Antenatal parent education- does it have a place in modern society?

ctmI adore parentcraft, why? Because I adore discussing the subject I love so very much. I love talking to women, their partners, their families about something which to them is unknown and very very scary.

Parentcraft is a funny thing! Some midwives adore it others can’t think of anything worse than “preaching” in front of a group of perspective parents.

It saddens me the lack of funding and hours the NHS invests into parent education. Year after year, maternity reports publish how important antenatal education is in facilitating positive mother and baby outcomes.  How discussing stages of labour, mode of delivery, pain relief, postnatal care and infant feeding to name a few are absolutely vital to achieving positive outcomes.

This week I was lucky enough to look after a lovely couple I had met in my parent craft classes.  Half way through her labour she told me how much she loved parentcraft and how informative it had been!! She recited aspects of the sessions I had spoken about including the stages of labour and the amazing oxytonic affects produced by feeling supported, loved in labour! I felt such a sense of achievement that the sessions had really helped the couple and I went on to deliver their beautiful baby girl!!!

I believe there is a place in today’s society for parent education but midwives must evolve and adapt in order to engage the audience. Nowadays information we all need is just a click away on an app or a search engine. But nothing beats a positive engaging face to face session.

I certainly won’t be shying away!!! I can not wait to get stuck into antenatal education when I qualify!! Spreading the word of the wonderful physiology of pregnancy, childbirth, infant feeding and much much more!!!!

 

 

Mysterious midwife? Vs obstetric nurse

So at the end of this week I will have finished my nine week community placement and I am absolutely gutted! 😩

Community to me IS midwifery- community encompasses the entire midwifery continuum. From booking to postpartum the community midwife is highly skilled in all areas of midwifery. For those who are unaware of what a community midwife does an average day from personal experience is a full antenatal clinic dealing with a wide range of medical, social issues, recognising safeguarding problems- including domestic violence, mental health problems, poverty amongst many many more.

Postnatal home visits, parent education, meetings with multidisciplinary agencies, phone calls from colleagues, anxious women, the hospital…. the list goes on!!!!!!!

One of the most beautiful amazing things we get to advocate in community is homebirth. Indeed research tells us that giving birth in the comfort of your own home with your family, partner, home comforts round you increases oxytocin- the hormone of love, childbirth, bonding and feeding which will therefore lead to positive outcomes. Of course some women are not suitable and we throughly risk assess all women in our care at booking to determine plan of care for delivery, providing the woman with the most upto date evidence based practice.

Of late, being an avid tweeter I have become increasingly alarmed by a small but growing consensus of people who believe midwifery has no place in contemporary society. These people believe it to be an ideology, a fantasy, a dream concept. I was very disturbed to read one post attacking midwives for our quest to promote normal birth as being for our own selfish gains. Believing that promotion of normal birth, home delivery to be nothing more than a ridiculous ideology that no longer features in a medicalised world.

This is the very reason why I feel midwifery is not just underrepresented but STILL in 2017 the average joes’ knowledge of childbirth and maternity is so poor that it is very easy to whip up so much negative hype- particularly on the back of terrible tragedies such as morecombe bay.

Why is childbirth seen as such a mysterious entity??? Why compared to most industrialised countries do we have abysmal breastfeeding rates?

Who do we blame for the increasing trend towards the medicalisation of child birth and the entire maternity care package?

Its somewhat of a wicked problem but all I know is the role of the midwife is to show care and compassion, to recognise deviations from the norm and REFER!!, promote normal pregnancy and labour. To be a midwife you need to care, care about the woman you are looking after, the baby in utero. Our strive for normality in childbirth proves how much we care! We want the very best outcome for the gorgeous ladies and babies we look after.

So please help spread the word-……..Midwifery is a vocation not a cult!!!!

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.

 

Top Tips for Your First Placement

 

There is only two weeks until the first year placements start!!! Not only has this made me super nostalgic (and panicky because I’m halfway through my degree now), but it gave me the idea to write down some top tips.

Be YOU. This may sound like the cheesiest advice ever, but it’s true. With every placement, I’ve started this year, I’ve been quiet and not myself at all for the first few weeks because I’m so nervous. But what I’ve (finally) learnt is that once I started acting like me, I felt so much more relaxed. Make jokes, smile, talk to your colleagues. The secret to making it through any shift, even when you’re not having a great day, is with the people you work with! PLUS, the more you act naturally on placement, the easier it will be to feel more and more like a proper nurse, not just some clown in a uniform.

