RCM Conference 2014

I thought I would do something a bit different this week. On the 11th of November I attended the RCM conference in Telford, so, I have decided to share my experience with you.

 My trust paid for tickets for 5 of my cohort to attend the conference, and I was lucky enough to be one of those 5. In turn, we felt as though it was a shame that other student midwives in our cohort would miss out. As co-president of our midwifery society we funded another 5 tickets for student midwives to attend the conference. We picked the lucky girls out of a hat and after lots of excitement we began planning our trip to Telford.

4 of the girls and I planned that we would have a road trip the night before and have a girly night in Telford. We booked our rooms in a Travelodge near the International Centre and started counting down the days. When it finally reached the morning of the 11th, we dragged our bags with us to uni, in anticipation of our 3 and a half hour adventure!

Our lectures finished early, at about 2.30pm, so after going for a wee, loading up on travelling snacks and then going for another wee, we were ready to set off. After some initial sat-nav trouble, we were well in to our journey. We talked for the entire journey, from midwifery to men (we student midwives definitely know how to talk). About 2 hours later, our pelvic floor exercises were no longer efficient and we had to stop for another wee break and a drink. 1 more hour in the car and we had arrived in Telford, tired, hungry, needing another wee but definitely excited.

After putting our faces on in the hotel room, we called a taxi and had a lovely meal in Zizzis in Telford town centre. Several bottles of Prosecco and wine were consumed (not by me - I don't really drink), so instead I treated myself to dessert, pomegranate sorbet with popping candy…. yum.

 Taxi home arranged and Zizzis bill sorted and paid we got back to the hotel on a high, and then proceeded to crawl into our cosy beds. We fell asleep watching Knocked Up (us student midwives never escape pregnancy).

The next morning our alarms summoned us out of our cocoons of warmth and out into the freezing cold. We then progressed to have a fight with the television remote and then flood the desk with the faulty kettle, but nevertheless we succeeded in making a brew. If all else fails, student midwives can always make tea, against all odds.

We put on our amazing new society t-shirts and hopped in the car again, in search of a McDonalds breakfast and then our final destination - The International Centre!

After more sat-nav trouble we were running too late for McDonalds breakfast and so we headed straight for the International Centre, in perfect time to register. It was packed inside the venue, I couldn't believe that all of these people were midwives or student midwives, and we were all united in a passion for midwifery. We registered and we got given our welcome packs, which had our IDs, programmes and the all important lunch ticket inside.

First on our list of priorities, hot chocolate, obviously. After queuing for ages in the Costa queue, hot chocolates and flapjacks on board, we made our way to the main hall where the introductions were going to be made. As we were walking through the venue I couldn't believe all the people I was seeing, Cathy Warwick, Lesley Page, Sheena Byrom and a few of my lecturers! The audience was so diverse, with people from all over the country attending. We had got there early and had managed to get some fantastic seats, and our excitement bubbled over as the conference finally got going.

First up to speak was Cathy Warwick, she spoke beautifully and eloquently about the RCM pay campaign for the 1% salary increase. She cleverly undermined the government's rationale against the 1% pay rise, and filled all of the people in the room with pride in themselves and admiration in her. My favourite part of her speech was this: "when midwives speak with a collective voice, they will be listened to." What a way to start, we were all fired up and fuelled with our passion for midwifery, as Cathy introduced the keynote speaker Dr. Ed Coats.

Dr. Ed Coats is an obstetrician and gynaecologist, he's married to a midwife and has a newborn son. He was definitely on the right track. He was funny and clever and very relevant, as he related his trek to the South Pole, with Ben Fogle and James Cracknell, to life in the maternity wards. He discussed the importance of teamwork, and the similarities he had noted between maternity and walking to the South Pole. He told us "the feeling of the emergency buzzer going off is the same as being at -50, all of you have experienced -50." His parting words were that "sometimes admitting your weaknesses is important in a team" and to me, that was particularly relevant, and is also something I'm experiencing on a day to day basis whilst training and running a midwifery society. Dr Ed's speech was definitely a surprise but we all loved it and he was my favourite speaker of the whole day.

After Dr. Ed finished, the student midwives conference started, so we moved over to a different part of the venue. All of the speakers lined up looked brilliant, but I was particularly excited about Michel Odent!

