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My Student Midwife Journey

Registered Midwife (BSc Hons 1st Class)
by babycatchertobe @ 2015-10-24 16:36

Yes you read correctly, it is all over! Three years of blood, sweat and a considerable amount of tears have culminated in this. Michelle Tant. RM.

The last few shifts went by without drama, I managed to squeeze in a shift on Triage which was really helpful and spent the rest of the time in Community where my mentor signed me off as competent and gave some lovely feedback so I finished feelings as prepared as I could be I think. The rest is up to me apparently and the wait began for the paperwork to be completed and my name to appear on the NMC register. Which finalised this morning as my iTp married up with my registration and I can  officially practice as a midwife!

Another piece of news is that I wrote an article and it has been accepted for publication by the MIDIRS Digest so I am very excited about that - it is about the factors influencing fathers feelings about breastfeeding. It was developed from my undergraduate dissertation and I have to say one of the biggest challenges was reducing it from 7000 to 2500 words! Not really sure what to do now, I'd like to write more but may just take some time to concentrate on being a midwife for a little while.

Incidentally I watched a lot of box sets whilst waiting for my PIN. Probably far more than was sensible but after three years of not having a single unaccounted for moment I decided I could do with the time out and for student midwives coming up to finishing I would suggest you do the same. And breathe...

So this is the very last blog post on this page. I am no longer a student midwife though my journey as a midwife learner is just beginning. I hope you have enjoyed reading my story and that it might even have been useful in some way. I wish you the very best of luck and success in your own journey, I can't tell you it is going to be easy but it is most definitely worth it in the end.

2 Weeks to Go

My current blog platform is sadly folding and so I am moving the blog over to my other blog. I've re-read and satisfied myself that my future PIN isn't at risk though I've enjoyed the freedom of the anonymity I must say.

On looking back I realise that many of my post titles have included a period of time and today's update is no exception. I honestly cannot believe it. Just 14 days left to go. 5 shifts left as a student midwife! These last few weeks have been great confidence builders for me, practising in the community is an excellent place to really understand your sphere of practice as well as gain a good appreciation of continuity of care and carer.

I can't remember if I already said but I had an article published in Essentially Midirs so that was very exciting (haha for me anyway!). I wrote about the challenges of supporting women in the postnatal period who have babies in the special care unit. You may have worked out by now that I love writing so I was thrilled to see my work published and I am currently working on another piece. It would be lovely if it got published but at the moment I am just enjoying writing it.

So all I have left to do now is my final few shifts, my final interview with my community mentor and to hand in my portfolio which has been quite a challenge but hey ho.

Since writing last I took (and passed) another exam, a joint module with the nurses about leadership in the NHS. It was more interesting than I thought it was going to be, I passed my dissertation with a mark I am over the moon with.

It is the middle of the summer holidays so I'm also juggling children, thankfully my husband works part time and has also managed a decent amount of time off so with any luck we will survive the last 3 weeks.

I have NO CLUE what I am going to do once I hand everything in. Box sets I suspect.
In an effort to wrap this blog up with a nice pretty bow I will update once I'm all done. An actual grown up midwife! Blimey.

The end is suddenly in sight



This update is not quite as soon as I planned it to be however on the plus side, my absence from this blog has meant that I have finished my dissertation, taken my final exam and only gone and got myself a job!

Yes, a real life midwife job.

The relief really is palpable (ahem) and I am now swinging between excitement and terror at the thought of having my own registration. Excitement at the thought of finally doing what I have been working toward for so many years and becoming the midwife I imagine I might be. Terror at the thought of the responsibility... though I must say this is tempered by the knowledge that I will work within a team and while as a midwife I can practice autonomously, I will never be in isolation.

I have also reached (and surpassed!) that mecca of student midwifery numbers, magic number 40!

Again another relief and now my plan is to concentrate on building my confidence and skills in supporting women experiencing high risk labours. Realising I could carry out normal care, build a relationship with the woman and her partner AND do all the documentation was a revelation and gave me the confidence to go into my midwifery job interview knowing I could do my 'bread and butter'.

I now have a month or so left on delivery suite and then the remainder of the semester in community where, all being well, I will be signed off as a competent midwife by my community mentor. Still lots to do and a lifetime of learning but right now I'm feeling optimistic.
 

The light at the end of the tunnel and gold standard midwifery

It is February which means that in a little over 6 months I'll be qualified (all barring my doing something utterly stupid of course).

I am currently in the middle of writing my dissertation. In the interests of maintaining some sort of anonymity all I will say is that it is something to do with Breastfeeding. I am enjoying it far more than I imagined I would which is a pleasant surprise though admittedly I do find myself whinging about it a fair bit. Perhaps if it was just one thing to do then it wouldn't be so bad but there are a million and one extra things to do before qualifying and on occasion those things feel like an insurmountable mountain. On other occasions I chalk it all up to building character and resilience. So in theory by the end of this course I will be a fascinating person who can cope with anything...

Hmm.

I have recently finished a 4 week placement in delivery suite and will shortly be going out into community. I feel I made some decent progress while on labour ward which was reassuring so I am looking forward to coming back and consolidating that (as well as finishing off my numbers and remaining labour ward skill).

I have been starting to think about where I want to work ultimately (in terms of setting rather than location) and at the moment I feel that I want to work in the obstetric unit for the following reasons. I love normal labour and it genuinely gives me a thrill to see it happening and to be a part of that experience, it is a privilege and a pleasure. I firmly believe that the updated NICE guidance is spot on and low risk multiparous women should be given the information about birth outside of the obstetric unit and the choice to birth at home or in a birth centre/midwifery led unit.

