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Sunday, 2 November 2014

Clinical Placement - Week Two - The Birth Centre

Bonjour beautiful bloggles!

Week 2 is over and I’m more emotional than a dog-owner watching Marley and Me. And let’s be honest, that film is killer.

I had 3 more shifts in the birth centre this week and I feel like I’ve come away stuffed full of knowledge, experience and pride. To top it all off I ended my last shift by delivering my very first baby!!!! Woohoo! You can read about that here!

I had a couple of shifts with my sign off mentor this week and I’ve got to say she is FANTASTIC. I feel like the woman is a walking talking font of knowledge and a master of multi tasking. She enters the room like a tranquil tornado and can deliver a baby, keep the Mum calm, manage the other midwives in the birth centre and explain to me in detail about everything she’s doing all-at-the-same-time! Both of my mentors are inspiring me so much and setting a great example of the kind of midwife that I want to be.

I had 2 more witnesses in 2 days…one a very quick water birth that was great to be a part of. I think the Mum was shocked that the baby came so quickly but that is so common with multiparous (women who have already birthed a baby) women from what I have seen so far. It’s a lot to do with the cervix not taking as long to efface and dilate but also I think the woman and her body know what to expect and so the pushing comes a little easier and familiar if they had a fairly uncomplicated first labour. 

My last witness was a lovely birth with a Mum of 4 (now 5!) who really appreciated my support. I had assumed, stupidly, that as she had already done this 4 times she might not need as much encouragement and may have wanted me to take a step back leaving it to her husband to be her support, boy was I wrong. Her husband was very present in the room but more as an observer during her labour, he was a lovely man but it seemed apparent that he would only come to her if she asked him too and they both seemed happy with this distance. I stayed by her side, holding her hand, helping her control her breathing through each contraction and making sure she was drinking plenty of water as the gas and air (entonox) can make you feel very spaced out and give you a dry mouth…especially after hours of panting through contractions. She didn’t want me to leave her so I sat in almost complete silence by her side for most of the labour. She had only briefly been introduced to me after handover from a colleague but immediately she wanted my support.

The amount of trust these women and their families bestow upon the midwives and students is just beautifully overwhelming and makes me feel so grateful for their belief in us. The silence is something that becomes second nature to you as a student midwife. There’s no awkwardness or need to speak all the time and it can be very peaceful to have such calm in-between the contractions.

As I was sat next to her on the floor by the birth centre bed (they’re less of a bed…more like a sofa with a bean bag on to detract from the medicalised labour ward rooms) I was able to monitor the fetal heart beat with a handheld monitor every 15 minutes to ensure that it was recovering from the normal decelerations that occur during the compression from contractions. There was no need to do a vaginal examination, as there are other none-invasive signs that the labour is progressing to the transitional phase. With this lady in particular, although her waters had ruptured earlier, as the baby’s head moved down more of the fluid began to gush out and there were signs of bulging, if she had the urge to push we would let her go with her body as we knew she was ready to deliver. Her husband came over to give her support as she started to push so that I could help the midwife prepare for the delivery with towels and opening the delivery pack… becoming more involved in the actual delivery was so exciting!!

Once baby was born and put onto the mother’s chest it was all very quiet and peaceful in the room. Usually when babies are born there is an eruption of emotion and pure elation in the room. Tears and cries of joy fill the silence but with this lady I felt a very different air of tranquillity so I kept quiet and busied myself with helping the midwife. I’d later find out that this silence actually was golden…What I loved most about this birth was that the lady and her husband were Muslim and after their lovely little girl was born they had a few religious rites that they needed to perform. The father put sweet water onto the baby’s gums and recited an ‘adhan’ in his daughter’s right ear so that it is the first words she hears... this is why it was so quiet after the birth. An adhan is a call to prayer is used in the mosques daily "there is no deity but God, and Muhammad is the messenger of God.”

