Friday, 12 June 2015

Bloggie Blog

Hello! It has been a stupid amount of time since my last blog so I do apologise! I have been so busy with 2nd year placements and assignments that this blog, along with my social life, have sadly been neglected.

I will begin with my placement on Fetal Assessment Unit (FAU). It was probably one of my favourite placements so far. It is essentially an assessment centre where women can attend if there are concerns over maternal and/or fetal wellbeing. They can self-refer or be sent up to the unit by community midwives if observations detect a deviation from normality. Cases that I came across mainly consisted of reduced fetal movements, abdominal pain, itching and high blood pressure, but you can be presented with anything and everything.

Over the course of the week I became much more confident in undertaking assessments. I needed some prompting at the start, and I was quite weary of getting anything wrong so I was always asking the midwives to check things! However, by mid-week I was starting to take more initiative. When women presented with symptoms, for the most part I could identify the associated conditions, risks and procedures. It was a lot of blood tests and CTGs! Even though I am probably the shakiest person you will ever meet, I’ve always had the knack of venepuncture. I had to take blood from most of the women I saw, so it was a great opportunity to increase my confidence. Some ladies required special measures to obtain a sample, so I learnt how to take blood using a butterfly needle and syringes which I had never done before. A definite highlight of the week was when I managed to take blood from a client who claimed no midwife had ever successfully obtained a sample, and apparently even the anaesthetists had struggled in the past! Probably a lucky shot, but I was happy all the same.

Although I was only there for a week, I developed great relationships with the midwives working there. They were friendly, approachable and extremely knowledgeable which is all you can ask for in a mentor. I was working alongside another student midwife from my cohort too, and we get along really well. It is always good to have another student on placement, you can help each other out! I even grew close with clients- some women experiencing more complex conditions attended the unit up to three times that week.

Now that I think about it, it was a week of firsts for me. I performed my first membranes sweeps, a procedure I’ve been asking mentors to let me do for ages. They can be really difficult, especially on primiparous women. Fortunately I have long fingers which certainly helps! Following one sweep, I asked a client to give me feedback and she wrote the loveliest things in my pad! I also tried my best at a couple of speculum examinations. I found it really fiddly but I’m starting to get the hang of it (especially now that I’ve had more practice in Triage placement).

I could go on for so long about how much I learnt on FAU but this blog would be 1000s of words! My next placement was on Neonatal Unit, which I had been looking forward to. It’s safe to say I’m glad I went down the path of midwifery instead of paediatrics- it just wasn’t for me. The nurses and doctors were lovely, and I am happy I was given the opportunity to see how the ‘other side’ works. However, as cute as those babies were- I prefer to be able to have a conversation with my clients!

I then had a week on triage- this was similar in ways to FAU. Many women attended reporting the same problems (aches, pains, movements) if it was the night shift as the fetal assessment unit closes in the evening. There were many women with query SROM (waters breaking) and contracting, so I got lots of vaginal examinations and speculums in. Surprisingly, I managed to get the majority of exams correct- which I was over the moon about. Except for one where I assessed someone as 4cm and they turned out to be 8. I have no idea what happened there.

Triage consisted of liasing with lots of different people- from paramedics to mental health services. A lot of the time we acted as a signpost, assessing clients and then transferring them to the appropriate ward. Women at various points in labour were often in the unit, and so much of the time my guesses of progress from outwards appearance were proved entirely wrong on internal examination. One was so close to delivering that I ended up facilitating the birth seconds after her admission to labour ward!

My latest placement was with a specialist community midwifery team who caseload clients in need of extra support. The midwives’ caseloads differed depending on their own specialism and interests, however the cases mostly comprised of women with mental health problems, teenage pregnancies, and those with social care involvement. I found this placement enlightening, and I was inspired by the commitment that the midwives had for their women. I was happy to see a model of community midwifery as it probably should be- continuous care, a named midwife, and no appointments. The specialist midwives each had their own weekly drop-in clinics, during which their clients could visit at any point in their pregnancy. They were so well supported, I know that I would love to have that standard of care for my pregnancy.

I am now very near to the end of my second year. I am in shock that I have made it this far. I am starting to see clients who I have cared for in their previous pregnancies which is so weird! I’ll find myself looking at their toddlers thinking ‘I felt you when you were in your mummy’s tummy!’

Just one week left of placement now on the ward. I have a lot of competencies to get signed off so I am feeling a bit stressed at the moment. At least I know that I will obtain a range of experiences caring for antenatal and postnatal clients on the ward, so hopefully I will be all signed off for year 2 practice in a matter of days.