Freshers…all fresh faced and in information overload!

Welcome freshers…..WELCOME! To all the first year student midwives (and nurses)…welcome:-)

You are probably feeling a little overwhelmed with information? You are trying to settle into a new room/house/city if you’ve left home, getting to grips with MyManchester/ Blackboard, meeting new people, finding your way around campus, trying to work out how to fit in all your study skills & core skills, finding your way to campus and battling traffic for 9am lectures, trying to find somewhere to eat which doesn’t involve queuing for half an hour…. etc etc! I am feeling slightly panicky just reading that back! I am not here to throw more information at you just to guide you gently in a supportive direction!

overwhelmed

I am going to give you a few tips to get through the next few weeks of block uni before you head out on placement:

  1. The huge amount of information you are being given is just that…….MASSIVE! Don’t panic. Use your independent study as timetabled and give yourself one whole day off at the weekend where you do NO studying at all. Do something you love on this day! Your brain needs time to consolidate the huge amount of learning and information you are taking on board. Cramming more and more information in constantly is counter productive. Have a day off, do something you enjoy, spend time with friends and chill. You will be more refreshed starting again the following day.
  2. Eat properly! You are freshers and it’s the first time away from home for some of you. Midwifery is not a ‘normal’ degree where you are in lectures 11 or so hours a week! You need to be in good health and that means taking care of yourself physically (as well as psychologically!) to ensure you can maintain the required high energy levels to sustain you through the next 3 years of this degree.
  3. On the same note-get plenty of sleep! Go out and enjoy yourselves but allow time to recover properly…burn out is a huge issue on this degree so start as you mean to go on by resting plenty and being sensible with drinking alcohol! I am hiding my eyes as I write that as I know I sound like an old lady/mum (I am both!) but you can still go out and enjoy yourselves but don’t go out every night and ensure you rest!

drunk penguin

 

 

 

 

4. Try not to look too far ahead…..get through today’s lectures learning as much as you can and do the extra study but try not to worry about what needs doing tomorrow. After this first 6 weeks you will be on placement where you will only be in university 2 days per week (with the associated independent study/extra reading) so this is a really intense period of learning compared to the rest of your degree. See these next few weeks as the foundations being laid for what is to come. You are first years, you are not expected to know everything (we are never expected to know everything but certainly  not as first years!).

5. Be KIND to yourselves, be KIND to your cohort (believe me…they will get you through the next 3 years as few people outside of this degree understand the intensity!) and use us (the 2nd/3rd years, your PASS leaders and all support mechanisms out there!) we are here to help and we want to help.

Go forth and immerse yourselves in the adventure you are embarking on! xx

 

Advertisements

Mind your language!

I have realised as I’ve reviewed my previous blog posts that they tend to be quite personal. This post started as a very non-personal post but then, as I rolled ideas around my mind, I was reminded of times when the language used by Healthcare Professionals (HCP) had profound effects on me; some of these were positive and some negative but all forever imprinted in my memory and all influenced my experience of particular situations so, once again, this post will include my own experiences!

Late summer is a very bad time for me as in August 2013 my beautiful husband left me and our 3 sons and disappeared for 3 hauntingly long, soul crushing days when he made a serious attempt on his life only saved by the fact he was a pretty clean living fella with a nice healthy liver which did its job and chucked the massive paracetamol/ibuprofen overdose out of his body causing permanent liver damage but leaving him alive. This is not a post about mental health or suicide so the details of the lead up to this are not relevant here but suffice to say those 3 days were the worst of my life. I envisioned having to tell our 3 young sons their daddy was never coming home and having to raise my boys without my best friend and soul mate by my side. I imagined trying to support my in-laws with the grief of a second child having already buried their daughter…..they were the darkest 3 days of my life. The reason I am sharing this is to demonstrate the importance of the language we use as HCP.

By day 3 of this nightmare I was fully expecting a suicide note to turn up in the post, instead I got a phone call from a nurse from an emergency department in a hospital ‘down south’. She rang to tell me my husband had turned up and was being treated for the overdose he had taken. Now, the past 3 days had pretty much broken me but I did not break down in tears on the phone for many reasons, one of them being I was a practising counsellor at the time and was familiar with the language of attempted suicide and depression and I heard the news in a seemingly calm way. I then came off the phone and broke down both physically and emotionally.

My husband informed me, during a conversation much much later when we were debriefing during one of hundreds of conversations we had about that time that the nurse told him she thought I was “very clinical and a bit cold considering what she had just told me”. This stayed with me and continues to. I felt judged and misrepresented. I wanted to ring her and tell her that the reaction she heard was the result of 3 days without food and very little sleep, the reaction of a desperate wife and mother clinging to the only version of herself which was solid (the counsellor). I doubt that this particular nurse would even remember that conversation  a week later never mind 4 years later, but I remember it and my husband remembers it. He didn’t need to hear his wife had been clinical; he had no idea what sort of reception he was going to receive when we finally spoke to each other but what he needed to hear was that I had been informed and was ready to talk to him when he felt ready (which is actually exactly what I had said).

