Compassionate care in Maternity Units

Compassion is the key topic of conversation in the NHS of late following the Francis report both Nurses and midwives have been accused in News articles of not providing compassionate care to our patients.

Let’s just consider this for a moment, THE profession for caring and looking after the sick and vulnerable is being accused of not caring? Caring professionals are not caring? This is a huge issue. How have we got to a stage as a nation where this can be a realistic fear that we face? When our relatives are in the care of hospitals or maternity services it is reasonable to assume that they will be more than cared for, that they will be cherished and nurtured and looked after to the very best of the staff’s ability. How it saddens me that this isn’t the case in many places, hospitals and with some healthcare professionals.

It is a career path chosen with people only in mind. It is chosen specifically with CARING and LOOKING AFTER as the very embodiment of the role, to doctor or to nurse someone to health or to be ‘with woman’ are the very foundations of what I thought were everyone’s aspirations as a budding healthcare professional. One would like to think that you wouldn’t even be recruited into a health related course without showing compassionate qualities in your interview and in your characteristics. It is however becoming increasingly worrying that the focus of basic care is being somewhat overshadowed by the academics of our profession. Research and knowledge is imperative, I am not of course trying to suggest that they are not crucial to our roles but they are there to enhance the role and to make our basic care as good as it can possibly be.

Perhaps we all start of as compassionate individuals and are worn down by under-staffing, those ‘I haven’t even had time to wee let alone eat’ kind of shifts and the constant additional paperwork demands. It is no lie that NHS employees joke the job makes them cynical. How sad is that? As a midwife I have always felt, and hope that I continue to feel that my job is a privilege. A satisfying job does not come without some hard work and although it has its more challenging days and less challenging days I can always go home knowing that I have done something with my day that was worthwhile, that made a difference and that will have made the families I look after just that little happier. The idea that others may not naturally care for and have empathy for their patients not only offends me but is one that I struggle to understand. Everyone has bad days, of course they do, we all have busy shifts too when you tell your women ‘Of course I have time to do that with you’, knowing full well this means lunch is out of the question today then. I know that after days, weeks and months of working yourself to the ground like this it gets tiring and your enthusiasm wanes.

BUT

Your patients needs don’t.

They need us, they need our smiles, our enthusiasm, for us to simply CARE.

I hope that those healthcare professionals that give the NHS a bad name can clean up their heartless act and commit to their patients. How do we beg for more staff if we have these individual’s bad behaviour to explain?

Thankfully these are a minority.

To all of the hard working nurses, doctors and midwives out there. Keep at it, keep giving those patients the best as you love it when you get that ‘thanks you made a difference’ at the end of a shift. Maybe then the NHS can spend money on some extra staff rather than compassionate training?!

Things will have to get better it is just going to take time, and spread the compassion to your colleagues. I wish you luck, keep caring.

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Midwife Fact of the day

A smaller baby IS NOT easier to push out.

This is a common myth among smoking women who wrongly believe that they will have an easier labour if their baby is smaller. I get women saying this to me all the time and I get really sad at how they think that their smoking will actually help them! I have examined many small, wrinkly, unhealthy looking placentas that have been gritty to touch instead of healthy and smooth as they should be. This is what feeds your baby oxygen and needs to be in tip top condition!

Your baby will be smaller, weaker and therefore less able to handle the stress of labour.

With your midwife’s support you can give up and help you and your baby to be healthier!

The Merry Midwife :)

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Maternity Service Awards – London

I am writing this post as I sit very content on a return train from London, destination home having been priveledged to attend the Maternity Service Awards at the Houses of Parliament yesterday. Well done to all the trusts and teams who gained some well deserved recognition for their commitment and passion.

Present at the ceremony was the chief Secretary for health, Andrew Langsley, who spoke genuinely and sensitively about maternity care. The NCT, who hosted the awards spoke about their vision for parent information provision and services for parents which, whilst this is positive – it saddens me that there is such a news from an outside source.

If you ever get the opportunity to attend a conference or ceremony then I would urge you to get to it! It helps you to keep abreast of current issues in maternity care and to keep focused and optimistic. It is also an amazing chance to mingle with anyone right from midwives to nct leaders, lsa midwives and chief execs!

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I’m a Doctor, don’t you know?

The other day I was going about my business assisting the Registrar to suture my client after an instrumental when into the room pops the Consultant on-call…

(Please consider the lack of dignity that the  lithotomy position offers at this moment, and that the woman had never met the Consultant and he had no involvement in her care…..oh and he didn’t knock he just waltzed right on in)

To the Woman “Hello”

To the Registrar- commences discussing the patient in room 3

Me to the Consultant “Would you care to just pop outside Doctor and then I can keep it more private for the lady…” (Spoken quietly at the edge of the room, after approx 3 mins of staring at the woman’s perineum so as to try to not be disrespectful or unprofessional)

The consultant to me “Don’t be ridiculous I am a Doctor!””

Me to the Consultant “I don’t care who you are, at the moment you are just another male looking at the woman’s perineum which I am sure she will not appreciate, and neither would I appreciate if I were in her position”

I think some reminders in how invasive birth can be if handled in this manner would be welcome in obstetric units. Oh and this is not just a Doctor bashing session – please remember as midwives too that we have a duty of care to respect women’s privacy and dignity in birth so knock when you wish to enter a room and ask if you may come in! Not only is this polite to do so but actually helps foster a better birthing environment.

Any thoughts or similar experiences?

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The labour diary

“Right, your waters have gone so we don’t like to leave you too long. I have made you an appointment to come back tomorrow morning at 8am, ok?”

Ok, heard this one? Said it yourself?

Let’s consider the NICE guidance on this…

Induction of labour is appropriate approximately 24 hours after prelabour rupture of the membranes at term. NICE guidelines- Induction of labour 2008

So what happens when the woman has srom at 11.30am? Well unfortunately, women are brought back in a lot of maternity wards at 8am the following morning at 8am, prior to the advised 24 hour period without being given the maximum chance of a spontaneous labour. This is merely due to logistics of the unit and that it seems easier to ‘book’ women in at 8am and 8pm, rather than ad hoc which would be much more individualised. Let’s not forget that a large majority of women will labour within 24 hours of srom.

Other issues that concern me with the original quote:

  • ‘we don’t like to’ who is we?! How patronising
  • Where is the choice, do you offer conservative management?
  • Ok? Does that count as informed choice? Where is the chance to voice that time isn’t appropriate?

What are your thoughts and experiences?

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Hello women, midwives and indeed any other individual who has landed accidentally in my womb of thoughts, confusions and dreams

I am a mere midwife who has been qualified for 3 years now (so midwifery has been my life for 6 years) ooo that’s flown! I am therefore I suppose somewhat a newbie to the world of midwifery in comparison to a lot of professionals out there but I hope to still make a contribution, to learn continually and to teach others (if I have anything to teach). I have thought recently about how best to make reflections and to learn from my day to day experiences, blogging seemed to be the way forward….so here I am.

So why the merry midwife?*

Well, I like to think I am quite an optimistic individual, some would argue rose-tinted spectacled, but I fear that midwives are facing hard times, negativity, lack of support and possible burnout. Every midwife has colleagues who are spent, have lost their way or are cynical beyond imagination. WHY?!

Midwifery is supposed to a passion, a privilege, some would even say a calling. I mean, it is only the miracle of life right?!

Thankfully, there is also billions of bursting with energy midwives or budding midwives out there to remedy the problem. Go on, spread a bit of merry in your midwifery today,

The Merry Midwife

-x-

*No irony involved in this blog title, ever.

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