Safeguarding Children: An Interview with Belinda Chideme
Belinda Chideme joined us for an intensive week of teaching and working with the students on the Masters in Nursing (Child Nursing) programme.
This clinical Masters programme is a first for Africa. When this first group of nurses graduate in 2017 they will be carving out new career pathways in the health system. Fittingly, Belinda is every bit as much of a pioneer as the nurses she is teaching.
Belinda’s own career has seen her develop through a variety of roles within the UK National Health Service. Initially training as a paediatric nurse at a major London teaching hospital, Belinda gained experience in paediatric critical care, haematology, oncology and community nursing. It was while working as a community paediatric nurse that Belinda’s interest in safeguarding was awakened.
Belinda explains: “You get a bird’s eye view of how children with special needs live, what they are vulnerable to, the pressures the family is under. For example, we would train parents to pass nasogastric tubes, and there were situations where children were not being fed appropriately because Mums were anxious about taking on a role that is traditionally a clinical or nursing one, on top of their other responsibilities at home. That made me think about how to safeguard these children better.”
Safeguarding is defined in the UK as ‘action that is taken to promote the welfare of children and protect them from harm’. (Source: https://www.nspcc.org.uk/preventing-abuse/safeguarding/) Whilst every health professional has a duty to protect children and young people, Belinda works as a Named Nurse for Safeguarding Children and Young People within a large NHS Trust. Belinda’s role requires her to be involved in policy and guideline writing, and attending senior level meetings in the Trust, as well as representing the Trust at several Local Safeguarding Children Board meetings. Belinda also advises individuals and teams and reviews practices and events, including when there are allegations made against professionals, contributes to national serious case reviews, educates staff on safeguarding practices, and supervises senior clinicians in their respective areas. Finally, Belinda’s role also includes being the point of escalation when there is a need to challenge decisions made by internally and by external multi-agency professionals such as the police or social services.
Belinda has developed the specialist clinical knowledge which she needs to inform her decision making, enabling her to have an in-depth understanding of the situations she encounters. Although, predominantly a strategic role, it’s definitely hands-on, as there is need to have oversight of and take a lead role in all safeguarding children matters that come through the hospital.
Belinda says: “I line manage and supervise the operational clinicians. I get involved on the wards when there are significant concerns, a need to cover the operational team or if the presentation of the parent or professionals, is making it difficult for the operational team to manage the case.”
Belinda has undertaken additional education and training to prepare for her role, including a recognized safeguarding children course. The purpose of her visit has been to share some of this knowledge with the first generation of advanced paediatric nurse practitioners at UCT.
Examples of the types of issues that the students have explored with Belinda include ethical dilemmas about the treatment of very sick children. In tertiary care settings especially the psychological and emotional demands on families and staff can make decision making complex. “So in palliative care, where do you draw the line? I’ve advised in situations where parents are wanting treatment to stop, but clinicians think treatment should continue. Part of my job is to assess with an intention of ensuring that everyone involved remains focused on keeping the best interests of the child paramount ” says Belinda.
Born in Zimbabwe, Belinda moved to the UK in 2002. Having seen something of the South African health care system during her visit, can Belinda see a place for her type of advanced specialist nursing role here? “Absolutely” says Belinda. “The nurses on this programme are a really good bunch of people that have come with knowledge and experience. They have the ability to reflect, and that's what I’ve been doing with them.”
Belinda is full of hope for the future of these pioneering nurses: “They all have the ideas, they all have the passion. They know what needs to be done and they can work out how to make it happen. Ten years from now a new generation will come in, and the walls will have been broken down for them. But it’s about what you can do with what you have.”
Belinda’s visit was made possible by a travel grant from the Burdett Trust for Nurses.
The Children’s Institute at the University of Cape Town assists practitioners and policy makers to support the interests of children http://www.ci.org.za/
UNICEF South Africa’s website has a range of resources regarding child advocacy and child protection http://www.unicef.org/southafrica/resources_2549.html
Royal College of Paediatric and Child Health produced a document which sets out the role and level of training required by all staff working in a health care setting. You can access it here.
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