Wednesday 27 February 2013

When nannies say 'goodbye' to a family revisited

I am fascinated that by far my most popular blog has been "When nannies say 'Goodbye' to a family" and that when I look at the search terms that people use who find 'SusanSays', they are often about this theme.

From this I draw the obvious conclusion that it is a subject that concerns nannies, and probably families too, and that people are looking for guidance on how to go about saying goodbye.

I'm not sure that there is much more that I can add to make this process any easier.  In my original post, which was based on a nanny's decision to move on,  I recommended such strategies as:
  • being clear with parents and children about when you would finish;
  • speaking positively about future plans for the children eg 'next week you will be going to daycare', or 'next week Jane will be taking you to the park and you'll have fun with her just like you do with me';
  • acknowledging that it is hard to say goodbye, that it is OK to feel a bit sad;
  • perhaps creating a book of photos of fun things you have done, or giving the children a photo of you with them;
  • not making promises you can't keep about future contact.
When you have a fixed term contract with a family it can be easier to finish than when you have no finishing date in sight.  It is particularly difficult when the date to finish is out of your hands and happens suddenly, perhaps because of a change in family circumstances, or because a family has been increasingly unhappy about your performance and has not let you know their concerns or given you an opportunity to make changes in the way you work.  In these circumstances you may not have time to prepare the child, and you may be feeling shocked and battered by the circumstances.  There is little point trying to change the mind of the parents, so say goodbye with as much dignity as you can, and use your agency and friends for emotional support and for professional direction in areas you may need to change.
When I wrote recently about 'Professional boundaries' I also mentioned that not becoming over-involved with the children and their families makes it easier for everyone when you leave.  This does not mean being cool and distant, but it does mean that while you are warm and affectionate you do not let the children and family become more important to you than people in your life away from work. While you might spend a little time outside work planning the next day or the week's activities, you need to have a life of your own away from work where you socialise, form relationships and meet your own social and emotional needs.

It is hard, working alone in a family, not to think of yourself as the most important person in the child's life, but this is not reality.  The child's parents have this role.  They lend you their role in the hours you are caring for their child, but it is only a loan. From the start of the time you meet a family you need to be clear to yourself about your role and what that means.  You are, as the legal term says 'in loco parentis' ie in the place of the parent, BUT you are not the parent.  You act like the parent, in the parent's absence, making decisions about the care of the child (in accordance with the parents' wishes), about diet, activities, safety...all the aspects of daily life with children.  This is one of the reasons why we are very keen that nannies employed by our agency:
  • make their planning for the children clearly available to parents;
  • make reports on the children's day.
Doing this helps make clear your role and informs parents what their children have been doing in their absence. It also gives the parents an opportunity to give you feedback on how you are fitting in with their ideas.

Most families these days don't expect their nanny to stay until their children are old enough to leave home, but at the same time do not want to see their children have to face too many changes.  At the same time, nannies often have changes in their own circumstances, (eg marriage or pregnancy) or are looking for a new professional challenge, so many move on after about 2 years.

Change is part of life, and we need to grasp it with both hands, looking for new opportunities, not looking back with regret.


Tuesday 19 February 2013

DisABILITY

Sometimes, life's not fair.

Instead of a healthy baby at the end of a 40 week pregnancy, a baby may be still-born, or born prematurely with many of associated health issues, or a physically or intellectually disabled baby, or one with major illness.  It seems so wrong, so unfair, that the usual hopes and dreams of having a healthy child can be so dashed at a time that is meant to be so happy.  Yet this is the situation a surprising number of parents are faced with and they need to find ways to manage what may be a life changing event.  Other parents face disabilities in their children as their children grow, whether from illness, accident or gradually emerging disorders like autism.

First reactions to the news that one's child is disabled vary but denial and grief figure prominently.  Even when antenatal screening has shown that problems may exist, being confronted with the baby brings many emotions, including by many parents a strong sense of protectiveness, but also from others, rejection, although this often modifies with time.  It can be hard to let go of the fantasies parents might have had of for example, playing cricket in the park with a son, or ballet classes or ....It is also not uncommon for mothers in particular to needlessly blame themselves for some behaviour during pregnancy.

The nature and extent of disabilities and illnesses varies enormously.  Some are incompatible with life so the baby will die young, while others may only have a mild impact.  Others are far more severe and will require life long care, others fit somewhere along this spectrum but to each child and parent and family, some adjustments will be required.