In situations of high emotion if you don’t know what to say, stick to the facts. Do not include your opinion and do not pass judgement.

So, onto another example of poor communication and the use of language.

During and after the traumatic delivery of my eldest son (for the midwives amongst us he was an undiagnosed malpresentation and a 36 hour induced labour ended with a rush to theatre for a trial forceps then emergency c-section). Things midwives said to me included:

During labour:

“what do you mean you aren’t getting the sensation to push, everyone gets the sensation to push” (not true, however I believed I was weird and not a ‘proper woman’ as I wasn’t ‘doing it’ right)

“you aren’t trying hard enough” (I used quite a lot of bad language at this point)

“Please try to push harder we need to see more maternal effort” (I cried)

post delivery:

Well, if you had pushed that baby out you’d have broken his neck” (Yes, yes this was actually said to me – his ear was the presenting part so it was probably true but I did not need to hear it)

“We took bets that you wouldn’t deliver him naturally” (so many things wrong with this sentence I do not know where to begin!)

So….therein ends a couple of examples of the poor language used to me personally during interactions with hcp (I have lots of examples from friends but I won’t share them as they are their stories!)

I now want to share some good examples of when HCP have used language in a positive way and how these have also stayed with me.

Following the above traumatic delivery my community midwife (who I respected so much she is a major reason I wanted to be a midwife and who I now know as a colleague) said to me “none of this was your fault. You did nothing wrong and nothing you did could have changed the outcome” (she knew I had wanted a homebirth with candles and words of love not theatre lights and words of terror). These words alone gave me permission to let myself off the hook for not being good enough to have a ‘normal’  birth.

*side note*  Please be mindful of using the word normal it can be very damaging. In terms of delivery I feel ‘vaginal delivery’ is enough without the word normal in front of it, its unnecessary. 

When my middle son broke his wrist and I waited 24 hours to take him to a&e because I thought it was just a ‘bit bruised’ I felt like the worst mother in the world and told anybody who would listen how awful I was and how could possibly I leave him 24 hours in pain poor little soul etc etc. A lovely radiographer took me to one side and whispered in my ear “I am a radiographer, my son broke his ankle and it took me 24 hours to bring him in; I thought he was just moaning”! Brilliant! Still makes me smile and instead of coming out of that situation feeling awful I came out feeling forgiven (although the middle boy still mentions it when he is wanting sympathy!)

All my sons have been in hospital for one reason or another most of which were when they were babies and the language used when communicating with me as a terrified mother has mostly been lovely and comforting (we will ignore the paediatrician who told me I would not be ‘allowed’ in the room when my 8 week old son was having a cannula sited in his head as we mothers tend to get ‘hysterical’ AND the paediatrician who looked at the 90ml bottle of breastmilk it had taken me AGES to express and said “is that all you’ve managed?”……we shall ignore them!!!!).

But this is what I want to leave you with (and something I remind myself of when working with women and their families)…

We may not remember all the people we work with and support or all the things we say but they remember us and they remember what we have said.

…………………….Years and years later.

Ask your friends and family about the midwife who delivered their babies….ask them what she was like (my Nana,at aged 95, could still remember the midwife telling her to stop screaming when she was delivering my 11lb mother as she may disturb the neighbours!).

Ask your friends and relatives about their GP and the things they have said to them over the years,  or the nurse who looked after them when they had their tonsils out when they were 7 years old (“eat the cornflakes or your mummy won’t be able to come and see you” ….I realise I have not had great experiences with HCP!!!!); ask them about the student midwife who took them to one side when their wife was haemorrhaging post delivery and explained who all the scary people who had just rushed into the room were and what they were doing; ask them about the consultant who told them there was nothing more they could do for their beloved dad; ask them about the importance of language and words.

Also, don’t lose sight of the influence of non-verbal communication: our body language speaks VOLUMES. Being clinically good is fundamental to being an effective HCP but being kind and respectful ensures the experience of the people we care for is remembered for the right reasons not the wrong reasons.

What we say matters. It MATTERS. If we are having a bad day and we are a bit too blunt with our language or we are too harassed to sit down and explain a procedure or we are tired and turn a blind eye to somebody you know is on the verge of tears and needs a friendly ear…..these things matter. Of course we have bad days but share these with your colleagues and friends; try really really hard to not let this influence the experience of the people we care for as they are mostly vulnerable and usually scared.

Thank you x

 

 

 

Miscarriage & Midwifing

Before continuing to read this please note it may be triggering for those who have experience of baby loss…..please bear this in mind and take care of yourselves before reading further. This is an incredibly personal post so please note all experiences are based on my experience of miscarriage.