However a huge amount of women are now classified as high risk and their options are limited and choices are harder to make. Although some women are confident enough to stand up for the sort of birth they want, accessing SOMs, declining certain interventions etc, not all women feel able to do this. It seems to me that many women accept the status quo of 'doing as they're told' under the belief that doctor knows best and they feel they have to let go of the control they have over their bodies, any choices they thought they might be able to make in pregnancy, labour and birth and leave their dignity at the door.

Now I am fully aware of my remit as a midwife and I understand that there are a great many situations where the doctor really does know 'best' (so to speak, seeing as I also believe that women 'know' too) however the scope of normal midwifery care is to give woman centred care, to be her advocate, to provide evidence based care within my sphere of practice. Therefore it is my privilege to provide care for those high risk women. To be at her side as her labour deviates from the 'normal' path, to identify the areas where she can retain some control over her experience, to carry her dignity with me as I meet her at the door to 'my' house to welcome her as my valued guest and help her to feel at home.

These women are equally as deserving of 'normal' midwifery care because normal midwifery care has the woman at the centre, and I believe I have much to offer her, regardless of whether she is planted in the middle of normal or hanging over an obstetric precipice.

I hear a lot about how independent midwifery and caseloading is the gold standard of midwifery but I believe gold standard midwifery is much more portable than that.

My plan is to update more regularly before I qualify, as much for my own record as letting you in on this crazy journey. Til next time.

Third Year Elective - Birth Centre



For my elective I chose to stay in the UK and go to a preferably busy birth centre and after a lot of emailing, phone calls and generic stress, I managed to sort one out. My message to students starting to think about their elective is to plan early and make contact reasonably early, though not so much so that they forget about you! They are likely to require references from your university, proof that you ARE in fact a student and not just some random who fancies watching babies being born.

I am now half way through and have seen a variety of experiences, including an obstetric emergency which I have to say was handled with such calmness and efficiency, an outsider would have a hard time knowing there was one going on at all, it was amazing. Obviously I won't go into detail but I also saw a wonderful hypnobirth and the way the woman breathed her way through her huge powerful contractions was fantastic. She was of course very well prepared and was determined to birth naturally so that certainly would have had a primary bearing on her experience.

The transition from 1st to 2nd stage was interesting though and I think I will be doing some reading up on the effect of breathing away all the contractions on the natural urge to push. Obviously my experience at this point is fairly limited. Altogether I've been present at around 50 vaginal births (27 of my numbers squeeee) and the ones who've simply gone with their bodies and pushed spontaneously when they felt the urge have been the most satisfying from my point of view because she has done it herself, listened to her body and done what felt right.

Then there's others where I've encouraged women to ease the baby out at crowning gently by blowing out because you can't push when you blow out. So I get the idea that the contraction force will bring the baby down but I've not seen that in a primparous woman, even with an epidural. I don't know. I think what I am incoherently trying to articulate is I wonder whether conditioning a woman to blow out through all her contractions takes away her ability to listen to her body's signals telling her she needs to push her baby round the bend now?

What I do know is I want to see more hypotherapy births. The power and control was so firmly in the woman's hands it was breath taking. We, the birth attendants, were gathered around her and supporting her but she was the centre and it was exactly how I imagined it should be.

The baby was born and we were quiet and the time belonged to the new parents, no shouting congratulations, no bustling around clearing up, just quiet and watching and absorbing. I loved it and I am ruined.
 

Only 52 weeks to do how much?!

First day back at uni today and first day of third year and perhaps I'm tired but oh my goodness, the volume of the work to do in this year is huge.

* Dissertation - due June 2015
* Management and planning exam
* Elective and presentation
* Practice document with 11 skills
* Breastfeeding evidence book and workbook
* Caseload a minimum of 2 women
* Portfolio

Then of course there's time in practice, study days, paid work and if I can squeeze it in at some point I'd quite like to see my family.

Hey ho.

End of second year already?



The second half of my second year has flown by despite my best efforts to slow time down. For those of you interested I did survive theatres and I learnt so much. I didn't mess up the sterile field even once which was a great relief as you would imagine. My confidence in maternity theatres has grown which was my intended outcome. I subsequently completed my pre and post op theatre care clinical skill and my advice to anyone facing this skill is to spend as much time with recovery nurses as you can, even if your trust doesn't have them on delivery suite, make the time to spend time in general theatres recovery with them. You will learn so much!

My next non midwifery placement was on the special care baby unit. The babies there were mainly premature babies now a couple of months old. Still so small and needy and I spent a lot of time doing observations and enteral feeds. I learnt the importance of parental involvement and this was one of my takeaway learning points. It must be utterly exhausting, both physically and emotionally to be the parent of a wee one in special care.

I also learnt plenty about thermoregulation, hypoglycaemia and jaundice and the nurses were very generous with their time and teaching skills. A number of them highlighted the fact that following midwifery training I could go into neonatal care and while I see this is a possibility for some, it's not my path! The time I have spent in non-midwifery has been so valuable in so many ways, not least in cementing the knowledge that midwifery is where I want to be.

We started our inroad into research this year with a short essay about the research process. I enjoyed it far more than I imagined I would and this has meant that the dissertation doesn't loom quite so formidably on the horizon, though of course it is still looming fairly large! The seed has also been planted for my future self and research which was the other surprising byproduct! I didn't see myself as a researcher but the module really opened my eyes to the possibilities and the excitement of discovery and being a part of informing practice so who knows.