A while later after the mother had bathed and dressed (you would have NO idea she had just birthed her 5th child from looking at her!!) you could tell that she was just brimming with oxytocin haha! She was in such a happy, chatty, excited mood and as a student I was able to sit and talk to her whilst the midwife completed the admin for her discharge. I took the opportunity to ask her all about the rites of birth in Islam… she was so enthusiastic and knowledgeable! I find myself in awe of religious people and a little jealous of their ability to have so much faith and conviction in their beliefs. I soon realised that I’m going to experience a lot of different religions and really I should research to try and understand their different traditions so that I can be respectful and accommodating for the woman and her family when caring for them.

So there you have it, my last witness and I’m now birthing babies with the help of my mentors. I wanted to do a separate blog-post about my first hands on birth so I’ll get that written and posted ASAP! I’m bursting with excitement to tell you all about it!






Friday, 24 October 2014

Clinical Placement - Week One - The Birth Centre


I feel like I need to pinch myself, I've just finished my first week of placement in the birth centre at my placement hospital but I still feel like I'm dreaming!
I'm bloody-actually-flipping doing it! Although the last year and a half has flown by so fast there's still a huge part of me that can't believe what I've achieved (and I'm a teensy bit proud of myself too but shhh).

My first 5 weeks at Uni were intense and nerve wracking but SO much fun. I've met some lovely ladies (there are no men on our course booo) and my cohort are a diverse bunch of confident, caring and capable women who all strike me as super passionate about women-centred care. So YAY :)

All my stressing and worrying about making friends or feeling under qualified were soon assuaged when I realised that we were all pretty much in the same boat. It was lovely to feel that from day one we were all supporting each other, even if it was just helping someone find the loos!

There is a great mix of students ranging from 18 to 50yr olds, originating from many types of academic and social backgrounds. Some, like me, have taken access courses or A'levels but there are also people with no qualifications that have some fantastic work experience under their belt. There are a lot of us (63!!) so we've had some issues with small classrooms and communication blips but all in all we are working together like one big ol' happy family and everyone is friendly, patient and kind.

Of course there are smaller cliques forming within the cohort but everyone is comfortable mixing and working together as a team which is so lovely.

Don't wanna brag but I reckon that if there was some kind of generation-game-styley-name-

memory-quiz-thang I could remember the whole cohort....that's how friendly it is.

So yeh....I'm chuffed :D

We hit the books big style and after a couple of awkward days 'breaking the ice' and finding our feet, we were straight into lectures. I'm really enjoying learning again, especially the biosciences module which is similar to my access course but more in depth. We're also looking at midwifery from a historical and objective perspective which is fun, as my friends would tell you I love a good debate and hearing other peoples views...even when I disagree with them ;)

We also had a skills week in which we were taught how to take observations such as heart rate, respiration rate, temperature and blood pressure. We practiced urinalysis, injections and abdominal palpations... For me it was skills week when I started to feel a little bit wobbly.

Personal circumstances meant that I wasn't having a great time at home but Uni and the lovely group of girls I've become close to (thank god!) was really keeping my brain focused on other things, still...I felt drained, exhausted and was really struggling to concentrate...

Halfway through that week I really had to give myself a good talking to. This has been my goal for so long and I've already struggled though a year of college, interviews, assessments and a full time job... I pulled myself together and had a really good sort out of all my Uni notes to help me straighten out my head. The rest of the week I fully immersed myself in the skills lectures and came out feeling prepared and confident about starting placement.

We had one last week of lectures at our university hospital, also arranging some study groups so that we could do some extra revision to prepare us for clinical practice. The group of friends I've made are so supportive and without them making me laugh and feeding me cake (it doesn't matter what you do the stereotype fits. Midwives eat cake A LOT) I don't think I would have finished our theory block feeling as happy and content as I did :)

We had an evening of wine and Indian to celebrate (and commiserate our last full weekend of freedom) and wandered off towards our placements like lambs to the slaughter.... Just kidding (sort of)

So....PLACEMENT! I'm working at my local hospital on the very cushty birth centre where low risk, or manageable risk (as I have come to learn) women can come to give birth.
There are birthing pools, bean bags and fancy bubbly light thingies which make it all a very nice relaxing environment, one of the rooms is actually bigger than the flat I used to rent so yeh....it's niiiiice.