Having a child with a disability can be a major challenge to a family.  Since we no longer shut away children with disabilities in institutions, the vast majority are cared for at home. Depending on the severity of the disability or illness this may involve:
  • regular medical and therapy appointments;
  • purchase of specialised equipment, or long waiting lists for funded equipment;
  • considerable physical and emotional stress on caregivers and on other family members;

Given the nature of our society, the majority of practical care-giving tends to fall on mothers, who are often stretched to pay attention to their partners and to other children in the family, let alone to themselves. Many marriages breakdown, possibly because of disagreements about how the child is treated, or about the amount of time and money devoted to one person to the exclusion of the husband or other family members.  Many siblings with a disabled brother or sister feel alienated for the same reason, or feel overwhelmingly burdened with responsibility for their disabled sibling.

Statistically, it is also clear that there is a strong link between disability and poverty.  Families with a disabled child are far more likely to be disadvantaged, partly because of the additional costs of caring for the child.  Adults with disabilities find employment opportunities difficult and many are un- or underemployed, compelled to live on benefits.  Others are too disabled to work and may live with their parents which may lead to difficulties with their care as the parents age and die.

For all this though, having a disability is not necessarily all negative.  One of the groups that has a very positive attitude to their situation is the deaf community who have adapted by having their own language and parts of which reject having cochlear implants to help introduce sound into their world.  There are also very strong disability rights groups who advocate for their members and who insists that we see the ability, not the disability.  I once heard a friend confined to a wheelchair, criticising another woman in a wheelchair for not having a good attitude: 'she gives people with a disability a bad name.'

Just as life for 'normal' people varies enormously in terms of how it is lived and what is achieved, so it is for those with disabilities. 


I was born with a congenitally dislocated hip, certainly not a life threatening condition, but one that meant many operations, long periods in hospital and having physical therapy and which has had long term effects on my mobility.  I was, however, blessed to have a mother who, though not highly educated, and who certainly had never read a parenting book, but who believed I should just get out there and do things.  I was reminded of her when I read the recent inspiring speech of Paralympian Kurt Fearnley, born with a severe disability, but whose parents encouraged him to move around after his siblings, getting bruised and battered as a result but letting nothing stop his enjoyment of life.  In his speech he recounts the freedom of his early childhood and the change that happened when he was introduced to wheelchair racing.

He goes on however, to speak of the National Disability Insurance Scheme and his hope that it will address many of the issues that face our community as we respond to the needs of the disabled and those who care for them.  Legislation to introduce the draft NDIS was introduced into Parlaiment in November 2012, to enable the Scheme to be trialled in four regions in Australia, before being finalised this year.

As an Agency, we have always been happy to provide nannies for families where either a parent or a child has a disability.  At times this has required specially targetted recruitment looking for a nanny with the appropriate skills, at other times, we have looked at ways to manage the work so that it may be shared between two nannies if the load is considerable, but where specialised nursing procedures are required other arrangements may be necessary.  These placements may take extra time to organise because of their special requirements, but do contact us to discuss your needs.


Friday 8 February 2013

Immunisations/vaccinations...

It is hard in the modern Western world to comprehend the scourge of what are commonly regarded as childhood illnesses.  Children in the past died during the epidemics that regularly swept through the community, others had life long health problems (people are still dying from post-polio syndrome from the mid Twentieth Century epidemics), others were rendered sterile (particularly as a result of mumps), and those mothers who contracted rubella during pregnancy had babies who were born blind and deaf.

Much work has been done to develop vaccines to counter these diseases and children from newborn up to adulthood, in Australia, today have access to a comprehensive program of free immunisation. This issue is topical for me personally, as a friend, of mature years and with limited exposure to children, has recently contracted whooping cough (pertussis).  This is a most unpleasant illness for adults (sometimes described as '100 days cough') but is potentially life threatening for babies.

Writing about it on our Facebook page threw up some interesting information.  After being very rare in the community, whooping cough is on the rise and it is now believed that childhood immunisation does not necessarily give life long immunity.  There has also been a rise in the number of people who are not immunised, both among recent migrants and those who make a conscious decision not to have their children immunised.