First up was Alison Baum - the CEO of Best Beginnings. I was really looking forward to this as I had recently downloaded her "Baby Buddy" app, and it is brilliant. I think it is a brilliant tool for mums, mums to be and health professionals alike. It is so clever and a fantastic use of today's technology to enhance antenatal care and maternal education.

Then we heard from Paulina Ewa Sporek, a 2nd year student midwife, who is also the founder of the Deaf Nest Project. A project to enhance the care of pregnant women and their families with hearing loss. She told us lots of interesting statistics that I was unaware of previously, for example 8 in 10 people would like to be educated in sign language but only 3 in 10 people get the opportunity to do so. And that 1 in 6 members of the population have some form of hearing loss. It was an inspiring and interesting speech about an aspect of maternity care that desperately needs improving. You can find the Deaf Nest report here http://www.deafnest.com/#!research/cvjx and also follow them on twitter @NestDeaf. Paulina also was responsible for the most inspiring quote of the entire day:

"people who are crazy enough to think they can change the world, are the ones that do"

Finally in this trio of speakers was Katie de Freitas, discussing her special project on Cultural Competency and how to improve our knowledge in maternity. Another interesting and valuable talk.

Michel Odent was next, we all had goosebumps the minute he walked up on stage. His topic was childbirth in the scientific context, and he was utterly fascinating. But what I enjoyed most about his speech was how passionate he was about the topic, his enthusiasm oozed out of him and that meant he was a joy to listen to. There are so many quotes of his that were brilliant so I will list them below:

"A newborn baby only needs maternal love…is that new?"
"We need to protect birth as an evolutionary process"
"The birth process is an involuntary process controlled by archaic brain structures…"
"Stress in labour is important for babies"
"Our role is to protect women in labour from having their natural processes disturbed, with benefits to both mum and baby"
"As you turn off your light to sleep, so we should turn off the lights for birth"
"We see birth as an infinite process and our key task is to protect it"
"Birth does not need to be managed"

Hopefully this gives you a little insight into Odent's speech, and also some food for thought with regards to childbirth in the scientific context.

Lunch! And off we strolled to do some networking. We met so many people interested in the society, and were lucky enough to get hundreds of freebies. Before we knew it lunch was almost over, and we had the utter privilege of having a chat with Sheena Byrom before she started her speech. She was the most lovely and welcoming lady and we can't wait to invite her to our study day next year.

The next trio of speakers were also fabulous. First up was Liz Blamire, a newly qualified midwife talking about what it is like to be a preceptor and the trials and tribulations of being newly qualified. She had entitled her speech "So, do you love your job then?"… I loved this and it reminded me of the title of my first post on this blog. Liz was really lovely to listen to, it was like seeing the light at the end of the tunnel. One of my favourite parts of her speech was "the day you stop learning is the day you should put your pinard away in a cupboard." She was very realistic and didn't sugar coat the preceptor year, which I think we all appreciated and respected.

Stephen Hamilton was up next, a mental health nurse by trade he had taken a slightly different path and had ended up talking to us about acquiring resilience and stress management. He was fantastic to listen to, his entertaining tone and witty aspects of his speech engaged the audience and we loved his cliches. But he gave us some valuable tips about stress management and the importance of taking time for ourselves. He ended with the famous quote "women forget what you did, they'll forget what you said but they'll never forget how you made them feel."

Finally in this trio was Dotty Watkins. A head of midwifery in Sheffield. She was discussing interviewing for our first jobs and how to conduct ourselves in interview. She gave us some fabulous tips including: being careful with social media, spellchecking CVs and cover letters and staying "in the loop" with research and evidence. Dotty suggested that if you do all these things "before you know it, you've embarked on a way of life, not just your first job."


Last but not least, Sheena Byrom, discussing maternity and social media. This was a really interesting and contemporary topic. She stated that "there are 500,00 messages on social media about the NHS, we need to be part of that conversation." She offered us lots of insights into relevant and useful maternity-based websites, as well as offering us advice on how to be safe and that "wonderful things are happening in social media but we need to retain our professionalism." She also told us how "social media gives women and midwives a voice to collaborate together to stand up and make a change." And she ended with the inspiring message "never doubt that you can change the world with the touch of a button."

After Sheena had finished we had to leave to beat the traffic. Our arms were aching from the freebies and we were hungry and tired but we left with happy hearts, and full of admiration for the career which we are all privileged to work in.

