Run off my feet..... Midwife shortage........

Over the span of my career I have usually changed my jobs every 3 to 5 years, for me this has been a good career choice because I feel it has allowed me to be broaden my views. I also believe that it is important to move outside my comfort zone to continue to grow and give the best possible care by experiencing different ways of doing things.

Clinical work is the same where ever you go, babies are born... what is different are the people, both the consumer and the staff, the institutional polices and the paper work. Once you find your feet in terms of seeing how the institution works and the people within it you can then concentrate on the job at hand.

It is interesting when you begin somewhere new or different, it is important to just watch and say nothing........I usually spend the first few days observing, making notes so I remember simple things like how to page for someone, therefore not having to continually be asking the same question. I have also learned to bite my tongue so as not to step on any toes or upset anyone, this has taken me many years to master (this is only because things are done differently to what you are use to). The other thing I have learned over time is you don’t mention “this is how we do it at.............” yes you guessed it, the response would be if it is so good there go back. I suspect this is the same for everyone and every job, not just synonymous with midwifery & nursing.

What is so disconcerting is the shortage of midwives and the requirement or expectation to do more than is normally required because there is just not enough staff. This can be from pushing beds to highly skilled midwifery tasks and no one to take over when you finish your shift....because everyone is so busy. The problem is that no one is willing to say “no” I won’t do it” and why is that? Because the client/patient is the one that ends up having to wait or is disadvantaged. My argument is put it in writing, put what occurred in writing... and send it to management.... copied to the CEO.... however staff are also reluctant to do this.....and why is that?... because this to takes time and effort..... Whilst we as midwives and nurses have this attitude nothing will change and the expectation will remain the same. This will then lead to work dissatisfaction, resignations and burnout.

The other observation I have made over the years is the concept of “this is how we do it here, it’s worked for as long as I have been here, so there is no point changing”. There have been selected staff that always have this attitude... and you will find these staff have been in the institution for a long time. Change is always a difficult concept for some people and this can make work life difficult. This is not intended as a criticism, rather an observation.

So much work and not enough time or staff.... the good intentions of some staff in doing everything for clients when they ring the bell, an example would be.. "pouring a glass of water or filling a jug of water" where the client should be encouraged to get out of bed and do it themseleves, can create more work when you are very busy. But those good intentions are paternalistic and disempowering. However these attitudes can in themselves create more work for midwives & nurses... also clients equally becoming disempowered just by being in a hospital. Women who have had a normal vaginal delivery.....who by being in hospital gain a ‘sick’ mentallity and lose a sense of their power by expecting the staff to do everything for them.... ring the bell to fill the jug up with water... or to pour a glass of water.... where as if they were at home day 2, they would be getting it themselves... these women should be at home.... birth is a normal process.....(Yes if these women have had a caesarean section and are day 1, then the midwife will be filling the jug of water and pouring the glass of water). If we had more midwives we could send low risk women home within 6 or 12hrs supported with midwifery care at home, a community base service surely this would advantage everyone.... being at home has to be better than in a hospital.

Audrey - Is our Health System failing us?

Audrey is my sister-in-law, my husband’s sister. Audrey looked after our house and pets whilst we were on holidays. Unfortunately 10 days before we were due home, Audrey had a serious car accident as she was leaving our house for a day out. It was a case of car verses bus, needless to say the bus won. Audrey sustained serious injuries which included a compound facture of her left ankle, actually shattered ankle, and a dislocated and fractured left wrist together with multiple bruising. She was treated in a trauma unit in a major hospital. We were notified of her accident as well as her other siblings whilst in the UK. It is very difficult when you are overseas trying to obtain information about a loved one in such a condition. However after several days of concern, Audrey was recovering, she is lucky to be alive.


Audrey won’t mind me saying she is 72 years old; however she does object when I call her old, so I won’t say she is old. I asked Audrey to smile for the photo as I was going to put it on the blog, and I can not have a sad sack on. However you can imagine this is very distressing to anyone let alone a 72yr old who really has not been sick and is in generally good health and self sufficient. This sort of accident would rock you to your boots.
Audrey was told that she would have months of rehabilitation and would not be able to walk for at least 3mths. This strong self sufficient woman has now been told that she will be staying in hospital and relying on the system until she is well. This is a lot to take in. So now what do we do, we move her from the trauma unit to a regional hospital, I hear you saying what’s wrong with that? Ok you discuss it first and then make a plan and notify the family and then move. No this is not what happened to Audrey, someone came into the room packed up her things, put her on a stretcher and transferred her, just like that. Audrey arrived at the regional hospital traumatised, upset, crying and nervous. The staff were wonderful, reassured her, comforted her and called her daughters who were very upset to see their mother so upset and in pain.
Was this necessary? What adverse effects will this have on Audrey’s recovery?
Audrey settles, her family are about 20 mins away and have organised a roster system to provide constant support for their mother. She begins to recover much quicker and feels that her support network is in place.
Then several days later she is told she is moving and is moved that afternoon, very much the same way as before, no warning to a hospital that is now 45 mins away from her family and they can only visit in the afternoon. Audrey’s mood drops; she feels isolated, lonely, away from her family and shares a room with three other women whose needs are greater than hers. When she rings the bell it may take the staff 15mins before they answer, that’s enough time to wet yourself especially when you are 72. Goodness I have problems when I need to go without having to hang on for 15 mins and the rest it would take to get the bed pan etc. She feels she is a bother to the staff; she worries about the other patients in the room when they ring the bell and it takes a long time to respond.
Audrey now wants to go home, however unable to care for herself she will be depending on her daughters to help her. Her daughters are more than willing to help, but there is a danger about going home to early.
I am not criticising the staff because they take so long to answer the bell, the criticism is directed towards the government because they are not addressing the issue of workforce shortages that is not enough nursing staff.
Nursing and Midwifery shortages are growing every day, we are hugely understaffed and over worked, and nursing standards are reflecting this because nurses do not have the time to provide quality care as they have too much to do.
Audrey is very aware that the health system is failing her and the nurses of this state, it needs a massive injection of funds and staff.
Patients like Audrey understand that there are staff shortages, but there is no excuse for rudeness and bad nursing.
Take the time to talk to your patients ask why are they upset, don’t just leave them crying or say “you have a broken arm it is meant to be painful” empathy and compassion go a long way. It is all in how you talk to patients, kindly, respectfully and with empathy.
Nursing and Midwifery needs passion, you need to enjoy your work otherwise it reflects in the care that your give your patients / clients.
Smile and the world smiles with you, if you do not like your job then do not do it, find what your passion is and do it, then everyone is happy.