I finished the year with a delivery suite placement, punctuated early on by the dreaded OSCEs. For nearly two months I lived, breathed and dreamed obstetric emergencies. Drilling them into my brain, reading, talking to myself, posters all over our bedroom (God bless my long suffering midwifery widower of a husband), playing with dolls and pelvices (Pelvi?)and finally the big day came, and went. I survived and my hard work paid off with the sort of marks I'd hoped for.

Not long after the OSCEs we had a massive postpartum haemorrhage on the unit. I dashed into the room and started scribing and realised very quickly that I was looking around the room anticipating the next action to be taken. It meant that my documentation was spot on and I had some lovely feedback from the midwives about it which was a real confidence booster. My advice to any student is to take on the role of scribe when you can, you will learn so much.

So I ended my second year with 25 births in my book, one in my very last shift which was a wonderful way to end the year. I was completely exhausted though and the reality of a break hit me like a tonne of bricks and I slept so much for a couple of days. Following my brief hibernation I have been enjoying the time off and trying not to think too much about the fact that as of Monday I will be a senior student. Third year and no leaning on the old "I'm just a 1st/2nd year" thing anymore. This is it. One more year until qualification and all that keeps washing over me is how on this sweet earth will I know enough, and be confident enough to be a real life midwife this time next year?

The midwives are so lovely an reassuring and have been telling me that third year is the best in terms of building confidence and starting to get a real feel for the kind of midwifery I want to practice, and the type of midwife I want to be. So I'm also excited and optimistic. I'll keep you posted :)
 

Just over halfway!

Having finally pressed submit on a public health essay and sat the exam on pathophysiology and altered health in childbearing, I can now say I am over halfway! I read over my previous post and noted with a slightly raised eyebrow my comments about second year blues. It's fair to say I've been having them though I'm hoping I'm past the worst of it... though the OSCE's aren't yet upon me so we'll see. The sheer volume of work, the mountain in front of me... I wasn't seeing the wood for the trees. Submitting the huge essay helped.

I have now delivered 19 babies which includes one set of twins so actually my deliveries stand at 18 currently. I've been keeping a private brief log of all my mothers and babies experiences, something I have a slightly fond idea of carrying on throughout my professional life. Every single one has been special in it's own way and I carry memories of them all. The twin birth was extraordinary and a massive learning experience.

I swing between delivery and catch because it can be either. It's fair to say that midwives have varying degrees of involvement in birth! One woman birthed her baby the second she crossed the delivery room threshold - I pulled on my gloves and caught, yes literally caught that baby with my fingers in 2 fingers of the gloves. I didn't drop the baby. Phew. Repeat the Scout motto - be prepared! I now carry gloves about my person at work at all times because you JUST. NEVER. KNOW.

I finished the first half of my delivery suite placement just after Christmas and moved into my non-midwifery placements. I have now completed my gynae ward placement and am onto theatres. Gynae ward was great, I think I improved my basic care observation skills and have a new found appreciation for the importance of pelvic floor exercises. DO THEM!!!!! The nurses were great, really welcoming and keen to help me get the most out of my experience. I enjoyed getting to know the patients over the course of the shifts, learnt so much and saw the nurses doing their thing - they are amazing. The job they do under pressure, with staff and bed shortages, is nothing short of incredible.

It was interesting to reflect on the differences between nurses and midwives. Are dual qualified nurse/midwives better midwives than direct entry midwives? Nurses are better at looking after women with co-morbidities and I don't dispute this... midwives must be comfortable within their sphere of practice. If a women presents with symptoms outside of the normal, then refer onto the multi-disciplinary team. Acknowledge the different skill set with some overlap - this makes us complimentary rather than competitive I feel.

It is generally accepted that general theatres have a culture all of their own so I'm also interested to discover what the differences between general theatres and maternity theatres are, so will be watching carefully. Theatres has been fascinating, I've seen some gynae and some breast surgery. I'm hoping to increase my confidence in the theatre setting, at the moment I'm stuck at the internal dialogue which goes a little like this "Please God don't let me mess up the sterile field...Don't faint for goodness sake.... Please God don't let me mess up the sterile field...Wow!!!!.... Please God don't let me mess up the sterile field..." And so on.

Well that's about it for now, I'll let you know how I get on!

Second year?



The new cohort of first years started this week at university which can only mean one thing... I am officially a second year student midwife!

Obviously this is not a massive surprise but I have to say that the realisation did hit me quite suddenly yesterday when we had our 'meet the first years' session. I reflected on the same session last year when I was in the same position, nervously sat in a circle with the second years, looking at them thinking "wow they must know so much!" and "I can't even imagine being a second year". And here I am, sat there thinking "Oh no they think we know loads! Arggghhhhh" Just smile.

The moment did pass however and we enjoyed spending time with them, giving some reassurance where we could and welcoming them to the rollercoaster. Ahhh, we're growing up!

It was interesting though; thinking about my initial reaction to the situation. Because actually we DO know so much more now then we did at that moment and that really came home to me in the two lectures we had yesterday. Lectures which would have been utter gobbledegook to me this time last year but because of the grounding in anatomy, physiology and midwifery, they made sense and were interesting rather than a scary time of trying desperately to learn the basics. I realised that the basics are in there and now is the time we are reaping the benefits of that grounding and building on it.
Cardiac disorders are frightening things if you don't know the structures of the heart and the circulatory system so it was a revelation to be sat there fascinated rather than scrabbling.