I recognize I am a person who processes life events by writing about them. I realized quite soon after my miscarriage that I would need to write about it to help me grieve but now the time has come I don’t really know where to start. I do know I want to reflect on my experience as a student midwife grieving over my lost baby and how I felt/feel.

I started this blog post by doing a quick search for research and other blogs written by midwives who had experienced baby loss but the area is quite sparse. I was surprised by this as midwifery is dominated by women and as miscarriage effects 200,000 couples each year and 1 in 4 pregnancies end in miscarriage (Tommys.org.uk) the chances are a lot of midwives are touched by miscarriage.

I feel like midwives losing babies is a subject not really talked about. Maybe it is discussed among colleagues, friends and peers but my experience is it all feels a little taboo…..like if I talk about it I may be judged as not being able to do my job or might fall apart when taking care of pregnant women….I can’t really verbalise my feelings regarding this other than this was my personal experience of miscarriage as a student midwife. I felt like I needed to just carry on as taking time off may be perceived as a sign of weakness (this is not something I was told by anybody but it was how I felt). This degree is relentless…if I took time off I may never go back so I felt I needed to be ok…to show resilience, put my head down and ‘power through’.

I started my midwifery degree with 3 school age children and felt my family was complete. Both my lovely husband and I were both told, for various reasons, our individual fertility was irreparably damaged so as a couple our chances of conceiving were zilch….which was fine! After a particularly gruelling schedule of placement, exams, essay deadlines, family pressures etc I felt ill…..really ill. More than tired ill and more than stressed ill…I felt dreadful. I have been pregnant 3 times so I recognise the signs. I returned home after my first exam and did a pregnancy test……which was positive!!! I was stunned! Being a StMw (Student Midwife) the first thing I did was calculate my EDD (estimated due date)……our baby was due on our 13th wedding anniversary…..surely this was a sign that the little miracle bean growing inside me was meant to be?

After the shock settled for both me and my husband we started to get excited….this was a door that was firmly closed, bolted, locked and double padlocked! We had been given a chance! I knew the stats….I am 41 for goodness sake! I recited the stats to my husband to try to keep us grounded in the reality that this pregnancy was unlikely to continue but we had got pregnant against the odds so surely I would be ok?!

I went through a whole array of emotions and my thoughts were racing:

I wouldn’t graduate with my cohort which was gutting BUT I would have a much wanted baby…. which was wonderful!

We had no money…..no answer to that really except we would manage!

We are OLD – our youngest is 7 so we would be starting again when all our friends had similar aged children to ours….we didn’t care, we love babies and children!

….and many many more random thoughts…but most of all we were thrilled and, as all couples who are pregnant with a longed for child do, we made plans. We planned when we would tell people, when I would leave uni, when I would return, how I would cope with the pressures of a full on degree when pregnant in my 40’s, who would do my booking as I know all the community midwives in my area? Would people judge us as irresponsible and foolish? The odds of having a healthy baby were not in our favour so would family/ friends/ fellow midwives judge us for getting pregnant especially given all my husband’s health issues and my ever depressing age?! Do you know what?….we didn’t care! We felt so happy and blessed!

I grew our baby for 10 days….10 remarkable, wonderful days when I felt fertile and hopeful and excited. 10 days of hope and dreams and of improving stats (I found an app that showed the likelihood of me miscarrying reducing by the day)…I fell in love.

We were going away for a few days to end my 3 sons’ fortnight holiday from school. I had 2 exams and an essay deadline during this fortnight so the boys had been bribed to tolerate my emotional absence and grumpiness with promises of having 100% mummy for 4 days at the end of their holiday. On the Friday morning we were going away I started to bleed. By Sunday night it was pretty much all over. The hcg line on the pregnancy test had gone from a strong line to a faded line only visible when held up to the light. I was inconsolable and angry….why let me get pregnant for this to happen? I felt my body had let me down. I felt foolish for hoping….this was an incredibly early miscarriage and in a cold, clinical light I could accept that my very efficient body had dealt with a non-viable pregnancy quickly and with little fuss; but this knowledge did little to stop my heart from breaking.

I called my local EPU (early pregnancy unit) on the Monday morning we were leaving our mini break to confirm what I already knew. The very lovely, kind sounding nurse confirmed I was likely miscarrying and informed me to repeat the pregnancy test a week later to ensure all the ‘products of conception’ had gone and to ring immediately if I started to haemorrhage, have severe pain or pass large clots. My pregnancy was all but over. When we returned home I found the pregnancy test with the strong hcg positive line and I sobbed; that proved our baby had been real, albeit momentarily.

I was on placement in the community the next day and was also scheduled to attend a 20 week ultrasound anomaly scan with one of my caseholding couples.

Would I be ok?

Part of me felt silly for being so upset…this was very early (I was about 6 weeks) and people lose babies at all stages of pregnancy how dare I be so upset about such an early loss? But I was…it was the loss of hope and loss of a future we had dreamed of and imagined. The loss of us being parents to 4 children and being a family of 6 ….or more! We had joked it may be twins (my age and a family history of twins increased this possibility).