My tips for first year student midwives

I can't believe that I'm a 2nd year student midwife. Without sounding entirely cliche, the past year has flown past. Everyone told me it would, but I wasn't quite prepared as to how quick it would really go.

I remember how nervous and excited I was on the first day. I remember listening to all of the lecturers in the induction week, and thinking that going on placement, delivering babies and essays seemed a million miles away.

I'm going to write this post in the hope of passing on knowledge to the new first years starting tomorrow. These are tips that I wish I'd known and utilised in the past year, and that I hope will help you out!

1). Buy a planner - Being a student midwife is chaotic to say the least, I would not have survived without my planner. It helps you plan your time much more effectively, and it helps you with the transition from lectures to placement and back to lectures again. Last year I had a specific midwifery planner, made by the lovely lady that runs the website below. The customer service is fantastic, they're fairly cheap and they are tailored for student midwives. Mine had a "catch chart," a wipe clean meal planner (brilliant for students living in halls), a log of placement hours, a budget planner and also a place to log childcare hours (which is fab for you mummy student midwives).

This year, I thought about a new planner too late and haven't been able to order one. However all of my housemates have one and they're just as good this year. The new planner includes a a vaginal examination guide which is brilliant. I nipped to Staples and bought a really lovely planner. I mainly wanted a lot of space for each day and also a space for addresses and contacts, as I'm focusing a lot on my uni's midwifery society this year. It also has an embedded notepad in the back of it, which is brilliant for my to do lists (you wait - you'll love lists as much as I do in a years time).

https://www.facebook.com/StudentMidwiferyPlanner?fref=ts

2). Memorise your portfolio - In your first year you'll get given your portfolio, or what is officially known as "progression points." At my university our portfolio is split into four different categories. We have our key skills which includes things like bed making, basic observations e.g. blood pressure, temperature, pulse. We have the admin pages which include our fine grading, interim reviews and service user feedback pages. We have our observed assessment pages, for a full antenatal and then a full postnatal check. And finally we have our midwifery skills pages, which are then divided in to type of midwifery care e.g. antenatal care, postnatal care, intrapartum care, neonatal care and drug administration.

In all honesty, your portfolio will become the bane of your life. The best advice I can give you, is to sort through your portfolio before each placement, and make a note or highlight the things that you want/need to get signed off. Discuss these things with your mentor when you meet them, and without fail get them to sign them as you achieve them. Signing in retrospect is really difficult, as often mentors don't remember things you've completed.

3). Privatise your social networking sites - The nursing and midwifery community is very wary about social media usage at the moment. It is true that in interviews, they will look at your social media as the first port of call. If possible, privatise your social networking as much as you can, but in general just be extremely careful about what you post.  I know of several people who have had to face repercussions over what they have posted on social networks. I go with the general rule of: if you wouldn't want to see one of your future mentors to see it, then probably don't post it.

4). Knick knack recommendations - There are certain knick knacks that will make every student midwife's life easier. These are just some of the midwifery accessories that I use regularly.

My torch pen was my life saver when I was working at the midwifery-led unit earlier this year. As a midwifery student you will advocate normal birth, and within all this (you will learn why) we really advocate having the lights dimmed when possible. Trying to see whats going on with the lights off is not easy, as amazing as midwives are, not even they have night vision! My torch pen allowed me to see what was going on when I needed to, without ruining the woman's environment.

A pocket gestation wheel is something that you will use constantly, in the majority of your placements, but community in particular. It allows you to work out gestation, EDD (estimated due dates) and some wheels will also identify landmark weeks e.g. when scans are, when a GTT (glucose tolerance test) would be if needed. A very handy tool.

A badge reel for placement is something you can't be without. Although my trust does permit lanyards, lots of trusts don't as it is a risk for infection. In general however it is just a nuisance, it interferes with everything. I have been completely tangled with a blood pressure cuff before, not a good impression to make! A badge reel means your badge is always handy to get through doors, especially if you have to run for an emergency or run to theatre.

5). Put yourself out there - Placement is scary, there's no denying that, but it's also exhilarating. Even now, a year later, starting a new placement every 4 weeks is nerve-wracking. Imagine starting a new job every 4 weeks? Meeting new people, finding out where you eat lunch and where the toilets are and all that jazz. Luckily however, this is made 10x easier by the fact that most midwives are lovely, friendly and willing to help in any way they can.