Except in rare instances (eg where a child has a seriously compromised immune system while being treated for cancer) people who conscientiously oppose immunisation hold strong beliefs which tend to be based on discredited and erroneous research connecting immunisation and autism.  There is NO link between immunisation and autism.  and while eating a healthy diet may strengthen an immune system there is no evidence that it protects against illnesses like whooping cough, measles, mumps chicken pox, hepatitis, polio and the rest.  Children who have not been immunised must be excluded from a child care centre or school for prescribed periods of time if illnesses which can be prevented by vaccine are found to be present in the facility.

For parents, this means ensuring your child receives all the prescribed immunisation, which are listed in the health record book you received from the Maternal and Child Health Centre.  You will need to produce this record when your child enrols at school.  Yes, injections are unpleasant and we hate to see our little ones subject to them, but better a few seconds pain than the consequences of the illnesses.  It also means discussing with you doctor your own immune status and possibly arranging booster shots, or even primary immunisations if you have never received them.  Either you or your child might have a mild reaction to the immunisation, but this is NOT the same as the illness.  Sometimes it is possible for even immunised children to at some stage get a mild case of the illness but they are not subject to the same intensity of symptoms and risk of side effects.  If they show signs of particular illnesses they must be kept home from child care or school for given periods of time.

What does this mean for nannies, child carers and teachers?  The first step is to discuss your immune status with you doctor and have the necessary injections.  If at some stage you think you are showing signs of the illness, do not go to work until you have seen the doctor and had your condition confirmed or cleared.  If children in your care are notified as having one of the diseases you can attend work if you have been immunised.  If you have not been immunised, you cannot attend for the required exclusion periods.

If you are a parent employing a nanny, it is obvious that a question to ask at interview is whether the nanny has been immunised.  You may wish to make this a condition of employment.

Modern medicine is often criticised, but the prevention of common illnesses through immunisation has been a wonderful advance.  It is up to us as a community to take advantage of such measures to protect us and our children.  Small pox, as a disease was successfully eradicated from the world by vaccination, and in time hopefully other illnesses will be too.

Links:
The Science of Immunisation questions and answers.  Australian Academy of Science
Immunise Australia Program, Department of Health and Ageing
Blue Book, Guidelines for the control of infectious diseases, Department of Health, Victoria
Raising Children Network, Immunisation



Friday 1 February 2013

Professional nannies or babysitters????

As you have probably noticed, I have increasingly been using the term 'professional nanny' in my writing.  This reflects my view that in our modern world, the demands of home-based care of children require workers who are:
  • suitably qualified, preferably degree or diploma level;
  • experienced in the care of children, preferably at least 2 years post qualification;
  • practise their role at an advanced level, with evidence of planning in accordance with the Early Years Learning Framework, and references detailing this and indicating satisfaction with the developmental activities of children in their care;
  • enthusiastic approach to their work with children and their families, good communication skills and an understanding of the complex needs of many families;
  • evidence of a Victorian Government Working With Children Check, Police Check and current first aid certificate, preferably with epi-pen training.
This is a very demanding list, but reflects my belief that as parents are paying a considerable amount of money to employ a nanny, they are entitled to the best possible standard of care for their children.

At the same time, as an Agency, Susan Rogan Family Care:

  • negotiates with client families and potential workers to achieve the best possible rates of pay, and working conditions, including annual leave and superannuation;
  • supports the placement with visits from consultants and regular contact between the agency, the family and the nanny to ensure all parties are happy with the way the placement is working;
  • is available to help negotiate any difficulties in the placement;
  • provides regular opportunities for in-service training for their nannies.
It is my belief that this offers far better support to families and to nannies than is available to people responding to internet, newspaper and local advertisements.

While sometimes those employed in this way may be excellent workers, more often they tend:
  • to have no qualifications;
  • little knowledge of child development, behaviour or age appropriate activities;
  • limited awareness of safety and hygiene requirements;
  • limited responses to different, sometimes challenging, behaviours.
From the point of view of these workers, often:
  • wages and conditions are poor: long hours for low rates of pay and often no superannuation;
  • there is no support and encouragement in their work;
  • there are no opportunities for in-service training to develop skills and understanding;
  • there is no one to advocate on their behalf with their employers. 
Which would you prefer to be: a professional nanny or a baby sitter?

Who would you prefer to care for your children: a professional nanny or a babysitter?