Throw yourself into every opportunity (if you’re comfortable****). I made a habit of not saying no to any task that was handed to me, just so I could experience everything. Sure, I didn’t always want to walk down to the Pharmacy and ask (for the 8th time that day) where our medication was , but it helped! I got to know the hospital, understand the breadth of the role that the pharmacy has, and take a little breather from the business of the ward. Even boring tasks help you learn something, even if all you’ve learnt is I’m not a mad fan of this!

****Sometimes, you aren’t ready. There are times when you will be asked to do something (like giving an injection) and you might not feel ready. That is OKAY! Talk to your mentor, learn the methods and take some baby steps. You get to decide when you’re ready!

Don’t beat yourself up for making mistakes. They happen all the time. We are learning and working! You’ll do things wrong sometimes and that is okay. Whoever is teaching you should walk you through it anyway.

Talk about your day! One of my favorite times of day whilst on placement is going home and getting it all off my chest. Since I live with non-nurses, I often filter out the gory bits (bless them) but it really helps to process the day and reflect.

Get your paperwork sorted out on time! Both of my first-year placements involved me panicking because I didn’t talk to my mentor about paperwork. I thought it would make me look pushy. It doesn’t. 99.99% of the time, your mentor might have just forgotten or they might have a plan of their own. Just talk to them! If issues arise from there, talk to your PEF and AA.

And finally- GOOD LUCK! This journey is hard and can be frustrating, but there will be so many days when it’s so so worth it.

If anyone fancies trying their hand at blogging their experiences with placement, why not give us an email, a Facebook message or a tweet? We’re always on the lookout for more student nurse’s and midwives!

PTSD and Midwifery- Don’t be ridiculous!

So I arrived home today after a  day of lectures to find the latest edition of the Midwives journal- The Royal College of Midwives (Winter edition 2016) . Having a read through I stumbled across an article regarding PTSD in the workplace.  ‘Facing the truth- PTSD and the profession’ (RCM 2016).

As I read the first paragraph my heart sank- thoughts of nightmares, comments of panic attacks, drinking to stop the thoughts, ascribed so eloquently, this sounded more like a scene from Full Metal Jacket.  As I read further it was revealed that the account was taken from a first year student midwife who had witnessed a horrendous birth at the end of her first year.  My heart sank further- statistics now show that 1 in 20 midwives will experience clinically significant post- traumatic stress disorder in the UK (Sheen et al 2015).

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PTSD affects anyone who has been exposed to trauma, as student midwives, registered midwives and practitioners we are all aware of the enormity of our profession- the severe lack of funding and TLC our precious NHS needs deserves. The RCM (2016a) report that the pressure on midwives has never been as great, longer working hours, no time for basic human necessities like having a wee! Not getting breaks, teamed with the fact that the birth rate is up almost one quarter in the last decade (Office of National Statistics 2014) ,compounding staff shortages and increasing multiple births, increase in maternal age and expectant mothers with pre-existing conditions means the strain and stress on the midwife has never been so prevalent.

The RCM  has recognised this and has adapted the ‘caring for you’ charter.  The aim is for organisations to acknowledge and sign the charter.  To improve the health, working conditions and quality of care of student midwives and midwives.

What I take from this article and what I think we all need to remember is that we must care for ourselves- A midwife who works in a positive, compassionate and supportive workplace is more likely to deliver positive, compassionate and supportive care!

SOOOOOOOOOOOO TAKE CARE OF YOURSELF AND EACH OTHER!!!!  WE ARE ALL IN THIS TOGETHER

A moment of CALM: de-stress with new wellbeing workshops for student nurses and midwives

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It’s well known that in order to properly care for others, we must first take care of ourselves. I’m sure many of us have shared that advice with our friends, family, patients or their carers, yet how good are we at following it ourselves?

As the term progresses and the list of assignments builds up, it is tempting to put our health and wellbeing on the back burner. There are so many competing demands, especially as many of us juggle uni work with part-time jobs, family commitments or other personal issues. It can be overwhelming at times: every student nurse I have spoken to has felt the pressure at one time or another, yet you can often end up feeling quite isolated, thinking ‘is it just me?’ Believe me, it’s not.

Don’t fear – help is at hand! After feedback from previous students, a brand new project has been set up to support students throughout the year. CALM has been designed been designed specifically for student nurses and midwives, aimed at tackling some of the regular issues we might face during the course.

On offer is a four week Mindfulness course starting this afternoon which will give an introduction to mindfulness and share techniques to cope with anxiety and stress. Mindfulness is about being present in the moment, switching off from the endless distractions and learning to calmly accept the emotions and thoughts that fill our minds. Over the four weeks you will be given an introduction to acceptance and be taught some simple stress-busting tips including how to carry out a body scan and breathing exercises. You will also learn how to recognise stress cycle and ways to build mindfulness into your everyday routine.

