Juggling and prioritising

02 April 2017
Volume 25 · Issue 4

Abstract

Heidi Stone, winner of last year's BJM Student of the Year award, reflects on the highs and lows of her preceptorship and her plans for the future.

The past year has flown by and I am proud to say that I have survived my time as a preceptee midwife!

I've personally delivered 12 cute little babies into the world and witnessed numerous couples becoming parents. I've supported women labouring naturally, women with epidurals, and women who have gone through days of the induction process. I've assisted normal deliveries, instrumental deliveries, elective c-sections and unfortunately too many emergency c-sections to count, but all for the same goal of achieving a safe and happy birth for both mother and baby.

All deliveries are unique and (I can't deny) scary at times — especially in an elective caesarean delivery when you look behind you in theatre and realise that you have sole responsibility for resuscitating the baby if it doesn't come out crying. Knife to skin seems to take forever and I find myself willing the baby to cry as I play out the neonatal resuscitation algorithm in my head. Thankfully all babies have behaved but my stress hormones often haven't!

The delivery suite has been very difficult at times. I have had to pull the emergency buzzer on a couple of occasions to summon the multidisciplinary team to rush in and assist. I have greeted them with that scared ‘rabbit in headlights’ look, my mind going blank from the pressure and anxiety, incapable of informing them of the woman's history and feeling frustrated and incompetent. However, the team are amazing and seem to be psychic. They know what I want to say even though nothing comes out of my mouth.

I am now on my postnatal/antenatal ward placement caring for families shortly after their life-changing experience, assisting and supporting them in their transition to the responsibilities of parenthood, reassuring them that what they are worried about is normal, while making sure they are recovering from their experience and are well enough to look after their offspring.

“I have tried to listen to my own tips on self-care: I make time to eat and go to the toilet and realise that there is always a five-minute window somewhere in the crazy 13-hour day.”

I have tried to listen to my own tips on self-care: I make time to eat and go to the toilet and realise that there is always a five-minute window somewhere in the crazy 13-hour day. I've learned that it's all about juggling and prioritising. Midwives who are able to do this perfectly seem to be the most in control. I'm getting there and, yes, I am quicker now at documentation and my computer skills have also improved. But no matter how much I manage to speed myself up, I am unable to give as much time to these new mothers as they need. This is something I really noticed coming from the delivery suite to the postnatal ward. The mothers had quite rightly been receiving one-to-one care throughout their labour and then, all of a sudden, when some of them need us the most, they are transferred to the postnatal ward and have to share a midwife with seven other women and their babies. Try as I might and no matter how efficient I aim to be on each shift, I must sadly say that I leave each shift wishing I had more time to spend with certain women. Don't get me wrong, the team I work with are amazing, which makes the day run much more smoothly. A competent health care assistant or maternity care assistant on shift really lightens the workload and our dedicated discharge midwife is a godsend for happy families desperate to get home and settle in with their newborn. However, I personally feel like I have never helped enough, something I know resonates with my colleagues, and unfortunately this is something that is never going to change in the wonderful, demanding world of the postnatal ward.

My final placement as a preceptee midwife will be out in the community. This is an optional placement, but I feel that to complete my preceptorship, I should complete my studies by refreshing my community midwifery skills. I've previously enjoyed the autonomy of the community setting, particularly managing my own clinics. However, I have a feeling that the challenge will be to keep to the time limit in my 20-minute appointments, as I always talked too much as a student and made my clinics overrun!

Overall, this past year has been challenging but fun and I am lucky to work with the supportive multidisciplinary team who have been there with me through my huge learning curve as a preceptee midwife. I've cried tears of sadness and joy. I've learnt a lot about myself and every experience I encountered, good or bad, has changed who I am and the way I practise. I admit, I've gone home on days when everything seemed to have gone wrong and I wonder why I gave up that desk job, but then I realise how lucky I am to be in a position to help new families like the midwives did mine all those years ago. I can honestly say I wouldn't change it for the world.