Just realised the other day, that in the humdrum of everyday life, I have completely forgotten about my blog! Time to update on how things are going, now that I am a qualified midwife, and what to expect in the first few months.
My first rotation placement was on the Maternity Ward of a busy urban hospital. There are 36 beds on the ward, for both ante- and post-natal women. There are also transitional care babies on the ward, who may be underweight, or premature, or on IV antibiotics. The ward is almost always very busy, and sometimes completely full, and the pressure is on to empty beds for women coming down from Delivery Suite. The community we serve is very multi-ethnic, and it’s always interesting to find out where women come from, and hear their stories.
I started out with a full week of induction, including training on manual handling, blood transfusions, pumps and other equipment etc. In the next 3 weeks, I was supernumerary on the ward, which meant I wasn’t counted in the numbers of midwives officially counted as working that day, I was only given a few women to be responsible for, and a ‘mentor’ was available to me if I had any questions. I took full advantage of all the midwives I was working with, bouncing things off them, getting second opinions on CTGs, and asking about Trust protocol in so many different areas. I was nervous to start with, but caring for 4/5 women at a time was similar to what I had been doing as a third-year student, and once I had found out where everything was stored, I felt a bit more at home.
BUT, then I became a proper midwife, no more supernumerary shifts, and that first few weeks was really tough…
It was a busy time on the ward, and I was caring for up to 11 women on a 12-hour shift. The problem was that I was really slow at everything! Getting a woman discharged took me an hour, and when 5 or 6 needed discharging in a day, there just weren’t enough hours. The ones who were staying in were probably the ones who needed care the most, as their babies were unwell, jaundiced, pre-term etc, or they themselves had had very difficult births, or had other medical problems, such as hypertension, obesity, or infection
I felt like I was constantly firefighting, answering callbells, providing pain relief, checking blood pressure and temperature, giving emergency breastfeeding support, to women who were crying because it wasn’t working. It was overwhelming. My worst days came when I was also preparing women for caesarean section as soon as handover was finished, doctors were milling around asking if they were ready, delivery suite were phoning for them to be sent up immediately. I had a list that I needed to follow, get them in a gown, and into TEDS stockings, check their obs, fill in the pre-op checklist, prepare a blank treatment sheet for drugs, enter them as an admission on the electronic system, and make sure we had a valid group and save on the system so that we would be able to request bloods for a transfusion rapidly if it were needed.
Somewhere in there, I also needed to explain what the routine was when going into theatre, when the partner would be able to be there, and to reassure them that it wouldn’t be scary like operating theatres on the telly, that it is friendly and informal. I think the experienced midwives do the whole thing in 10 minutes, it was taking me 30 at least. The stress was massive. And once I’d finished all that, it was already 9.30, 2 hours into my shift, and I still had 9 women to look after who I hadn’t even seen yet.
I made mistakes, of course I did, (and still do!) We are only human, and it takes time to be familiar with new systems, new staff, and the increased level of responsibility. It felt like there was never enough time in the day, and I would get to the end of my shift with two women who were still desperate to be discharged, but I somehow hadn’t managed to find the time. All of which was handed over to the night staff, who never complained about it (to my face). The midwives I was working with reassured me, reminding me that we provide a 24-hour service, and that the night staff would only be bored if we didn’t leave them something to do! Everyone was very kind, and the women especially were so understanding.
Over time, things got better. By the time I was 2 months in, I had figured out how to prioritise the tasks I had, and how to delegate to the HCAs who were lifesavers, removing catheters, helping with breastfeeding, answering callbells. I became more familiar with how the paperwork worked, and got faster at doing those jobs. It became more fun! I started to settle in, and after 10 months on the maternity ward I loved it so much I didn’t want to leave for my next rotation onto delivery suite, but that’s another post😊