The right time, the right place…ment

Like the renegade master, I’m back once again – but not with killer beats, no, with tales of placement.

Here’s a little recap of what I’ve been up to over the past 6 weeks while out in placement in antenatal assessment settings.

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How is second year feeling so far? MAN, IT’S LIKE, I KNOW THINGS!

So it’s a step up from first year?: Yes, leaps and bounds – but that only became massively apparent once in placement and the complications we had been learning about were suddenly in front of us with faces, names, and questions.

Questions? WAT?!: Exactly, but it was like that wonderful feeling in the first year when a woman asks you something and you magically know the answer. But it’s not magic, because you learned it with your head and your mind and your brain.

Harder questions though, yeah?: Well, more complicated. All questions are hard if you don’t know the answer, and so yes, there were some hard questions – but being in a placement environment, you’re being taught things as you go, so you learn the answer and can answer the next person. I did this with some twin pregnancies. I sat in with the registrar when she was talking to a couple about their pregnancy, then when the next woman had the same questions, I could answer them before handing over to the registrar for her to come in and talk through everything. Parrot-fashion learning is great for some things, but it’s knowing when to say “I don’t know, but I’ll let them know so that they can talk it through with you.”.

Is it easier learning in the classroom or when you’re out there? I’m a visual learner, and a do-er, but there’s no way I could have learnt half the stuff I’ve learnt without having done the theory first. While you’re there to learn, you still don’t want to look like a fool if you’re asked questions you really should know.

What was the hardest thing?: Getting up very early to do 12 hour shifts.

Seriously?: Yes, but if we’re talking skills, then I would say I get stuck on daft things. Some things I can pick and quickly and run with it. Some things haunt me. I kept getting gravida and parity mixed up, which I knew in first year. It’s such a silly mistake to make too.

Anything else?: Blood bottles and their corresponding envelopes to go to the lab. I never got it wrong because I checked it every time, but I feel like it’s something that should be academic now. I’ll get it.

How about the best thing?: Managing to provide quality care when feeling like I was spinning plates; I’d met the woman week before and she’d been presented with a complication in her pregnancy she wasn’t expecting.

Complications can be expected?: Well yeah, if there’s a history of them in previous pregnancies, of the woman has a pre-existing condition – diabetes for example is pre-existing, whereas gestational diabetes mellitus (GDM) can develop during the pregnancy and say adieu when baby is born.

So how did you identify the care had been ace?: Because I met her in the second part of my placement, we had a familiar chat because we’d met previously and then I was able to do the clinical things knowing she felt at ease with a friendly face. When she was discharged, she popped her head round the door to thank me and said I’d been amazing and made her feel much better.

Nice!: I thought so! Sometimes a long wait can be made ten times more bearable with a cup of tea and a genuine question of “How are you feeling?”

So it can make the difference then, do you think? Having met the woman before?: In a lot of cases, yep it really can – that’s not to say you can’t give exceptional care if you’ve only met the woman for the first time when she’s in the throes of labour, but in antenatal appointments, trust is a big deal and you have to hope for a little so that you can get as much info as possible, but prove you’re willing to earn the rest.

Um, why should you? Can’t you just show it over all the appointments?: Well you don’t always get to see the woman more than once, and sometimes that woman has had a really crappy time with services before and been left feeling betrayed or patronised. My chequered past in customer service and performing arts lets me talk to just about anyone with a certain amount of confidence, but the gift of the gab only gets you so far. You have to under promise and over deliver.

That’s a customer service phrase isn’t it?: Yes

Hate yourself a little bit for using it?: Yeah, it made me a bit sick in my mouth, but through the vom, it’s exactly what I’m trying to say

Fine, explain it: It’s straightforward, a busy antenatal clinic is a bit like speed dating – you only have a short time to show this person that you *do* care, find out how they are feeling, see if anything new has cropped up and help them decide what care they need – if they’re going to call you in my speed dating analogy

Ok, still on board, but the over deliver thing?: Ok, an example here – a woman comes into clinic, you only see her twice before she gives birth as you’re her new midwife. You tell her you’ll come and see her after the birth, but her previous midwife was very busy so often didn’t catch up with her women herself, and someone else would do the postnatal appointments.
“I’ll come and see you after the birth” = under promise.
Checking the maternity system to see when she gives birth and heading to the hospital to see how she is = over deliver

So going the extra mile then?: Well yeah, but midwifery is that every day. Whether people realise it or not, you’re always hoping to be more than you’re expected to be, but over delivering is really making them have that facial expression where they look like you’ve got them all the Christmas presents they never got when they were kids.

Like you’re bringing them a Teddy Ruxpin?: And a Mr Frosty and a Fashion Wheel.

So have you done something like that then?: A couple of times. It actually makes me sad in a way that women are always surprised when you do the good things, because it makes you wonder how low their expectations were.

Well that’s a cheery way of looking at it: Ha ha, yeah fair enough, but having to say “Of course I am, I said I would be” when she says how pleased she is that you’re there does have some echoes of her previous disappointments with things.

All in all a good placement?: Yes. Brilliant, everyone was teaching, I was allowed to be autonomous under guidance which is perfect for the second year, and I never felt that people were too far away if I got an inkling that I might get out of my depth if I went it alone with meeting a woman having looked at her notes before hand. Ideal.

What’s next?: Time at Uni and working on PAL (peer assisted learning) sessions for the first years – December is their placement session and I’m going to RSVP the hell out of them. Admin battling is half the panic over when you head out.

Any other exciting things?: Oh the minor instance that I’ve booked and registered for my elective placement today.

WAT?!: It’s for the next post 😉

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