My shifts consist of three twelve and a half-hour shifts per week, either day or night hours with an hours break. A lot of people have reacted to my shift pattern with "ooooh so you get 4 days off?" But after one week in the job (which included 2 night shifts- urgh!) I can safely confirm that at least 2 of those 4 days are solely for recovering from feeling absolutely pooped! I don't mind the hours though because I really do think it's the best job ever! Hell - I'd do a 5 day week if they'd let me!

Before we can start being hands on in placement (meaning actually delivering the babies with the assistance of a registered midwife) we students have to witness 5 normal vaginal deliveries. Being at the birth centre means that as most of the women there are low risk I should rack up my 5 witnesses quite quickly! After my first week I've seen 3!

Now as this is a very public blog about very private care, I can't tell you too much about my experiences as I don't want to share any personal details about the women and families I've encountered or cared for. I won't ever name or mention any details which may compromise this anonymity but I will try to describe how I've approached care from a professional view and what I've learned from my experiences.

On my first day I arrived with another girl from my cohort- we met way back before we started Uni during occupational health checks so it was lovely to be sharing my first day on placement with her as well :) we were both pretty nervous and must have looked like such newbies in our pristine uniforms that scream 'I have no idea what I'm doing!!'. We were told that we had just missed 2 births (bah!) but this meant that we spent our shift providing postnatal care for 4 women and getting to know our lovely mentors. Both of them were really friendly and got us stuck in right away doing observations on the women and babies as well as showing us how to fill out the notes. It's really nice that they don't make me feel stupid for asking questions all the time and they always explain everything so well. The toughest part was saying goodbye to the families at the end of my shift, it's so bitter sweet knowing that I probably won't see them again!

I had a day off in between shifts and (as is always my luck) I had 2 night shifts to look forward to. I tried to get some rest beforehand and it wasn't as bad as I had anticipated. Especially as my first night shift was also my first witness!!

It had been a quiet night with no one in the centre and we had received one phone call from a lady in very early stages of labour so I had low expectations for the shift. Just before midnight and to our surprise the lady and her family turned up and she seemed to be in a lot of pain so we admitted her and started to prepare her for labour. She and her family were lovely and chatty so I tried to keep her calm and comfortable whilst gabbing away to the very proud Dad and grandparents-to-be. She had some manageable risks which we had to prepare for, but whilst we were arranging for the appropriate medications and pain relief she rapidly progressed! Within 20 minutes I had witnessed my first SVD (spontaneous vaginal delivery) and could not have been prouder of mum or felt more privileged to have been there. The mum was amazing and she was so pleased that the birth of her little baby boy had been my first witness :)

It was a great experience for me to understand how we prepare for any risks in labour and also how we maintain the management of those risks after a speedy delivery. As I still had a lot of my shift left, I was able to provide a lot of the postnatal care and see how we observe mums and babies with risk factors. I felt like I had a great relationship with this woman and she even requested my assistance with breast feeding which I found really touching. She did a great job and I was in absolute awe of how much she took in her stride.

I certainly won't ever forget her and her family - when I went to say goodbye to her I couldn't wipe the huge grin off my face.

My second night shift was even more eventful with 2 more births. One was super speedy again (note to self, my uniform is a no-no when dealing with explosive waters. Scrubs all the way from now on...) but the other took a little longer which enabled me to give the Mum some encouragement and support during her labour. I find it amazing how these women really listen to my advice and every time I encouraged her to slow down her breathing or relax her muscles she did it straight away. Feeling like she was using my knowledge was so fulfilling and it seemed to help her a lot. The baby girl was beautiful and had the longest eyelashes! I got to give her a cuddle whilst the mum had a physiological third stage which was also a great learning experience. Gravity is definitely the best aid for a natural delivery of the placenta.