Ask as many questions as you can, even if they seem silly to you, the midwives themselves probably asked the same questions when they were students. Equally, don't be frightened if the midwives ask you questions, have a go, often the qualified midwives want to learn from us as well! We know the most up to date evidence, we're learning the brand new guidelines and reading the newest books…. always remember you are a valuable resource to a midwife.

6). Keep a portfolio of achievements - At the end of your third year (as far away as that may seem) you will have to present a portfolio, which basically summarises you, why you should be a midwife and what you have learnt in your three years. You want to demonstrate all of the things that make you special. I bought a special folder, to put in any certificates, thank you cards, achievements that demonstrate who you are as a person. If you keep these things from the start, it won't be such a hassle when it comes to presenting your portfolio in the third year.


Okay enough rambling, those are my top tips for surviving your first year. Good luck, enjoy it and even on the hard days… remember all the reasons you want to be a midwife. Everyone has ha

Missing midwifery

Afternoon everyone.

Apologies for the delay in my blogs at the moment. I'm going to pull out the usual excuse, but this placement has been hard. As many of you will know (or experienced yourselves) in our 2nd year we have to have a certain number of hours doing non-midwifery placements. For me this includes: gynaecology, intensive care, sexual health clinic and the neonatal unit.

I started my gynaecology placement on the 13th October. It consisted of 4 x 1 week stints in different departments within gynaecology. First up was the early pregnancy unit (EPU). I have to be honest, this was the week I thought would be the most relevant, but I was dreading it. I was extremely apprehensive about the sadness and loss I would experience, in retrospect I was glad I had prepared myself for it. The first day was awful, I was seeing scans of people who had experienced miscarriages, who were being told they had lost their babies and I was also observing their counselling sessions. I felt absolutely heartbroken for these women and their families.

Although the staff nurses were lovely to me, the one thing that shocked me was how blasé it was to them. And on the rare occasion, that they were insensitive about these women and their lifestyles and choices. I found this only added to the sadness I felt during the few shifts I had on the EPU. I couldn't help but think, in a parallel universe, in another time or another place, that these women would have had healthy pregnancies and I could have seen them antenatally, been present for their births or seen them postnatally with healthy babies. I know midwifery itself can be tainted with sadness, trust me, I've seen my share of tragedy pre-EPU placement but the fact that it was pretty much constant and so intense really affected me.

I then went on to the gynaecology ward. Despite the fact that the ward wasn't sad, I felt resentful of it as I felt it was irrelevant to my training. I wasn't allowed to do anything and it basically just involved me running errands, walking women to the toilet and hanging around. Not exactly what I would consider a productive use of my time. I did see a woman whose cannula had tissued and had had antibiotics run into her arm, so that was interesting to see and a note to myself to always flush cannulas!

This week I have been in theatres, and although I really wasn't expecting to, I loved it! My mentor was fab and I saw some amazing things. I saw transobturator tapes (TOT) inserted (a treatment for stress incontinence), I saw all sorts of repairs, I saw a bi-cornuate uterus via hysterosocopy and laparoscopy (and then got tested on my knowledge of it by the registrar)… I'll include some stuff about bi-cornuate uterus' at the bottom in case anyone is interested. I also saw a vaginal hysterectomy, a full abdominal hysterectomy and all sorts of other things. Out of everything, I found this the most relevant to midwifery. Being able to visualise the female anatomy was unbelievably helpful and I have learnt that I'm going to constantly do pelvic floor exercises for the rest of my life to avoid a TOT!

The last place to go is gynae outpatients, the other girls have told me it's pretty good there so I'm hoping it will be a good few days. The aim of this post was not to bias people's opinions of gynaecology or non-midwifery placements. As I've said, I have found it useful and some it has been invaluable. However, I miss midwifery, I honestly do. This has confirmed to me that I never want to be a nurse and has just fuelled the passion I have for midwifery. The advice I have for anyone feeling disconnected to midwifery is: find the midwifery aspects in what you're doing, talk to your cohort about how they feel, write reflections and just think about the fact that these placements are only short. I can't wait to get back to uni and I am going to start counting down the days until my labour ward placement in December, finally going to try and start bumping my catch count!

