Tuesday, 20 January 2015

Busy Me! :)

It’s been a busy couple of months for me, with two placements to complete, two essays to write and a huge exam to prepare for!

However I can see the light at the end of the tunnel, with most of my academic work for the term behind me and my last week of placement for semester 3 finally here. Next week I will once again be a ‘normal’ university student, with lectures 9-5 and weekends off!

Today I received my grades for my placement on post-natal ward. I am over the moon with the feedback my mentor gave me, its’ given me a real confidence boost!

I wasn’t looking forward to ward prior to my placement, although I’m not too sure why. I have been there occasionally when transferring ladies from delivery suite once they have had their babies- and it always seemed so hectic. However my first day working there reminded me why I love what I do.  I had learnt a lot of what I was doing when providing post natal care on the community- this was the perfect opportunity to develop my confidence. My mentor and I worked well as a team, which I feel helped the women in our bays feel like they were being given enough time. This made for a positive experience for all involved- my client’s feedback was incredibly encouraging and my hope was to be more of a help than a hindrance to my mentor.

Some women were on the ward for over a week post natally, which gave me the opportunity to develop strong client-professional relationships. I was also blessed enough to provide care for women whom I booked and cared for antenatally- meeting their babies was a fantastic experience, especially as I had known some of these families for the best part of a year.

I grew in confidence in medicines management, administered my first injections, helped give a blood transfusion, and learnt loads about the various drugs under the ‘midwives exemptions’. My documentation improved a great deal (this is something that I can struggle with in practice) and I learnt how to discharge women from the ward back home. Once I became familiar with the ward, myself and my mentor would look after a bay each- and I started to take the lead in the care of the women and their babies. After a while I began to notice how much my clients appreciated my care. I received my first bouquet of flowers and was given lots of encouraging comments. My mentor was fantastic at teaching me new things, and I quickly grew comfortable with all of the midwives on the ward- everyone was so friendly and helpful.

I am now back on the community (I have already spent 12 weeks in this area during my 1st year) and I’m finding all that I learnt on the ward has helped me become more competent in practice, especially with post natal home visits. I am now in the final week on the community, and this is the only time I have here for year 2. Next year I will be expected to lead ante natal clinics and visit women at home on my own, so I’m using this placement to learn as much as I can and polish my practice so that I am ready for the responsibility that third year brings.

Speaking of responsibility, this week I need to find a woman (or two) to form part of my caseload. In our 2nd and 3rd years we are required as part of our midwifery education to take on a small caseload. We are recommended to take on between 2-4 women- and these pregnancies can spread the span of the remainder of our degree.  Ideally we shall book these ladies, then accompany them to scans, doctors’ appointments and, if they are experiencing a ‘normal’ pregnancy, act as their lead carer throughout their care.  We are then expected to be on call 24/7 whilst these ladies are at term- so between 37-42 weeks. We should then be notified by delivery suite (or by the attending midwife on call if a homebirth), and provide intra partum care (which hopefully includes delivering the baby!). We can ask any of our ladies whether they would like to be case-loaded, they could be planning a homebirth or an elective caesarean. Personally I am intending my caseload to comprise of predominantly low-risk ladies needing midwifery-led care, so that it is more likely that I can be her primary care provider throughout pregnancy, during labour and birth and post-natally.

Unfortunately, the majority of the women I am now booking on the community are due over my annual leave (and also my 21st birthday). I have my heart set on booking the ladies I take on, so I’m hoping for a ‘late booker’ (past their first trimester), otherwise I may have to settle at asking women at their 16 week appointments. I am so nervous about taking the lead for an entire pregnancy and beyond- but I can imagine this experience is going to be incredibly rewarding. It is a huge responsibility however I will still have my mentor for support and assistance along the way.

Monday, 12 January 2015

University of Greenwich Midwifery society

I cannot believe it is 2015 already! I qualify next year… Oh my goodness.
2014 closed with an exciting month, a brand new placement setting and the launch of the University of Greenwich Midwifery society!

The midwifery society was set up to compliment the degree programme, and is a chance to expand our knowledge with student midwives from other cohorts. I was excited for the opportunity to network with midwives, doulas, and whoever else attending with a passion for midwifery and obstetrics. I had been anticipating this event for some time, with the line-up being as impressive as it was. We had the honour of world-renowned obstetrician Michel Odent heading up the launch event, as well as midwives Amanda Burleigh and Tara Pauley delivering seminars.

Amanda Burleigh spoke to us about the importance of delayed cord clamping. Those who are ‘pro’ cord clamping had a real breakthrough just last month when the latest NICE (National Institute for Clinical Excellence) guidelines recommended not clamping and cutting the cord for at least one minute after the baby is born. At delivery, the placenta still contains up to 1/3 of the baby’s blood supply, and has been associated with a lower incidence of infant anaemia. I find this image of twins below really interesting. Baby A (on the left) had immediate cord clamping and Baby B had delayed cord clamping. Look at the difference in colour!

We then had Tara Pauley, a research midwife, talk to us about her complementary therapies clinic she has recently set up at Hitchengbrooke Trust for post-dates women. As I have mentioned in a previous post, after a lecture on complementary therapies by guest speaker Denise Tirran, I was very keen to learn more. Tara and her team offer services to their maternity clients including acupuncture and aromatherapy alongside optional membrane sweep with the aim of reducing their unit’s induction rate- which they have by a fantastic 5 percent! The NMC states that ‘You must ensure that the use of complementary or alternative therapies is safe and in the best interests of those in your care’ and ‘Registrants must have successfully undertaken training and be competent to practice the administration of complementary and alternative therapies’. Becoming a qualified complementary therapist is something I am interested in upon qualifying- however evidence on its benefits are sparse and often inconclusive. It is estimated that around 80% of pregnant women are now using complementary therapies- however this is rarely disclosed or documented with midwives. Whilst complementary/alternative therapies can be advantageous, they can be very dangerous when not used correctly- this includes ‘natural remedies’ like the well-known raspberry leaf tea. It is important for women to be aware that everything has its contraindications. I was surprised by the vast amount of women using complementary therapies and felt that my knowledge base in this area was still limited. With this in mind I decided to contact Tara Pauley and arrange an observational placement in her clinic for my transition project in July. To my excitement, Hitchengbrooke trust are happy to have me and I cannot wait to work with them in the Summer!

The final speaker of the evening was Michel Odent, who is famous for introducing concepts like home-like birth environments, birthing pools, and the application of ‘gate control theory of pain’ to obstetrics. Michel Odent is known for a few controversial opinions too, such as his view that men should not be in the birthing room. Despite being a relatively new expectation of fathers, it already seems engrained into our culture. Whilst historically women have been known to labour alone or with only female companions, I am not sure I entirely agree with Odent’s statement. Unfortunately I didn’t get the chance to debate this topic with him on the night! However, the in-depth discussions on the use of water in labour, cultural conditioning and microbirth were equally fascinating.

Here are few pictures from the night- a big thank you to the amazing Midwifery Society for putting together such a fab event!