I was a counsellor before training as a midwife and during my 15 years as a practising counsellor I experienced major personal life traumas but, with increased support from my supervisor I maintained my practice throughout. I know I am able to acknowledge my own feelings whilst also allowing the space within myself to empathise and be present for others in a professional capacity. For this reason I felt I would be okay to attend placement but remain mindful and aware of my own emotions whilst staying grounded in my role as ‘student midwife’. I have always felt it is my role as a professional to empathise not identify. Allow an individual to experience their own situation without inflicting my personal feelings and experience on them.

I sat in the 20 week ultrasound scan with one of my caseholding couples and I was genuinely excited for them. Their baby looked healthy and they were told they were likely having a baby girl. I was thrilled for them and felt emotional and privileged at being able to experience such a lovely, personal moment. I went home after finishing the rest of my shift and felt ok but the poignancy of the situation was not lost on me as I could still feel my body dealing with the loss of my baby.

So what can we do as midwives?

…….Baby loss is a fact of life…the stats prove this. The stats don’t show the women and their partners behind that loss. The stats don’t show how many midwives experience baby loss. The stats don’t give you the tools to manage that loss. I have coping mechanisms thanks to my previous career but I am not made of stone…..what I found hard was not a 20 week ultrasound scan but an 8 week booking appointment when I would have been 8 weeks pregnant and it would have been around the time of my own booking appointment. I didn’t fall apart and I was (I believe) fully present for the couple during that booking appointment but did I go and have a cry on the toilet after it?…. Yes I did.

What needs to change?

……I am not sure……more talking amongst midwives of their own experiences of baby loss (hence this blog…..very few people knew I was pregnant so I feel quite exposed writing this but I am trying, in my own small way, to challenge the perceived taboo) and an acknowledgement that miscarriages, even very early ones like mine, leave a footprint. Our wedding anniversary will come and go and we will acknowledge our baby existed for however short that amount of time was.

Miscarriage is discussed in a very clinical way with terms like ‘products of conception’, ’tissue’ and ‘chemical pregnancy’ but I needed to talk about my ‘baby’ and ‘hope’. I needed to talk about how I felt about my 3 beautiful sons not having the chance to meet their baby brother or sister. I needed to sob & sob and not feel guilty for crying over somebody who only existed for a short space of time. I am not a Christian or a particularly spiritual person but our baby existed to me & my husband and we need time to be sad. My husband was quite pragmatic until we did the final (negative) pregnancy test …until that point he must have been carrying some hope (I was not; the test for me was a relief that my body had dealt with everything and I didn’t need to go to hospital and have any medical procedures) and he cried. I was shocked…..I am embarrassed that I was shocked as I feel like I should know better but I was genuinely surprised he was so upset. Fathers need acknowledgement within baby loss too and they tend to grieve differently. My experience as a counsellor is it seems to take longer for men to acknowledge loss and therefore grieve. This is worth bearing in mind when supporting families with loss.

If you are working with women and their partners following baby loss, please acknowledge the loss; acknowledge the sadness and grief. Being told “well it was very early” is unhelpful as it undermines a couple’s grief, we needed permission to be sad not platitudes in an aim to ‘cheer us up’.  Being told “well at least you can get pregnant” is also unhelpful as that does not acknowledge the loss of this pregnancy and this baby which is what we were experiencing. What helped me was my amazing trio of fellow Student Midwives who were my friends. They were not clinical or ‘midwifey’ they were my friends and gave me permission to grieve.

Thank you for reading.

 

 

Mentoring-who has the power?

I am sat here just an hour away from heading out onto placement for a final shift on the ward I have been working on and am pondering the nightmare that is getting paperwork and skills signed off. Finding the time, apologising profusely for the massive amount of writing up of skills I do to justify that I am good enough, hoping the mentor feels the same and signs them…..will the anxiety ever stop?!

Part of my thought process has left me wondering about the power balance in the midwife mentor-student relationship. Ideally there would be no power imbalance and the mentor/student would be engaged in a mutual, respectful and supportive pairing but I feel this is unrealistic and ignores the fact that, as students, we are reliant on our mentors to provide good, honest feedback and ultimately grade us which can mean the passing or failing of our degree. Surely, even with my basic degree in psychology, this puts the power balance very firmly on the side of the mentor?

Students, generally, want to please our mentors and not just for the sake of a ‘good grade’ (I feel this is a little simplistic and patronising) but because we want to do well! As a second year I have not struggled and battled my way this far through a very difficult degree to be mediocre and just ‘ok’….I want to be GOOD and COMPETENT. This means when I am working with mentors I ask a million questions and watch, listen and then ask another million questions because I want to be the best I can be.