N x

One Born Every Minute

Even as a student midwife I do enjoy sitting down and watching an episode of OBEM, as do millions of other people. I love listening to all the different stories and of course seeing these beautiful babies being born. However, watching OBEM now is much more difficult than in my pre-student midwife days.

It is frustrating seeing everything we have been taught and all of the theory go out of the window in these programmes. My main bug bear (and something I repeat throughout the duration of the programme) is the number of women giving birth on beds; and the number of midwives that do not appear to suggest anything different to these women. Not only does it frustrate me on behalf of the women giving birth, but it frustrates me that this is the message being conveyed to all of the obsessed, hormonal and heavily pregnant women sat on their sofas watching.

It is something that has been proven and that is easily observed… If a midwife and a woman walk into a birthing room together, the woman will immediately gravitate towards the bed. I've seen it happen, and as a student midwife I have had the chance and the time to explain to women about the benefits of different positions.

There are times when labouring and giving birth on the bed is advisable. One of these times can be when a CTG monitor is required, another element that has a cameo on every episode of OBEM. A CTG monitor should only be used if there is a clear rationale for it, however it is an intervention that is often used unnecessarily on women. A CTG monitor does not necessarily force the woman to lay down, however most women feel more comfortable in a non-upright position, and often it is easier to maintain a clear trace this way; despite this, women should be encouraged to mobilise. Other reasons a woman may need to give birth on the bed is if she has a medical condition, if a forceps or ventouse delivery is required and with the majority of women who have had epidural pain relief.

Another aspect of the particular OBEM episode I watched this evening was the lack of encouragement the midwife appeared to offer this woman. The woman asked for an epidural - which is perfectly fine, but the midwife just said "okay."Although it is our role as midwives to facilitate women's choices, I felt like the woman should have been offered some words of encouragement and reassurance on how fantastically she was coping. My feelings are not because I wanted to the midwife to try to change her mind, but to remind her that she has faith in her, whatever her choices may be.

My biggest criticism of OBEM is how unrealistic it appears. It doesn't show the blood, or the amniotic fluid, or the delivery of the placenta. Nor does it show the women being checked and sutured. It doesn't demonstrate the business of the wards. The majority of trusts strive for 1 to 1 midwifery care, however this is not always something that can be achieved for the entire duration of a woman's labour.

I also believe that it needs to show a timescale. The way the programme is edited causes labour to look like: a walk from the car to the labour room, a few puffs of entonox, a vaginal examination and 2 minutes of pushing. For the sake of all the pregnant women watching, a time scale would give them a more realistic idea of labour. So that they understand that if they've been in labour for 12 hours and push for an hour and a half, that is not a failure, that is not slow progress, that is normal labour.

I guess that's it really, to summarise this, I don't believe that OBEM shows an accurate representation of normal labour and normal midwifery care. In practice I tell my ladies that it is a lovely programme to watch, I enjoy it, it's good television, but I advise them to take it with a pinch of salt and enter their own labours with an open mind.

N. x

My first delivery

I have wanted to write about my first delivery for an extremely long time, however I couldn't because I didn't happen until recently. It is part of our statutory regulations that confidentiality is maintained at all times, therefore I can't reveal any identifying details, and I wouldn't want to. Giving birth is the most personal and intimate experience a woman can go through and it should remain that way postpartum.

I was extremely excited for my placement on the freestanding birth unit, I had heard it was the most amazing place to work, and after my first week there I could understand why. The working environment was wonderful, the staff were lovely and the women were thrilled with the care they were receiving.

The one negative was that it was coming up to the end of the academic year, and lots of third years were under their required number of deliveries (which is 40, in case you didn't know). The third years are all lovely, and you can learn a significant amount from working with them and watching them practice. But I'll admit, it is a difficult thing to step away from a woman you've been caring for, in order to let a third year get their delivery. However, you have to consider the fact that when you're in their position you will want a first year to do exactly the same for you. I feel very lucky that lots of the women allowed me to remain in the room as a witness, as well as having the third year student carry out their delivery.

I was swapped for a third year (obviously with both mine and the woman's consent) several times in the placement, and although it was initially frustrating I appreciated the learning opportunity and the skills that the third years taught me. We also experienced several emergency situations together, and we supported each other, and afterwards she wrote to me commending me on my contribution to the emergencies.

