issues, occupational therapy activity for the day, safeguarding updates and so on. I talk about a mum needing to have contact with her older child and how we were going to support her.
09.30am to 12.30pm - Today is Tuesday and there are four ward rounds. Each patient has a meeting once a week where they have the opportunity to discuss how their care and treatment has been and their wishes for the weeks ahead. NNs prepared a piece for the report about mother and baby interactions during the last week.
During the meetings I give feedback to mums, offering tips, encouragement and advice. A plan is agreed about what support might be required and what activities they might like to do in the weeks to come.
Following all the meetings I update the baby care plans. These provide information about observation levels for baby, mum’s wishes, feeding methods and amounts of milk, any allergies or intolerances and importantly baby’s likes/ dislikes, agreed support and individual activity. Once the care plan is updated and mum is happy with it, she signs a copy for records and keeps a copy. As with any role the amount of administration time needed each day varies, but we see the most on Tuesdays and Thursdays.
2pm to 3pm - This is an hour of crèche time. Once again the babies can be in the care of staff, if mum wants. Today one child was asleep in his pram, two were in the play area and one needed a nappy change and bottle. This is a really enjoyable part of the role to see how a baby reacts and respond to stimulation, communicates their needs and likes. Over the length of an admission we can get to know a baby really well and enjoy, with mum, the new things they learn how to do.
4.40pm to 5pm - Following my break, one of the mums was concerned her baby had not filled a nappy today and she felt they were uncomfortable. We went into the sensory room and I was able to show her baby massage strokes that help to relieve trapped wind and move a stool down the bowel. I used a doll for demonstration and mum was able to copy on her baby. It is a privilege to witness the deep eye contact between the mother and baby, see her confidence grow and that loving bond develop. It was not long after that session that mum came to find me to say she had just changed an “explosive nappy!” This made me smile because the massage clearly worked!
5pm to 6pm -There are less glamorous sides to the role so it was time to change the nappy bins, clean the toys and launder the blankets, ensuring that the play area looks inviting but is clean for very young babies. I also spend a bit of time updating a display board to ensure the information is accurate and current.
6pm to 6.30pm - It was time to support a mum while she bathed her baby. This mum had a physical issue which meant she did not feel safe to bath her baby alone. They had a fun time together laughing at the splashing water and funny faces they copied each other pulling.
6.30pm to 7.30pm - It was time to document the day onto RIO. This is always a job that takes longer than you expect it to!
I end my shift by going into handover to pass the days information onto the night staff. There are many other aspects to the role and writing about another day might be very different!
If you want to find out more about Ribblemere MBU, you can email Francine or email Peter Bonnick, the unit’s Service Manager.