Turns out there is method in the NMC/University lesson plans and process after all.

So I am loving the lectures and I know it will get even harder but I am excited to learn about the things I see women experiencing in practice. After the summer break we went straight back to placements and the expectation is markedly increased as second years and I have had the opportunity to work a bit more independently (of course under supervision of my mentor) and that has caused my confidence to increase.

Whereas before on the postnatal ward I was responding to the women's care needs, I now realise that was on a bit of a superficial level. Now I feel more confident in the clinical skills I find I am wanting to know more about the rationale behind that care and what happens if I don't do something etc. Not that I wasn't interested before, just that my learning was being taken up with learning the basic skills and what are the presenting symptoms etc, now I've got head space to look deeper if that makes sense?

The NMC skills we have to get signed off this year are in more depth so while there are less of them, they'll no doubt take up just as much time. Then of course the OSCEs in June next year as well as the Public Health module and the dreaded 'seen' essay exam.

We also have the non-midwifery placements coming up - placements in Gynae ward, theatres, Special Care Baby Unit and Day assessment unit. Lots to occupy me and right now, this moment, I feel ready for the challenge. Bring it on.

Remind me of this optimism when I get second year blues please someone!
 

End of the first year... third of the way there?

It is with some surprise that I have found myself at the end of my first year of being a student midwife. Friends in the second year told me to watch out as it will be the fastest year of my life but I just thought to myself that there is so much to learn and July 2013 seemed such a long way away. But here it is. I've passed my 11 clinical skills required of me by the NMC as well as all the competencies for year one, I've passed both anatomy exams and the Safe Medicate drugs calculation exam. I've passed 2 essays and waiting on the results of a third. I've clocked up 625 clinical hours in community, labour ward and postnatal/antenatal ward.

That, people is first year. If I was under any illusion (and I wasn't) that the first year of uni is a 'doss' then that would have been shattered. While other 'normal' students finished for a three month break ages ago, us NHS students were still slogging it out with the divine prospect of a whole 3 weeks off starting last Friday when we handed in our Practice Assessment Document (PAD).

This year I've really pushed myself, worked hard and I'm proud of my achievements. I'm continually bowled over by the privilege to work with the women and families - they allow us into the most intimate of moments of their lives, into their homes, into their family history even. It's extraordinary and I love it!

There has been some tough times, babies born in poor conditions, understaffed wards, stressed staff and then of course trying to juggle the demands of the degree with my home life, my wonderful children and amazing husband who makes all of this possible. Rarely complaining, actually sounding interested when I come home and rearranging basically his whole life so I can go for my dream.

So second year in a few weeks. I'm looking forward to finding out what the skills are for this year and learning about pathologies in pregnancy and birth. I'm apprehensive about the increased expectation of me as a second year.

But right now I'm looking forward to going to Cornwall for a week with the family, reading a completely nonsense book (as opposed to heavy non-fiction midwifery texts) and eating plenty of Cornish cream teas. What diet?

I'll be back!

Cinderella of the service?



So I have now had my baptism into the world of the postnatal ward. If I'm honest it does feel a bit like another planet at times. I had this slightly rosy idea in my mind of spending time with women helping them to breastfeed, helping to make them comfortable, some baby care, probably quite a bit of nursing skills involved with obs, bit of wound care etc.

The reality was dashing around like a headless chicken trying to keep on top of drugs rounds, mother obs, baby obs, draining catheters and so many task oriented things that my head was literally spinning... because literally every single member of staff is stretched to, and beyond capacity.

There were the odd moments when I'd answer a bell and would get the chance to sit with 'her', spend some time and try to remember that I am actually supernumery, that being with women is the learning I am here for. Moments of her telling her birth story, proudly showing off her baby.

I think I had a reasonable understanding of the 'More Midwives' campaign before postnatal ward - busy times on labour ward when midwives are dashing between rooms trying to make women believe they are the only woman in the world right now, times in the community when a woman really needs a lot of input to get the feeding outcome she hopes for but the midwife is acutely aware of the 10 other visits that need to be carried out that day - but postnatal ward was literally a case of splitting yourself a million different ways.

I prefered the night to the day and I have a page full of things I need to reflect on. This short missive is literally all I have the time and energy for right now. Night night.
 

Baby Catching

I always had a strong suspicion that life on a labour ward would be pretty varied but nothing could really have prepared me for the reality. There is not a massive deal you can do to prepare yourself for the onslaught of emotions, learning, experiences and drama of the delivery suite.

And then... in the middle of all that a woman will gently breathe her baby out and you'll hold your own breath because its such an extraordinary moment and you'll remember exactly... EXACTLY why you're here.

I'm starting to think there is both baby catching and babies that are delivered having done a little of each! There seems also to be so much difference between midwives practice... hands off, hands on, hands poised, guarding, hovering. It's still early days for me yet but so far I can see benefit to both hands on AND off. I like the perineal warm packs which seem to be quite effective too.

I had a birth where the baby was born pretty flat and went grey which was horrendous and very scary, we rang the emergency buzzer and the room filled up so fast it was unbelievable. All was well and though scary was a great learning experience for me. I find that I am going home after every shift with a long list of things to look up and read... not that I'm finding I have any time to do it. Literally minutes here and there.