Eventually though it came to a head, I needed a delivery in order to get my portfolio signed off. By this point I was almost at the end of my placement, and my last shift passed with no labouring women in sight. After liaising with my mentors and the link tutors it was decided that I would permanently be on call until a delivery happened. I was permanently on call for 3 days and 3 nights… at the same time as trying to finish an essay, revise for an exam and an OSCE. I can honestly say I've never been so tired, but these are the things you do for this crazy course.

After a few false alarms, I got the call I had been waiting for, a lady in established labour. I got dressed and sorted and as I drove to the birth centre I told myself I wouldn't leave until I had had my first hands on.

I arrived and the midwife gave me a handover, the ward was extremely busy that day and so I was going to be this lady's main carer. I recognised her name as I had seen her antenatally, I was very pleased about this as continuity of care is something I feel very passionate about, and there's nothing I love more than seeing a woman I know deliver.

So I cared for this lady and her family for 12 hours, in the early hours she delivered a healthy baby boy, my first delivery! I can honestly say I will remember every detail of it for the rest of my life. It had been quite a rough haul, but I was so emotionally invested and despite being exhausted I was desperate to see this baby. In a way I am glad it was such a difficult day, I worked hard for it and it was so worth it in the end. I will always remember the thank yous, the pictures, their faces when I told them their baby's weight and especially dad's face when I showed him how to dress the baby.

As I drove away I found it hard to believe that I was the first person to ever touch that precious new life; that the woman and her family will remember me forever and that I have to do another 39 of these to qualify!

It was one of the first moments in my life where I have truly felt proud of myself, and I was practically glowing as I rang my mum and said "guess who has finally delivered her first baby?"It is a day that will stay with me forever.

So you want to be a midwife?

Hi :) I'm Nancy. I'm 18 years old, and as of right now I am a few exam results away from becoming a second year student midwife.

I originally started blogging about 6 months ago, but reading the posts back today they are completely cringeworthy! So, as I move into second year I thought I would start afresh.

Midwifery is a roller coaster. Lots of people ask me what it's like being a student midwife, and that's the best answer I can give them. Don't get me wrong, midwifery is the best thing I have ever undertaken. It is rewarding and inspiring and empowering, but it is extremely hard, and not something to be taken lightly.

You have to wrestle working full time on the wards, doing night shifts and long days, working bank holidays and weekends; at the same time as studying, writing essays, revising for exams and trying to ensure your friends and family know you haven't fallen off the face of the Earth. Each of these things is hard enough, let alone doing them all at once.

Midwifery is not like a normal degree. I see my best friends at university, studying their respective courses and I have to admit I often feel resentful; they have no idea what it's like for us. I feel frustrated seeing pictures of them getting ready to go out for the third time that week, while I'm 2 hours in to my third night shift in a row. It upsets me that they miss lectures without a care in the world, while me and my flatmates are dragging ourselves out of bed every single morning without fail. The impact of us missing one lecture is huge. It could be the difference between passing and failing an assignment; or knowing what to do in an emergency on the wards.

I don't want to convey that midwifery is all negatives, I just want to be extremely realistic in this blog. Doing this course is a lifestyle, it's not something you can do on a whim. You have to love it, you have to want it more than anything and you have to work hard everyday for it.

There are days when I get home from a day on placement and I ask myself why I want to become a midwife; but the next day I go to work and the day will show me the million reasons why I've fallen in love with this career. I get to be in the most privileged position, not only do I help bring life into the world but I get to be part of a woman and her family's journey. I am the person they look to, the person who supports them, who reassures them. I have been a shoulder to cry on, a cheerleader, a confidante and I have become an expert tea and toast maker.

There are certain moments that every student midwife lives for. The moment where a woman sees her baby for the first time and her eyes light up; the moment where the woman and her family thank you for everything you've done and the moment where you step away after a delivery and leave the woman and her family in their little bubble of happiness. There are more but these are the ones that stick out for me right now.

At the moment I should be on a 3 week placement on the low risk unit, unfortunately I have shingles and as far as I know I don't think I'm going to be able to return to this placement any time soon. I am so disappointed, I've been looking forward to this placement for a long time. This means I will have to make up 90 hours work at some point, which is a scary prospect. But hey… I told you it was a roller coaster.

N. x