On top of that are drop-in sessions on money management, for practical tips on how to make your bursary and student loan go further, and a session on housing for anyone who wants advice on finding accommodation that fits our hectic schedules. A series of free sport and fitness classes are also in the works, so watch this space!

meditation-1000062_960_720Starting this afternoon, the Mindfulness course will run every Wednesday for the next four weeks between 1-2pm and there are a couple of one-off money management and housing sessions planned for the rest of this semester. You can book a place on any of the sessions here or contact Eve Foster at sso.intern@manchester.ac.uk – and if you’re interested in the Mindfulness course, it’s fine if you can’t make the first session today.

Don’t forget that the university also offer a fantastic counselling service and a massive range of wellbeing and relaxation courses, from daily meditation sessions to longer courses on low mood and self esteem. There are also plenty of online resources and apps like Headspace that can help you unwind and de-stress.

You don’t have to become a incense-burning zen master to build mindfulness into your everyday life. Mindfulness expert Andy Puddicombe says in this TED talk that we only need to spend 10 minutes doing absolutely nothing to feel the transformative effects of mindfulness.

So kick back, switch off and just breath.

10 things I have learnt so far as a Student Midwife.

I am over a month into my second year of midwifery and already busy with placement and assignments looming on the ever nearing horizon. It has got me thinking about this crazy journey I embarked on a year ago, how different I am , how much I have learnt and I thought I would share some with you.

  1. Keep up to Date: It really is easier to write your notes and do extra reading in the time given as independent study in the week of the lecture. In hindsight this would have made assignments and exams a lot easier in first year.
  2. You will doubt yourself: I have on more than one occasion. I have wondered what am I doing here?! This especially after particularly difficult shifts in clinical practise. However you have to remember you went through a thorough process to get on this course, you do deserve to be here and if you have a rough day, talk it through with your peers, it will help.
  3. It’s not a competition: I ended first year with only three deliveries after a placement on CDU where women would end up in theatre or with intervention. I had actually delivered five babies but two women had retained placenta which doesn’t count. People will tell you they are on delivery number 16 and you will panic but don’t. You have time. It really isn’t about how fast you get there because you have plenty of time to get that 40.
  4. Women are Strong: It really is incredible watching women go through labour and birth. Their bodies are strong, their minds are strong and there really is nothing better than having the privilege to be present at such a special time in their lives.
  5. You are strong: Your body has to adapt to shift work, there are times when you are physically and emotionally exhausted but you get through it and get up the next morning to do it over again.
  6. Being an advocate for women: This is so important and something that over the last year I have taken very seriously. As students, we have the unique position of being more one to one with women and can learn a lot more about their feelings and their concerns. I have voiced women’s concerns to midwives and doctors when the women feels she is unable to.
  7. You change: My life is vastly different to how it was a year ago, your personal life does sometimes take a backseat and that can lead to some sad situations as it has to me, however it is all for the better. You do become stronger on this journey, its hard to see the things we see and not change in some way.
  8. Having said that, Make time for non midwifery things: I have a close group of friends of over 10 years from school and I always make sure that I meet up with them even when it can be difficult when you are working a lot of weekends. Read a book not related to midwifery. Go for a run. Have a duvet day watching Netflix. You will need a break from midwifery.
  9. Express any concerns: Sometimes there are a small minority of mentors in clinical placement who couldn’t make it any more obvious they don’t want you there which can make a day extremely tough and make placement even harder than it already is. Don’t take it personally but do tell your AA, the trust link lecturer or the PEF. In these situations you need to consider your own learning and your own well-being as it can be very exhausting and unnecessarily stressful to feel ‘unwanted’ or ‘in the way’ for entire 12 hour shifts.
  10. How worth everything it is: You are knackered 24/7. You have the biggest pile of research to do. You have a stack of paperwork to fill out. In fact your TO-DO list is never ending. You are on your third night shift of the week and your brain is slowly shutting down when a woman compliments you to your mentor or you help a woman you have been caring for all shift give birth and you realise it is all so worth it. It is a stressful and extremely demanding job but it is also one of the most rewarding when you witness the difference you have made for a woman at such an important time in her life.

There are more than 10 things that I have learnt, and probably better than the ones I have written here, but I do have a lot of work to do! Mine may be personal to me so it would be interesting to read things other people have learnt as a student midwife or nurse!!