We have now finished now for the easter break and I feel so ready for it. Being a student midwife is incredible and worth every moment of exhaustion but it really is full on and non stop. Theres uni days, placement shifts, assessments, clinical assessments, NMC competencies, sharing the womans experience case loading, extra reading, revision for exams, the exams themselves, then of course family life intertwined in all of that.

Last week I worked a night on saturday (sleep saturday afternoon and most of sunday), long day monday, night on tuesday (sleep tuesday afternoon and until 2pm on weds) then uni all day thursday.
So on thurs evening I was sat with my husband and commented that I felt I'd come home after being away for a few days. In that respect it can be quite hard and trying to grab moments with the kids and husband is tricky but needs to be done otherwise I end up feeling a bit disconnected.

Oh yes, the short story is that yay it's the holidays! Happily it falls over the easter holidays this year too :)

Why doesn’t everyone want to be a midwife?



Going onto labour ward was one of those things that felt so far away on the horizon that it sort of took me by surprise when it finally arrived. All that preparation and then all of a sudden there I was, sat in on handover. Looking up at the board, trying to follow the labour ward coordinator as she went through each of the womens details.
Surreal.

Thankfully my community mentor had given me a practical run down of my labour ward arrival. So I knew where to put my coat, my food, whether to get changed or not (not), where to go etc and it really made the difference, not having to worry about those things. No doubt its extra work enough having the brand new students come without them stood stranded in the corridor with no idea where to wang their sarnies.

After handover it was straight into the thick of it and almost immediately found myself supporting a woman in labour. It was amazingly intense and there were these moments when she was staring at me so hard and concentrating so deeply that you feel like she can see inside. Fanciful perhaps but I do know already that you develop such a fast relationship with these women that you continue to think about them after their discharge to the postnatal ward. Quite a wrench really.

I think I feel like I have found the inklings of my 'voice' in terms of supporting a woman in labour.
Feels weirdly instinctive and not awkward. Then going from that to the amazement on some womens faces. Even though they physically have just given birth, theres this amazement and surprise on their faces like "How did you get here?" Its such a special moment.

So what have I done? I've finally managed to take blood (venepuncture) and it wasn't scary at all. I've carried out VEs (vaginal examinations) and actually found the elusive cervix as well as assessing dilatation. Haven't felt any sutures yet even though I'm fairly sure I felt the bregma (anterior fontanelle). I've seen a baby born quite quickly and another not quite so quickly and needed a helping hand from a kiwi (a ventouse, not a New Zealander necessarily). I have also seen a cesarean section which took longer than I thought it would (and was just as bloody as I thought it would be). I've cut an umbilical cord, examined a placenta (or 3), administered a vitamin k injection to a newborn, passed things to the obstetrician while she sutured a 2nd degree tear. Made up feeds for twins and helped them feed. Cleaned a room - learnt how to do hospital corners, made tea and toast (and lots of it), done loads of obs and plenty of breastfeeding support. Oh and learnt a bit about CTGs and cord gases. And thats all the stuff I can remember while I'm sat here now.

The midwife I've been working with has been brilliant, given me lots of opportunity to get stuck in and I made a vow to myself that I would basically say yes to every chance given me to do something. So thats my words of wisdom to any future student midwives. Just say yes!

I took my exam a few weeks ago too and I'm hoping that went ok, feel reasonably confident I did enough to pass! (hopefully more than pass but you know what I mean!) Also got results back for my first essay and am very happy with my results for that so happy days.

I have not yet caught my first baby, despite all the above. I'm in a OB led unit so that has an impact but I know my time will come. Just enjoying the ride at the moment and learning loads. First night shift coming up soon. A little worried how I'm going to manage the sleep pattern thing but it'll be fine. I'm going to leave you with a quote from one of my favourite midwifery books. Enjoy!

"I remembered my midwifery school classmate, Gaia’s comment: “Just think about it. As midwives, we meet wildly interesting people and stay up all night with them. We ask them questions about their sex lives, eat their food, feel inside their bodies, snoop around their houses, drink champagne at all hours, and best of all, we get to catch delicious little naked, wet babies. What I can’t figure out is, why doesn’t everyone want to be a midwife?”

(Peggy Vince, Baby Catcher, Chronicles of a Modern Midwife)
 

End of first placement #sadface

Next week is my last week in this placement, my first of two community placements of the first year.
I've had an amazing time and learnt so much, my mentor has been wonderful, I literally couldn't have hoped for a better one. I've been fortunate to have her for most of the time too, some of my cohort are all over the place with lots of different mentors so the continuity perhaps not so good as well as getting skills signed off is a difficulty for them.

Working in the community has given me a real sense of 'my women'. When I see on the list that women I've seen before are coming in I feel really happy to be a part of their continuity of care, getting to know them, understanding what their fears are and being the support they need is a real priviledge and I've leart loads about the kind of midwife I would like to be on qualification. I think I've fallen in love with antenatal care... we'll see how I feel after being on labour ward, will my first love be taken over? Who knows, watch this space :)

So yes, my next placement is delivery suite and I'm a bit nervous but more about the logistics and practicalities of it - what will my new mentor be like? What do I take in my bag? Do I wear a vest top under my scrubs? Weighty stuff LOL.

No really, this is huge... labour, birth, obstetric emergencies... how on earth will I react? Only time will tell.

All things considered though I'm really excited about this next step, seeing another part of midwifery, the culmination of the mothers efforts, being there when it happens. Epic.
Wish me luck :)


First semester nearly done!