I wonder if mentors are trained and updated on the power they hold in the relationship? I am sure they are and every mentor I have been lucky enough to work with has been supportive and encouraging whilst providing excellent constructive feedback when needed. Have I been lucky though or is this standard? I am not so sure……

The issues of boundaries in the midwife mentor/student relationship is interesting. My previous career was in an appropriately, heavily ‘boundaried’ arena and I feel I am acutely aware of boundaries at all times but  there have been occasions when my mentor has been made aware of my personal circumstances when necessary as this will, of course, impact on my practice…..could this be perceived as over stepping a boundary? Or, for example, if I ask a mentor if she is ok because I know her child was ill and she left work early during our previous shift….is this overstepping a boundary?

Is this a little too ‘pally’?

What is ‘too friendly’?

What could be perceived as forging a ‘too close’ relationship with a mentor when you are together 8 hours a day/ 5 days week in a car and in clinic and you have your lunch together and you talk……most people come into this profession because we are compassionate so we reach out to each other as 2 women sharing information about our lives…..is this overstepping a boundary? What should we discuss? Should we limit ourselves to just discussing midwifery at all times? But this feels incongruent and, again, unrealistic.

Also, what of mentor-student relationships that are not nurturing but, dare I say it…..toxic and damaging? Where does that student go? Every student knows that we are reliant on the mentor for passing us therefore, dare we complain if we don’t feel happy? Dare we mention to our PEF, link lecturer, academic adviser, ward manager etc that we are not happy?

We SHOULD do but do we?

What if we are branded a trouble maker?

What if we are considered to not be resilient enough for this degree because we have struggled with a mentor?

What if we still have to work with that mentor and they know we have an issue with them?

What if we don’t have to work with that mentor but one of her colleagues and they know we have complained?

We absolutely MUST speak up if we are struggling as the damage of ‘carrying on regardless’ is insistent and could lead to further issues both psychologically and practically further down the line but I hope that midwife mentors are aware of the power they hold and that forging a good, strong, supportive relationship is tantamount to bringing out the best in a student and that the majority of students just want to be the best midwives we can be!

Thank you to every mentor who has treated me with kindness and compassion-you have modelled how to be an excellent midwife and excellent mentor.

To those students struggling with mentorship-please speak out.

 

ATTENTION FIRST YEAR STUDENT MIDWIVES… Your PAD, White book and signatures!

I APOLOGISE AS THIS IS LONG…STICK WITH IT….. IT’S IMPORTANT INFORMATION;-)

Ok…you first years are all starting to think about placement right? It’s about a month away for the student midwives so your uniforms will be arriving shortly if you don’t already have them and you will have your documentation staring out of wherever you have hidden it because, if you’re anything like me, the thought of even starting to read that huge PAD document thing on top of all the studying you have to do is so out of the question it’s unbelievable!

Well I am here to hopefully hold your virtual hand through the whole documentation experience and share my many mistakes so you don’t make them!

First of all let’s clarify the difference between your

pad

 

PAD (Practice Assessment Document)……

 

 

 

 

white-book

 

 

……..and your white book (Record of Statutory Clinical Midwifery Experience).

 

 

 

 

 

You may not believe this but it took me a good couple of months to work out who can sign what and how equally important but different these two documents are!

 

So I’ll start with what I think is the easier one-the White Book. This will be held by you for the full 3 years then handed in at the end of your degree. Your AA will look through this during your individual meetings just to make sure you are ‘on track’.

The White book is where you record your statutory skills which every student midwife at every university will have to get signed off before they can qualify. You have the space in here to log your 40 births which seems to be the area of focus for a lot of students but there are A LOT more skills you need to achieve as well as delivering babies. For example, you need to record evidence of  antenatal examinations & care of 100 pregnant women and examinations & care of 100 postnatal women and their newborn babies.

In these midwifery areas any qualified midwife can sign off your evidence. They DO NOT need to be a mentor/sign off mentor. This is important because you will work with a lot of midwives when on placement and you may carry out a beautiful abdominal palpation and listen to the fetal heartbeat with a pinard whilst your mentor is on a break and you are working with another midwife…..WRITE IT IN YOUR WHITE BOOK AND GET IT SIGNED OFF! The white book just needs the woman’s hospital number, the date, what you did and the midwife’s signature. It can be written up in a couple of minutes and signed there and then! Otherwise you will get home, not written down half the hospital numbers for the women you have worked with that day, for the ones you have written down you’ll have forgotten what parity the woman was or the pregnancy gestation and for the ones you can remember you will realize the midwife who you worked with is now on maternity leave and so won’t be around to sign that evidence off (YES…ALL these have happened to me!!!-it’s gutting!).

There’s areas of the white book which can be signed off by qualified Healthcare professionals who work in other areas i.e. neonatal staff  or breastfeeding support  workers but the important thing to get into your heads about the white book is…

ANY QUALIFIED HEALTHCARE PROFESSIONAL CAN SIGN YOUR EVIDENCE FOR THE RELEVANT AREA YOU WERE IN WHEN YOU COMPLETED THE SKILL

AND

GET IT SIGNED THERE & THEN!