So there you have it! My first week in placement!! I'm exhausted, overwhelmed and could not be happier! I'm hoping I get all of my witnesses before I start my placement on labour ward the following week as I feel really comfortable and confident in the birth centre now. It would be lovely to end my time there with my first hands-on delivery... Keep your fingers crossed for me and watch this space :D



Thursday, 2 October 2014

Applying to Uni - The Rough Guide for Wannabe Midwives

For the last couple of weeks my newsfeed on Facebook has been filled with anxious wannabe nurses and midwives posting about results and clearing... And now the results are in a new influx of students will be starting college with the hopes of getting a place next year.
Thinking about all of the worries and questions that I had when I first started out at college made me want to write a post with some advice for applying to study Midwifery at University. I want to share my experience with anyone who’ll be applying in the future and let you know that with a bit of help, hard work (and a lot of patience!) you can turn from a dream into a reality!
So here is my rough guide for applying and successfully getting a place, from choosing your Uni to the actual Assessment Days....I hope it helps!!
1) Don’t be discouraged!
From day one I felt like everyone in the ‘system’ was trying to put me off. I sensed a major lack of encouragement from most of the Universities that I looked at -and in it's place was an overwhelming sense of filtering out the ‘weak’ candidates. At every hurdle there was someone reminding me and my fellow applicants that midwifery is highly competitive, that it is a strenuous and challenging course and that anyone having any doubts shouldn’t apply.

Well… this certainly didn’t make me feel all warm and fuzzy about my future career.

Please, please - DO NOT BE DETERRED BY NUMBERS OR DOUBTS

Discouraging someone from applying because it is a competitive field is like telling the 100m sprinters at the Olympics not to bother racing because Usain Bolt is already running! There is going to be an element of competitiveness in every single occupation in the world and this shouldn’t be seen as a bad thing. Just because a course has 50 places and 2000 applicants it doesn’t mean that you have less of a chance of getting a place. Those places should be given to the most suitable people and there is nothing at that very first stage to say that you are not one of those 50.

Way back in the beginning when I was considering midwifery as a career I had lots of doubts.
Will I be able to do this?
Will I be able to deal with the lows as well as the highs?
Will I be able to cope physically, emotionally, financially?
A million things crossed my mind but one question kept on creeping back – Do you want to be a midwife? And the answer was always a resounding almost booming YES from that place inside my gut– you know the one that also gives you butterflies, the place that fills with dread when something is wrong or twinges when your women’s intuition radar is going off!
I couldn’t ignore that voice, the one that was yelling ‘Go for it!!

I know of applicants who have changed from midwifery to nursing which has a lower applicant rate. They feel it gives them more of a chance of getting into uni to then study midwifery on the 18month course for registered nurses after their 3 yr nursing degree.

Personally I think this route should be a back-up if your first year of applying is unsuccessful. Adult Nursing is SO varied and can be very different to midwifery in a lot of ways. Remember in Midwifery you are technically caring for a well person, in nursing you are dealing with illness, disease and death on a much bigger scale. The conditions you will be encountering are vast and although there are many similarities between the two career paths, it is a long detour to take if your heart is set on midwifery. Changing career because of scaremongering also take places off hopeful nursing candidates, better suited to the role.

The main thing to remember is that everyone has strengths and weaknesses, all journeys have ups and downs but most importantly you have to be in the race to even have a chance of winning it, so don’t be put off before you’ve even tried and don't be encouraged to go down a path that isn't the one you would have chosen for yourself.

Yes midwifery is hard work and yes it is a strenuous and challenging course, but surely those are good things? Personally I can’t wait to be challenged and thrown into the deep end - I looked at these points as a positive not a negative.

If you feel unsure and you are having doubts I would recommend speaking to a professional. My sister is a Doctor so I have always been able to ask her (millions of) questions and I also spoke to the very lovely SOM (supervisor of midwives) at my local hospital about my worries. Healthcare professionals are usually keen to chat and will help you decide if midwifery is for you.

