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.

Best poem nominated by United Nations in 2006

I have to share this poem that was passed to me at work today:

This poem was nominated by UN as the best poem of 2006, Written by an African.





The poem is called

Kid

When I born, I black
When I grow up, I black
When I go in Sun, I black
When I scared, I black
When I sick, I black
And when I die, I still black
And you white fellow
When you born, you pink
When you grow up, you white
When you go in sun, you red
When you cold, you blue
When you scared, you yellow
When you sick, you green
And when you die, you gray
And you calling me colored?

Poor Record Keeping has Midwife Cautioned

An experienced midwife was cautioned by the NMC for failing to maintain accurate records and then falsified records once she realised she had made an error. The midwife failed to maintain appropriate records which lead to a patient being given the contraceptive drug Depo-Provera while the woman was pregnant. When the midwife realised her mistake and that the patient was pregnant, she falsified the previous entry by adding the words "last menstrual period - first day 11.5.2005" and two weeks later made a further entry - "remembered conversation with patient".

This raises the question of lying to save yourself, however, the fundamental behavior of our nurses and midwives is that of “trustworthiness” that honesty is the best policy – to be dishonest brings our profession into disrepute. Our Codes of Conduct clearly give us guidelines of how to behave and what the expected standards are, this is clearly a breach of these standards.

The ANC did take into account the midwives good record, and that her actions did not result in direct or indirect harm to the patient and the subsequent outcome for the patient was not as a result of her actions. However the committee did find that the inaccuracy of recording and the incidents of falsifying records were not of the standard required of a registered nurse/midwife and resulted in misconduct.

"Nurses are required to adhere to their Code of conduct which says that they should act in a way to uphold the reputation of the profession. The panel considered her behaviour to be unprofessional and dishonest and outside of the NMC's guidelines on record keeping which say that "records should be written in such a manner that any alterations or submissions are dated, timed and signed in such a way that the original entry can still be read clearly".

The midwife had produced good testimonials and that this behaviour was out of character, also the midwife had been dedicated to the profession of nursing and contributed to academic teaching and nurse training.
The report also stated that “last year nearly 10% of the cases that went to a full hearing were to do with poor record keeping”.

Nurses and Midwives need to remember that accurate record keeping is a fundamental part of their practice. Poor sloppy documentation (record keeping) equals a non professional attitude.

Remember if it is not written it is not done!

ref: http://www.medicalnewstoday.com/articles/116988.php