marshall liz

It will soon be a whole year since I left my long-term post as a Health Visitor and stepped into the hitherto unknown world of the Family Nurse Partnership (FNP).

My journey from novice to fully trained (but still learning) family nurse has been exciting and dynamic, but at times daunting and humbling.

When I joined the FNP team, I knew the following:

  • family nurses work with first-time, teenage mothers from pregnancy until their child is 2 years old, delivering up to 64 visits for each client
  • the FNP is an evidence-based, licensed programme originating in the USA, and it demonstrates proven outcomes
  • the FNP has been expanding in the UK over the past 9 years.

Although I had received excellent bespoke training that gave plentiful preparation for this amazing occupation, I did not expect the degree of satisfaction and rollercoaster of emotions that accompanies the role on a daily basis.

Developing a therapeutic relationship with a new client early in her pregnancy, and exploring her dreams and future aspirations, is essential. I encourage clients to consider their strengths, interests, and ambitions and to imagine what life would be like in a few years’ time. Matching my client’s agenda to her interests might include supporting her to look into education and training. It is a privilege to share the hopes and dreams of these young girls, as they explore their feelings on learning about their pregnancy, realise how their life will change, and begin to think beyond the birth of their baby.

So, what is a typical day for a family nurse? One thing I learned very quickly was that there is no typical day, or week; my diary very rarely finishes the week as it started out. Once it ended with me sitting on a wall in a park, explaining the programme to a potential new FNP client. She said that she was not keen for me to visit her at home, but would be happy to meet me at the park, and that’s fine with me too.

With a caseload of 23–25 clients to see on a weekly or fortnightly basis, organisation can be a challenge. Working with teenagers requires patience and emotional flexibility; forgotten appointments and unpredictable situations are just some of the difficulties encountered when engaging with this group. Indeed, just when I thought one of my clients felt that she no longer needed her family nurse, I received a text message, which excitedly informed me that she was expecting a boy, and that she wanted me to be the first to know. Much of the time it is about rolling with resistance and being creative in order to get results.

I have also learned that being a family nurse brings me great job satisfaction, as I hope the typical situations below will demonstrate:

  • when one of my clients was struggling to breastfeed her 1-day-old baby, I was able to use my background in midwifery and health visiting to support and encourage her to continue
  • one mother was finding it difficult to keep her 18-month-old toddler safe as he developed independence and explored the world around him—I worked with her on understanding how a toddler communicates, which helped build her confidence and relationship with her son
  • a new 18-year-old father confessed to feeling unexpectedly emotional when his baby was born, and felt proud that he had been there for his partner to support her during labour—he commented that the FNP materials that we had explored together before the birth helped him understand what to expect
  • one of the most satisfying aspects of my role is when a mother ‘graduates’ from the FNP—a positive goodbye can be rare so it is important to celebrate their commitment, learning, growth, and achievements during the programme.
My weekly supervision is imperative in keeping me grounded in my role, as it can be emotionally draining at times, but as another unique day draws to a close, I wonder what amazing challenges, surprises, and joys there will be tomorrow.