 

OKAY…..big, deep, breath…..THE PAD! Unlike the white book your PAD skills and interviews get handed in at the end of each academic year but you keep the folder (mine is already wrecked!). Your PAD skills are handed in through an official process where you are given a deadline (date & time) and you complete a front sheet for each set of skills and hand them into an exams officer (I point this out because this process was much more official than I expected it to be and it unnerved me a bit!). Your AA will probably take your interviews but this does depend  on the AA; I still have my complete set of first year interviews but I know a lot of my cohort have handed theirs in.

Signing stuff- this is a bit trickier than the white book as the people who can sign your skills off are limited. Let’s just talk about the actual documentation as an opener……..

Interviews

Ideally, at the start, mid point and end of each placement you and your mentor need to sit down and do your interviews. These will be read and checked at your AA meetings and are important for all parties involved as they help you assess where you are up to and also help you gather your thoughts on whether you are getting what you need out of the placement and if not how you can be proactive in accessing more opportunities.

During your mid placement interview do not forget to get your mentor to sign the actual interview AND the mid placement interview section on the front sheet of the set of skills you are working on (i.e. in the community this may be ‘Midwifery Care Pregnancy & birth antenatal skills’ section of your PAD. If your mentor has students from different universities they may not be familiar with UoM paperwork as every uni is different so its your responsibility to ensure every thing is completed.

As an aside, I did not realize our skills directly related to the academic units we were doing until about 6 months in…..don’t judge me I was overwhelmed!!!

Also you will have your progression points at week 19 & week 52….these tend to coincide with final placement interviews but not always so stay on top of these dates….get them in your diaries as both your mentor and AA need to write comments and sign these.

Skills

The skills section of your PAD is divided into 4 sections. Familiarise yourself with the sections, notice which sections coincide with your academic units so you can use what you are learning in university to inform your practice and vice versa, then write them up! Sounds obvious but it isn’t always! For example, if you have been learning about abdominal palpation in university and you are out on practice in the community, tell your mentor you have had a session on abdominal palpation and the use of pinards. Let your mentor know that you would really like to practice this in clinical placement. Your mentor will support you in this (if the opportunity arises) then you can write this skill up using all the theoretical knowledge and the practical skills you gained then get your mentor to sign this skill off! This, I recognise, is an ideal world scenario but this is YOUR clinical placement….make it work for you. This is your opportunity to apply what you are learning in theory to your practice; it is NOT your mentors responsibility to work out which skills you need to practice and get signed off!

Mentor/sign off mentor/SIGNATURES

You will be assigned a mentor when you go on placement for every clinical area you will be working in. You need to find out if they are a sign off mentor (they are usually quite forthcoming with this information!). Only sign off mentors can sign your paperwork and assign you a grade. If your mentor is not a sign off mentor ensure you know who the sign off mentors are in that clinical area and try and work at least a couple of shifts with them. Your mentor can sign your skills but the sign off  mentor needs to countersign them. THIS IS NOT THE SAME AS YOUR WHITE BOOK ! So if your mentor signs off that you are amazing at communicating with women the sign off mentor needs to countersign and date this skill as well.

I am going to **star** and bold and italic this next sentence because this caught me out on my placement and meant I spent most of my last shift at my first year trust running around trying to find one member of staff and ringing my AA almost in tears……..

******AS SOON AS ANYONE SIGNS YOUR SKILLS IN YOUR PAD MAKE SURE THEY SIGN THE SAMPLE SIGNATURE SHEET FOR EACH SET OF SKILLS THEY HAVE SIGNED AND WRITES DOWN WHEN THEY LAST HAD A MENTOR UPDATE******

(i.e. if a sign off mentor countersigns a skill in the ‘intrapartum care’ section of your PAD and the ‘tackling health inequalities’ section of your PAD, THEY NEED TO SIGN THE SAMPLE SIGNATURE FOR EACH SET OF SKILLS.

Imagine the scenario….you are finishing a night shift on the midwifery-led birth centre and the midwife you worked with observed you support a couple during a lovely labour & delivery. You had the opportunity to write up the skills you demonstrated during this shift and you got your midwife mentor to sign these skills off and she quickly got the sign off mentor, who’d just come on an early shift to countersign them before both you and your mentor floated off home to sleep…… WITHOUT GETTING THE SAMPLE SIGNATURE SHEET SIGNED BY THE SIGN OFF MENTOR!!! YOU NEED TO GET THE SAMPLE SIGNATURE SHEET SIGNED (yes this is what happened to me!!!) If you don’t, as a first year your PAD will be referred and you will have to return to your old trust to track down the sign off mentor to sign the sample signature sheet and then resubmit the whole skill set. If you do not have all the signatures completed on the sample signature sheet in second and third year YOU WILL FAIL (this makes me feel sick!).