Researching your career options in depth is definitely the best way of establishing the best path for you to take (and listening to your gut ;D) - I'll pop some links at the bottom of this post where you can find more info about becoming a midwife.

2) Choosing Your Uni

For me this was quite an easy task, I live in London so there were many reputable universities which I can travel to within an hour or so, but for many applicants going to uni means uprooting and relocating to the actual uni itself. Here are some things to take into account when researching which Uni to apply to:

  • Location - Can you get to and from the uni easily or are you willing to move there? It might be worth spending a day or so checking out the closest cities and towns to see if you like the area.

  • Placement Location - Most Uni's will have you out on placement for about half of the year so find out which hospitals they work with. You can be placed at any of them (there's no picking and choosing, boooooo!) so you must be willing and able to travel to any of them at unsociable hours for evening and early morning shifts.

  • Reputation - you can generally find out on the university's website about success and employment rates for the midwifery degrees. 

  • Facilities - A lot of uni's now have state of the art practice labs, and lecture theatres which will make learning more effective and enjoyable. As midwifery and nursing degrees are overseen by the NHS, the curriculum will be very similar across the board, but the universities with better facilities will be more effective for ease of learning and study when you are not on placement.

  • Social life - I've already got a degree, so I've 'been there done that' so to speak when it comes to the partying side of uni life and from what I have read, healthcare related degrees are more 'work hard, play a teeny bit' However.... I don't think anyone can get by at university without letting their hair down once in a while. Check out the students union at your prospective Uni's and have a look at the sports and recreational activities that it has to offer. Making friends, having a hobby and going for a drink, when you need some RnR, will keep you sane :)

Once you have a short list of Uni's that interest you- see if they have an open day that you can attend. Many Uni's will also have specific open days especially for nurses and midwives which can be much more useful in finding out course specifics, placement hospitals etc. If you can't find this info on their website give admissions a call and they should be able to help. On that note, calling and speaking to the university was a big influence in my choosing. One of them (who shall remain nameless!) had extremely rude, unhelpful and incompetent staff. This played a huge part in my deciding where to go!

3) Applying through UCAS and writing your Personal Statement

This is such a tricky process, but with the right guidance it can be less stressful I promise!

If you are at college or sixth form you should have special University admissions tutors who will be able to guide you through the UCAS application. 

Filling out your form online is a lengthy task- the best thing to do is to have all of your existing qualifications to hand and go through the different pages slowly, ensuring that you haven't missed any special dates or marks off.

REMEMBER: Nothing is finalised on your application until it goes through your college and you have paid the application fee, so your tutors/teachers should pick up on anything that you have missed off before it is approved and sent off to UCAS.

If there is anything else which you are struggling with, the UCAS website itself has a lot of help sections and will be able to guide you through any problems.

Writing your personal statement is probably the most difficult part of the application. I wrote several drafts and really struggled keeping down my character count! It helps to write an outline of the basic points you would like to cover and set yourself a character count for each.

Some people prefer to hand-write their drafts, but this makes it hard to keep an eye on your character count. I found it best to write it in Word on a computer- as this will also check your spelling and grammar.

Here is my outline for a successful personal statement for midwifery:

Why I want to be a midwife
What is a midwife
Why my reasons for becoming a midwife fit with the role
My experience in a care environment
My current job role
College
Hobbies and interests

*For each of these points I linked myself, my attributes and my existing experience with how this is similar or beneficial to the role of a midwife.*

Don't forget to sell yourself. Don't be afraid of sounding arrogant, you want the universities to read your personal statement and think- wow check out this awesome, intelligent, capable and committed student! They know how competitive a field it is and will be looking for the strongest most determined students.

One piece of advice I would give to any mummies out there who were inspired to become midwives through their own birth stories - don't dwell on this fact. It's definitely a positive to note on your application- but they don't want to read about your baby's birth in depth or have too much info about your personal experience as a mother. They want to know what attributes will make you a great midwife, the skills and knowledge necessary for that role are very different to those of a mother in childbirth- Any advice given to women should come from evidence based research and not personal experience - this poses risks as each woman is different and we need evidence and knowledge to support our advice. You need to stand out from the thousands of other mummies that are applying so talk more about your transferrable skills than your experience during labour.