I don't know that I mentioned in my last post here that I did buy a cuff and steth... turns out my husband has an acute case of white coat syndrome and I was left with the worry of whether I needed to take him straight to A&E for chronically high BP. Worrying. Until he tells me that always happens and he could literally feel his heart racing as I put the cuff on. Why on earth he didn't tell me I have no idea so that practice avenue is out.

Thankfully I've now been doing it loads in practice and feel so much more confident! I can also do urinalysis (well read a dipstick anyway...) and am reasonably consistent on abdominal palpations. We have been taught Leopolds manoevers at uni and I've observed most midwives using Pawlicks grip in practice so thats interesting.

I've done some formative assessments so far and hope to get a few summatives done in the new year but we will come back onto community in the first year so there is a bit more time. I've done my first newborn blood spot test which was fairly nerve wracking but with the new testers (swipe rather than 'stab') its fairly good at getting the required amount of blood. Have you ever heard of Maple Syrup Disease? Neither had I until today.

I've also had a little taste of early starts and I'm really not a morning person, I come alive in the evening really so it feels counterintuitive to go to bed early but I'm starting to get used to it.

I've seen so much, the vast majority of which I can't possibly write about on here, but it is the most varied and interesting and amazing and simultaneously heartwarming and heartbreaking job in the whole wide world. (In my humble opinion)

I have a couple of assessments coming up including an exam and then in February I go onto my delivery unit placement. I am hoping that the mentor I get there is as lovely as the one I have in community.
 

First week of placement done!

Yes you saw right... I'm finally out on on placement. We had 2 days in uni and two days in practice and so far my experience has been great.

But first of all a quick look back on the last few weeks of theory block. As we got closer to the 'time' the content got more and more practical so we learnt about antenatal examinations, bookings etc including all the various observations, screening and diagnotic tests. I think I already mentioned that we have looked at the cardiovascular system but we went on to look at the blood, what changes in pregnancy, what blood tests are done and why.

As community is the first placement the topics seemed geared toward this initially though we have labour days coming up on our weekly uni days.

One of the most amazing topixs was the fetal skull. It has literally blown me away with how clever it is! Our lecturer had us make this cardboard model where the skull pivots to show which diameters can and cannot come through the pelvis. But the way the sutures overlap is extraordinary. The way she taught means I actually remember what the bones are called (handy) and what way round the sutures are (handier). There was a moment when I realised I was sat there with my eyes closed trying to work out how the baby was positioned running my fingers over the sutures and fontanelles - funnier when I opened my eyes, glanced around and saw I wasn't the only one!

So we had one final day in uni then we were sent out into the big bad world! The next wave of student midwives :)

My first day was in antenatal clinic, based in a doctors surgery. I was surprised by how many women we saw - around 20 in the day though still 20 mins each. Didn't feel horribly rushed though. One was an hour long booking appointment too.

I observed all day and this suited me down to the ground as I would probably have a heart attack if my mentor had thrown me in at the deep end LOL. Did get to feel a tummy though and actually felt what I was feeling for (a baby ;) )

My mentor is lovely and I think we're going to get on fine, she seems really supportive. Next shift was doing antenatal classes - I learnt loads! Every student midwife should sit in on one.
Well I'm exhausted and I have 3 shifts this week coming though Monday off which will be a novelty.

One last thought to leave you with... I was walking leaving the clinic and this amazing feeling washed over me. I felt with every part of me that this was exactly where I wanted to be, doing exactly what I want to do. Amazing.

Getting started on clinical skills



I've had my blood pressure taken a million times and I have to say... it looked pretty easy!

Turns out its not really. I did get it in the end but my ears are pretty sore from having my head in the VICE that are the uni stethoscopes. It was really hard to hear the sounds in a busy classroom so may go back and do more practice (or buy a cuff and practice on my long suffering husband). On the plus side I now know what the Korotkoff sounds are and how to take a reading. Happy days!
Feels like a step closer :)

Fetal development and Embyology tomorrow!
 


3 Weeks in, 3 weeks to go...

Well three weeks until they set us free in community. Well I say free, I just mean out of the classroom!

This week was the first week of full on lectures and the amount of theory has literally hit me like a train. We've made a start on the systems of the body - going through them from scratch. We are then looking at how the systems react to childbearing. We've started looking at the female reproductive system and anatomy. My group made a model uterus! Another lucky group got to make a Vulva so I think we got off lightly really.

Today we did the menstrual cycle, non-conceptive and the conception cycle. Who knew there were so many hormones?! Amazing. I do feel a bit like my head might explode with all the information but I do feel its sinking in. Last night I read up in Mayes Midwifery (our textbook) about the menstrual cycle and it was like reading Hebrew. Had the lectures today and re-read it this evening and I understood it!

Whoop!

This afternoon was infection control. Not to be confused with hand washing which is a separate session apparently! Saw some lovely pictures of uterine scars with necrotising fasciitus which was as charming as you might imagine.

I went out this evening and replaced all our home handwashes for anti bacterials (rather than just the nice smelling moisturising ones! No e-coli in my house thank you very much! I was quite shocked how MRSA was spread in a brand newly opened ward by bacteria on the Doctors biros! Scary stuff.

Wash your hands folks!

So we've done quite a bit this week and the next three weeks it just keeps on coming. Next week we are looking at the blood in more detail and learning how to measure blood pressure and how to take blood. Very exciting. I am really looking forward to getting on with the skills side of things.