Another starred, bold, italic section coming up……………………….

****YOU NEED TO DATE EVERYTHING YOU SIGN****

A LOT of my cohort got our PAD skills returned to us because we hadn’t dated our signatures on our skills documents! We had ensured our mentors had dated everything but we actually hadn’t! There is no ‘date’ prompt next to the student signature section but you do need to date it! I cannot begin to tell you what a complete pain in the rear it is when you have finally tracked down the sign off mentor to sign your sample signature sheet, hobbled, exhausted and emotional to hand in the PAD documentation hoping you never have to see it again, only to get it ALL handed back as ALL my signatures needed dating! Literally, every single one of the 60 or so skills I needed to go through and date! DATE THEM!!! Believe me you will not want that PAD handed back to you! If you aren’t sure if something needs dating and signing do it anyway! I am very much ‘better to be safe than sorry’ …once bitten and all that!!!

Think that’s all the terrible tales I need to pass on about documentation!! I do wonder how I managed to even get on this degree as reading back over this makes me look a bit lacking but I blame sleep deprivation!

You will be getting your uniforms soon-empty all pockets before you take it off and buy a tub of vanish….white is a TERRIBLE colour! What were they thinking giving nervous, tired students white?!! One night shift my pen had leaked in my pocket and because I was on an antenatal ward and the women were sleeping, all the lights were dimmed ….by the time I realised my pen had leaked I had fingerprints on my uniform, on some lovely white sheets, on a couple of CTG monitors and on my face!

uniform I was very glad I had purchased a tub of vanish big enough to bath a baby in!

Good luck and DATE EVERYTHING!!!!

 

`

 

 

 

Tips for first year Student Midwives….

CONGRATULATIONS! YOU MADE IT!!! YOU ARE STUDENT MIDWIVES!

How are you all finding semester 1? Terrifying? Is life sciences sucking the life out of you? Have some lectures left you running for the hills crying into your pints at the SU? Have you actually got over the shock of being a student midwife yet and now the reality of being a student midwife is kicking in?

cell-pic

Ok…so as a second year the horrors of that first semester are still fresh enough in my mind that I get goosebumps at the thought of how I felt this time last year but I am also sat here having survived so feel it may be a good idea to share how I got through it! I will add that maybe not everyone finds this first semester as a student midwife hard but I did and a lot of my cohort did so here are some tips that got me through to semester 2 in one piece and nearly sane!

  1. Don’t look too far aheadby this I do not mean do not plan…planning is GOOD (see point 2!) but do not look at your timetable for 4 weeks time and think ‘how can I possibly manage to do ALL THAT WORK?” . Think about what you need to do today and what you need ready for tomorrow. Have an awareness of assignments whilst you are reading stuff but don’t be consumed by it! One day at a time…your knowledge is building up one brick at a time so if you look too far ahead you will overwhelm yourself and you cannot possibly know what you do not know so just be with what you need to do now, today.
  2. PLAN –  you need to be organised! USE the time allocated to you for Guided independent study and independent study. If the timetable says 3 hours do 3 hours! It sounds silly but this will help you ensure you are doing the right level of work. I have a list of studying to do which I add to and cross things off as necessary! It helps me sleep at night not worrying I may be missing something i need to be doing!images-1
  3. Do not over think it (at this stage!)  At the moment you are bombarded with information and, lets face it, you’ve been accepted onto a highly competitive midwifery degree because you LOVE it and want to read and research EVERYTHING around it but you WON’T HAVE TIME! This was a downfall for me! More than once drafts would be returned to me as ‘too complicated’, ‘too complex’ etc because I didn’t want to just read and write about a nice straightforward pregnancy I wanted to research why a perfectly straightforward pregnancy and labour could result in a retained placenta WHY??? Goddamn it!!!! This is not the time for that level of ‘reading around the subject’-read what you have been told to read at this stage as you will have little time to read around the subjects if you want to get through the massive amount of material you need to get through and your FIRST YEAR is focusing on normality do not confuse yourselves by needing to know about the complex stuff….yet! Imagine your knowledge is being built and you need to embed the foundations nice and solidly before branching out further into the more complex stuff!
  4. Use everybody who offers support we are not just being nice we want to help you! Your AA, your PASS leaders, your mentors, midwives on your placement, your lecturers, your PEFs, your ward managers, your PEERS! They are all there as support – support each other! Knowing you are not alone in the struggle is such a bonding experience! Tell people if you are finding something so hard you are questioning your decision to train as a midwife! Take time to check out within yourself how you are feeling and reach out when you are struggling-learning to reflect on your experiences is important on  a lot of levels so the sooner you start the better!
  5. Be kind….to yourselves and others– please be kind to yourselves! Give yourself time off; spend time with your family and friends! Do non-midwifery related stuff! It is EASY to be consumed by this degree but self care is fundamental to resilience and good health so start as you mean to go on! Sleep well, eat well and invest in ‘you’ time it will benefit everybody around you especially you! Look at your cohort-are some people struggling? Reach out to them-this is not a competition we really can ALL succeed but its much nicer if we all help each other along rather than revel when people fall! We are training in a compassionate profession this starts with how we treat each other!
  6. Attend revision lectures – that is it really! Attend them-they are important!
  7. Use social media sparingly– so you did well and got 110% on your first assignment….AMAZING!!! Well done! Please consider why you would put this on Facebook! It’s super you’ve done well and you should be proud of yourself but tell your folks, tell your friends, shout it from the rooftop but jusocial-medast ask yourself why you are sharing that somewhere so publicly when you know others in your cohort are going to read it and maybe might not have managed to get such a great result! We all have areas we are strong in and areas we are not so strong in-support each other and celebrate successes but be mindful of how your fabulous result may make somebody feel who only managed 35% this time.
  8. Enjoy it! You will be frantic at times and wonder how you are ever going to get through your life sciences exam as well as hand in your poster assignment draft, get that presentation ready, complete your placement documentation plus have any kind of extra curricular life! But enjoy being a first year student midwife! Take time to stand on the 4th floor of uni place looking down Oxford Road at the buildings and the hustle & bustle and remind yourself you are a student at MANCHESTER a highly prestigious university! Go to the library and breathe in the smell of ALL THOSE BOOKS embracing how far you have already come and that YOU GOT CHOSEN! Do not be so consumed by panic that you lose sight of why you want to be a midwife. Oh….and learn to scan read! An essential skill!!!