If you have been reading journals and blogs (like mine hehe) note that down too- taking an interest and being studious is important in showing that you are keen and have the ability to study and research.

Get someone to read through your drafts, like a teacher or healthcare professional, try to accept their criticism and take it on board. At college many of us had our first draft personal statements ripped to shreds by our lecturers, but it was only those who really took on board the changes needed that were invited to assessment days and interviews. Being able to accept help and swallow your pride is a massive factor in being a successful student. 

When you are happy with your final draft and you upload it to the UCAS form, check, double check and triple check your spelling and grammar. Then TADA! You're done!

Be patient and try not to worry....

I know this is easier said than done, boy... did I stress myself out waiting to hear back from the Uni's. I must have logged into UCAS 10 times a day even though I knew I would get an email notification as soon as they had replied. It was awful going into college and hearing that other people had been asked to attend assessment days...and my first notification came from Kings College to say that they were oversubscribed and not accepting any further applications. I felt deflated and almost certain that all of my hard work would be for nothing....but sure enough after a few weeks the invitations came in steadily. I was offered 3 assessment days. Another hurdle, another worry....I was over the moon haha!

4) Assessment Days

This is the first stage of testing which you will undergo when applying, and it can be a bit intimidating, the best way to approach it is to try and relax, practice and prepare yourself.

Numeracy and literacy tests are a requirement determined by the Nursing and Midwifery Council linked to the recruitment and selection of pre-registration nursing and midwifery students. Which basically means - you have to do it (bah!) 

It enables the uni's to test you academically and also see how you handle being put under the pressure and time constrictions of an exam, something which will become the norm once you're a student. Each university will conduct them differently but using the same kind of setup.

All testing is undertaken in exam conditions - no nattering or copying - and will normally consist of a maths paper followed by an english paper usually between 30 and 60 minutes for each one. You may or may not be allowed a calculator depending on the university.

Some of the uni's that I went to chose to give us an hour long maths paper which was then marked. Successful candidates stayed on to take the english paper. It was all a bit 'X Factor' for me and I found it quite harsh that they called out names of those who hadn't passed the maths in front of everyone else.

My advice for these tests is:

PRACTICE do lots of practice tests (most uni's will make these available to you on their websites before the assessment day) and go over GCSE level basic Maths revision and basic English spelling and grammar.

PREPARE yourself mentally and physically. A good night’s sleep and a good meal before the test will help you concentrate (and stop you from passing out!).

READ the questions twice and always check both sides of all papers. I almost missed a whole english section until I flipped the page!! what a close call!!

BREATHE... my beloved Grandad Alf always told me to focus on my breathing whenever I was nervous, upset or anxious and it sounds so obvious but a deep breath can focus you in the most stressful situations.

The maths portion will differ for each uni but the english will normally test your ability to write well in a coherent and structured way. They may also use the english section to ask you to describe yourself and your experiences from the angle of midwifery so try to remember the style and content of your personal statement for this section.

Once again - try not to worry. Many of my friends failed assessments at their first try but it meant that they knew what to expect from their upcoming test days at other uni's and then they excelled. Take your time and do your best - that's all that you can do :)

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I hope that anyone reading this advice guide has found it useful... I'll be posting a guide specifically for the interview stage of the application process soon.

When I first decided to start this journey I never imagined in my wildest dreams that just over a year later I would be starting university after being given an unconditional offer at my first choice. All of the hurdles I had to battle made my dream seem so far away… but with the support of my loved ones and a hell of a lot of determination my dreams are now a reality…..and I’m so happy I could burst!

I know that if you really want it – you can do it too :D

Please post any questions or comments and feel free to send me any advice that you think I should be adding to this guide!

Useful links below!