Right well I've written this in double quick time as the other thing I am rapidly learning is multitasking time management. Although I would presume in order to manage time you would have to have some in the first place. Welcome to student midwifery!

One week down... 155 to go!



It takes 156 weeks to make a student midwife! (and another whole heap of blood, sweat and tears)

Just one of the many (many) things I've learnt this week :) Came back to uni on Thursday and really got down to the nuts and bolts about how to be a student midwife, conduct, travel, admin bits n bobs etc. Then Friday was the icing on the cake of my first week as a real life student midwife... a visit to my clinical placement site!

For confidentiality reasons (my future NMC PIN being at stake) in my blog I won't be giving you any specific details, ie location, names etc.

First port of call was a visit to the Occupational Health office where they took some blood to test for a few things including Measles immunity as it appears I'm of a generation that missed the vaccine (old then) and though I had the disease as a child they wanted to double check. Also checked for HIV, AIDS and Hep B. They gave me an Hep B booster anyway as I was vaccinated years ago for another job I had so hopefully that will cover me and my time as a human pin cushion is done for the time being...

Then onwards to the ID office. As I dashed from office to office the heavens opened so the photo ID that will follow me around for the next three years actually has me looking like a drowned rat :)
The feeling as I was handed my ID though was amazing. There it is in black and white... Student Midwife.

Yay!

Next thing was visiting the hospital which for me was another site. Travelled with some other SMs and the Lecturer Practitioner had no problem locating the lost looking group of newbies in the reception area.

After quick introductions we were given the details of our mentors, our community placement sites and our first three weeks off duty. We start in community in the week commencing 5th November. I will be attending antenatal clinic, parent craft classes and a homebirth shift over that 3 week period.
Its so exciting and I am itching to get out there!

We then went on a tour of the antenatal clinic with day assessment unit, then the delivery ward (quite busy so didn't see much of it this time) including all the 'behind the scenes' bits I've never seen before as a volunteer on the ward. Then a quick peek in the SCBU then onto the postnatal/antenatal ward.
There was such a lovely atmosphere on the wards and the 3rd year student who showed us around said how happy she was to be placed there and that all the midwives were so supportive. All great news for us incoming 1st years!

We ordered our uniform then visited the health sciences library before making our way home.
Next time I go there I will be wearing considerably more comfortable shoes. (ouch)
 

Two Days In

This is it, I am officially now a student midwife! Years of waiting (literally) have come to an end.
That chapter is over and this is the next part of the journey and it feels absolutely amazing! So I thought I'd do a first week midway update mainly as I know I'd be on information overload by the end of the week!

On monday I literally leapt out of bed which as my husband would tell you is unknown for me. Early mornings and being bright eyed and bushy tailed at that moment doesn't exactly come naturally so it is a sign of my excitement that I got up rather than peeling myself reluctantly! I picked up another student midwife who lives in my town and we made it in loads of time to the campus where we ended up loitering a little without intent, no idea where to go until some kind soul took pity on us and pointed out to us our room (which was a 17 mile trek and stair climb away).

We found the room and were greeted by the senior lecturer and a big friendly sign on the whiteboard...

"Welcome Student Midwives!"

Yay thats me! Thought I :)

We were ferried around that first day to enrollment which went very smoothly (phew) and to the Vice-Chancellors welcome talk (also the police and the students union reps) a bit of lunch and 'get to know yous' including a very funny icebreaker surrounding our purses.(?!)

The highlight of the day (aside from meeting the gorgeous and lovely women that are my fellow student midwives of course) was a talk from another of the lecturers who has a doctorate in Midwifery. She was so inspiring I literally sat there with my mouth dropped open. If I can catch a fraction of her passion then I'll be sorted. Absolutely amazing. Her amazement and awe of midwifery itself literally blew me away.

I was pretty shattered at the end of the day and was lovely to see my family.

Today started as enthusiastically as yesterday (good sign) and again got there in plenty of time. Think we may have a little room for manoever on timings but I'd rather be early than late.

Freshers Fair after a trip to student services (counselling/finance/accomodation etc) and got handed loads of freebies (highlight was pizza and haircut discounts) including lots of pens. Declined the condoms #justsayin

Was informed by delightful young thing that as a mature student I'm not past it yet and can still 'recapture my youth' by going clubbing with the rest of the freshers... I personally didn't tell her her fortune and hope other mature students were as kind as me :)

We met the second years for a bit before lunch and basically grilled them on all the nitty gritty... what to wear etc. All the really important things ;) It was brilliant to be able to chat with them and above all to hear how they all still love the course and still love midwifery. Hints and tips were in abundance and it was a really useful session. I'd imagine that it felt quite funny for them sitting in the place of the 2nd years they grilled last year in their first week. Without fail they all said how fast this first year goes and to enjoy it. (I intend to)

The day was finished off with a session of Q&A (useful), looking at the timetable (full), and discussing the clinical placement visit this friday (exciting).

So now a day off (sorry Reflection day) and back in on Thursday. Literally. Cannot. Wait.


6 Sleeps to go!



Less than a week to go! Absolute madness that this time next week I'll be able to officially call myself a Student Midwife! I am officially ready to go, all systems ready and awaiting instruction.

Paperwork: check.
Very cute Cath Kidston bag: check.
Passport: check.
Finance: check.
Placement shoes: check
Recommended reading main textbook: check
Far more stationery than I will have need for: check
Childcare: check (thank you to the many angelic people involved)
Travel: semi check - 1st week covered at any rate

I had an email from the course leader last weekend just finalising all the details of the first day and welcome week. Theres going to be a lot of enrollment stuff etc that week, so no actual midwifery lectures until week three as the second week is all about study skills and a couple of introductions to the modules.