 

What a difference a year makes…..a message to those starting uni in September

This time last year I was 2 weeks away from packing up my beautiful little counselling room and walking away from a career which I had worked in, enjoyed and become competent in for 15 years and I COULDN’T WAIT!

office-1Don’t get me wrong I loved….LOVED being a therapist and in some ways it defined me but I had pondered long and hard about the decision to change careers and it had been an exhausting slog getting to the stage where I felt confident to finally end my practice and leap into this new world of placements, essays, exams, university life, uniforms, night shifts, long days, hospitals, babies, women, families, doctors, midwives, HCAs, colleagues, blood, faeces, vomit, paperwork, paperwork, paperwork and STRESS but I was ready I WAS READY TO GO …or at least I thought I was!

What would I say to me this time last year:

“read everything you want to read which isn’t midwifery related because in a year you will feel guilty every time you pick up a non-midwifery related magazine/book”

“knit what you need to knit, sew that skirt and dress you’ve been desperate to get on with and RUN for hours in the evening when the kids are in bed whilst you still can as that time will swiftly become ‘study time'”

“play with your sons, read with your sons, cwtch them at bedtime and in the mornings before school because these are times you won’t be around for and you will be intoxicated with guilt for all the times you could’ve done this and didn’t. Enjoy taking them to school and picking them up as this will soon become a treat not a chore”

“go and visit your parents and explain to them that the next three years are going to be tough and you will work weekends and when you aren’t working weekends you will be studying over weekends as you have worked all week and yes, this is dreadful as dementia is slowly taking your dad away but drink him in now, absorb him and how he is in 2015 as 2016 will bring a bit less of him”

“go out with your husband-he’s a good, decent man and over the next 12 months he is going to prove time and time again that he can and will step up and be both parents to your sons and keep the kids fed, the house clean, the washing basket empty and the animals fed and you sane(ish) despite you doubting his ability to do any of these things at this moment in time”

“invest in the right people. You have amazing friends in your life, some will still be around this time next year and some won’t-friendships have seasons but you will meet the MOST amazing friends on this course and, along with a couple of decent friends already in your life, they will hold you and wipe your tears and tell you that you can do this despite you truly believing, in your soul, you have made a massive mistake. The friends you make over the next couple of months will be your ticket to making it through the next 3 years and hopefully the rest of your career because your midwife sisters are the ONLYpeople who truly understand what it takes to make it through this career choice. It is HARD but MY GOD it’s worth it”

“and most of all EMBRACE every opportunity….you are going to be scared at times, really scared; you’ve been really scared in your life before and you’ve managed to get through it but this will be a different fear; this is a fear of failure, a fear of actually causing harm because you don’t know what you’re doing, a fear or letting your family down, a fear of letting yourself down but don’t let the fear get in the way of being in the moment and experiencing every opportunity that comes your way because this job you are training for, this career, this vocation is a gift and a privilege and NOTHING that precious comes without a price”

Would I have heeded any of this advice….NAH! I was too excited but it’s nice to look back on and reflect!

To those about to start university-yes you’ll have doubts and you will probably cry and wonder if you’ve done the right thing at points over the next 12 months (& beyond I would guess!) but always force yourself to go and do your next shift as you just never know what might happen on that shift that confirms you’ve done the right thing! Plus-if you need support its there don’t be alone in your worry.