Right, had a sudden feeling I said I wouldn't be writing until I started. Oops.


 


12 Sleeps to go!

So now only about a week and a half to go! Considering how long this whole process seems to have taken it almost seems unbelieveable that it is pretty much here!

The bursary is done along with a myriad of other finance bits, the student loan, tax credits. Still need to sort the council tax student discount (yippee) which I'll need a proof of attendance from the uni for.
I just uploaded the pic for my uni card and NUS card (yay discounts!) and have enrolled online. I've received my timetable which includes all the details of the modules - so exciting to see the content, I literally cannot wait now to just get stuck in. 2 weeks of 'Welcome' and then the lectures begin in earnest.

And the other big bit of news is that I finished my old job... I was there for 9 years so it was quite an event for me really. I met some lovely lovely people there and I am going to miss them a lot!
Thankfully with facebook etc I'll be able to keep in touch, they seem really happy for me and that means a lot.

So now just a bit of time before my start on the 24th September... time to draw my breath, get the kids settled in school and nursery and off we go! I'll update again probably in my first week :)

First meet up


One thing I've been looking forward to almost as much as starting in September was meeting up with some of my future cohort.

I have to say I had a certain amount of trepidation about it. What if we didn't get on? What if we literally had nothing to say to one another? What if I didn't like someone and what if someone didn't like me? What if it felt like secondary school all over again?

Thankfully it wasn't like that at all (obviously I hear you say) and there wasn't a quiet moment all afternoon. Phew.
Roll on September :)
 

The Countdown is on!
Last year (2011) when UCAS opened I was sat with finger poised, ready to click that button and submit my application to become a student midwife. Before really starting to look into it, while it was still an idea, a dream in my head, it seemed very simple. I wanted to be a midwife, so when the time is right, I'll go to university, surely they are crying out for midwives. And surely as a mature applicant I'd just walk onto the course. Could I have been more wrong?

Nope.

On average in the UK there are around 25-40 applicants for every place offered at university which means that just to get an interview you have to really shine and stand out. How many universities interview seems to differ between institutions. One uni might interview every person who meets the entrance criteria, some will offer all those people a maths and/or english test and then interview the people that pass that, so lots of ways of shortlisting.

The personal statement is the first gatekeeper though. When you click that button, the personal statement whizzes off through space and lands on the desk of the admissions tutor and they read every single one. So you need to make sure yours stands out. I'll give you a tip, don't start yours with 'I want to be a midwife because I love babies'. You need to speak from the heart and you need to demonstrate that your life experience to date has given you the transferable skills you need to be a great midwife.

Then if you get an interview, there may be tests on the day too as well as the interview and I have to say that the day, while exciting, was very stressful. The enormity of the realisation that my whole future hangs on the next couple of hours... enough to send anyone to the edge!

Preparation for the interview is key. Research, reading, research and more reading. Literally immersed myself in midwifery for the months leading upto the interview date - though I only knew I had one a month beforehand... I also subscribed to The Practicing Midwife and read it like Heat Magazine! Love it!

And then the absolutely dreaded post interview wait. The longest couple of months of my whole life it felt like at the time. I can barely even begin to describe the agony of checking for updates on UCAS. I became what is known as a 'Track Addict'. I swung between hope and despair on an hourly basis. Convincing myself that I would be ok if I don't get in this year, planning what I would do to improve my application... It was all-consuming, the ifs, the buts, the what ifs and then one day, the day after I had sorted out my daughters childcare - I had taken a risk and arranged it as if I got into uni (and I have to say the mere fact of doing that had sent me into fits of supersticious doubt, despite the fact that stuff isn't in my nature at all...) - it was sunny, I was sat in a friends garden and I checked my email really absentmindedly.

"Track Update - Something has changed"

I have never felt so sick. I got up off the blanket and walked down the garden, logging into Track as I went.

"Unconditional Offer"

I did what any normal person would do under the circumstances... and burst into tears. My husband looked horrified as he had heard me muttering that it wa a track update and had been watching me anxiously. He alone probably (along with the StudentMidwife.net community) knew how much I wanted this. So I put him out of his misery and between gulps and sobs told him he is going to be the destitute husband of a student midwife for the next 3 years and to his credit, he couldn't be more happy for me. I'm a very lucky woman.

So the countdown has begun. I have completed my CRB check and received it back. Sent off my Occupational Health - I need to ring the uni to check all that is ok as I was sort of expecting to hear from them that I needed some more injections. I am about half way through the NHS Bursary application (www.nhsbsa.nhs.uk) which is a mission in itself!

I have a Mayes Midwifery text book, a Baillieres Midwife Dictionary, a pair of Clarks unLoops (comfy shoes that make me feel like I'm walking in the clouds), rather a lot more stationery than I suspect I need, a pinard (!!! I was given this in the SMnet Secret Santa) and a few other books.
On my list to do... finish Bursary application, buy a new uni bag and new pair of trainers, my converse have sprung a leak which makes me sad. Hoping to get some purple ones. Also want to get a purple silicon fob watch.

So if you have got this far, I do hope you join me on my journey. I'll be blogging throughout my midwifery training, from now to qualification (hopefully) so before we start I must warn you there is likely to be a fair amount of obsessing. Lets do this.

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