Being a mum, Communication, Compassion, New parents, NHS, parents, sepsis

A little story of Sepsis

A guest blog by my fabulous friend, Val Finigan 

‘I had an idea-to write a little blog every few months that would help the midwives and nurses at gtdhealthcare with their continued professional development needs, in preparation for revalidation.

So here goes, my first blog on sepsis.  I hope that you all enjoy it –please do comment if it is of use.

The idea of blogging is to share ideas and to embed ‘things’ into the blog that make shared learning easy. Story telling has become an important part of learning in healthcare.  Here I will share my two personal stories of sepsis and links to evidence based learning tools and red flag symptoms of sepsis.

Sepsis is more common than a heart attack ! Isn’t that shocking?

The 2015, NCEPOD report, ‘Just Say Sepsis’,  Identified an overall mortality rate of 28.9% per annum, at least 120 people die every day from sepsis in the UK alone.The sepsis manual 2017 (embedded) says “it seems highly likely that, across the UK, sepsis claims at least 46,000 lives every year, and it may actually be as high as 67,000”. Who would have thought that the figures would be this high?

Sepsis that occurs during pregnancy is termed, ‘maternal sepsis’. If it develops within six weeks of delivery it is termed postpartum or ‘puerperal’ sepsis. Sepsis is one of the leading causes of direct maternal death in the UK. See maternal sepsis tools in the Sepsis manual 2017 (below).

The HEE have developed a wonderful e-learning programme on sepsis which can be accessed via the web link below.

https://www.e-lfh.org.uk/programmes/sepsis/

They have also produced a short film that is really helpful

 

 

Sepsis is a condition which every health professional might encounter, and which can touch anyone at any time. In general, patients developing sepsis aren’t ‘labelled’ as being at high risk for that condition (in comparison with, for example, a majority of patients presenting with acute severe asthma or diabetic ketoacidosis). There is no one ‘hallmark’ symptom or sign, unlike the crushing chest pain which the public know might indicate a heart attack.

Because of this, patients tend to present to healthcare late, as evidenced by a 2015 report from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) which found that, where patients were felt to have presented late to hospital, in nearly 60% of cases it was because they did not ask for help and the delays were typically measured in days rather than hours.

The National Institute for health and healthcare excellence (2017) have also published guidance on the prevention and management of sepsis- to take a peek CLICK HERE 

I have had two personal experiences of sepsis, in the days when little was known about the condition. 

My first child had sepsis and septic arthritis at the young age of 7 (29 years ago).  She had suffered with recurrent Tonsillitis for two years and had been treated with numerous courses of antibiotics. She developed severe pain in her hip and over the next five days became increasingly ill.  An initial xray revealed nothing and because there were not hot spots seen, her symptoms appeared to become irrelevant; the hospital staff would not listen to me nor would my GP. Although I took my daughter on many visits to the GP and Accident and Emergency Department nothing was done. In fact I was labelled as an over-anxious mother and directed to the paediatric pain services to learn to control my daughter’s ‘discomfort’. 

On the 5thday of her illness she was hallucinating, confused,her temperature was 35C and she was mottled and cold to touch, her lips were blue. I took her straight back to Accident and Emergency.  Two hours later she was in theatre and then spent 6 weeks in hospital on traction and two weeks on intravenous antibiotics, her reminder a scar from thigh to knee. 

The final diagnosis came, Sepsis and severe Septic arthritis of the hip.

We counted our blessings daily; if I hadn’t been the awkward mother the outcome could have been worse. The hospital offered their sincere apologies and lessons were to be learnt.

One lesson I took from this-was always take note of what the parents are saying after all they know their child better than you do.

My second child had sepsis years later.  Age 11 years; his tooth was broken when he was hit accidentally with a cricket bat. The tooth was crowned and the temporary crown kept falling off.  Sepsis was quick to bite (pardon the pun).

This time there was a more rapid onset of symptoms. My son came in from playing out and said he felt unwell; he was shivering excessivelyand looked pale and mottled. His temperature was high, yet he sat firmly besides the warm hot radiator because he felt cold.  I took him straight to Accident and Emergency and the staff in this department were trained to spot signs of sepsis.

Immediately bloods were taken, he was admitted and intravenous antibiotics were were administered within an hour of our arrival at Accident and Emergency. Two weeks later we were back home with a well child.

So what can be learnt from these two examples of sepsis? The symptoms can be variable –take a look at spotting sepsis below. The onset can also be variable. There are red flag symptoms, early assessment, diagnosis and management are vital.

Spotting sepsis FINAL.pdf

Sepsis_Manual_2017_final_v7.pdf

I hope that the tools in this blog are helpful and that it has been useful. Please do comment

Thank you for taking the time to read it

Val Finigan July 2018

RM. IBCLC. RGN. PhD. MsC. BA (Hons). FHEA. QTLS. Honorary research fellow, senior clinical nurse gtdhealthcare

NHS

What is culture? @JennyTheM’s midwifery musings

Culture is the way something has always been done . Culture raises its head in many places including religion,politics, midwifery ,medicine , nursing education, the way we speak the way we work , the newspapers and tv we watch – we are easily influenced.

Take for example The House of Commons where the culture is for members of Parliament to shout out to each other, to heckle to humiliate and sometimes to belittle. It’s a very male dominated place and I wonder if it would be the same full of women – will we ever know?

FGM was a cultural norm but now it’s being challenged and stopped – see what I mean ?

CLICK HERE for guidelines around recognising & reporting FGM and female cutting)

Culture in a workplace it’s about doing things the way that “things” have always been done . Sadly for some it’s about behaving the way they’ve always behaved.

This is based on messages (DMs) I receive from many midwives and Student midwives across not just the UK but the world 🌍

For example

  • not tackling bullying head on
  • being in a group when someone is talking about someone who is not present and you know it’s wrong but you don’t speak out because no one else is speaking out
  • Joining in with that group to comply
  • It’s about people clucking together like hens that everything is bloody marvellous when it truly is not

I could go on .. for me though being an anti culture agent (yes that’s me !!) is about

  • Speaking out
  • Not being part of a clique
  • Seeing the people you work with as professional colleagues not “mates to muck about with “
  • Working everyday with evidence based research to GUIDE you
  • Seeing the woman (I am a midwife so I don’t say patient ) as the focus of all actions deeds and words
  • Questioning the norm
  • Challenging crude comments
  • Reporting behaviour that is not professional and doesn’t adhere to the NMC CODE
  • Constantly thinking about why you are doing what you do and not just simply doing it (fish don’t see water)
  • Being the change you wish to see in maternity services (or politics or whatever your work is in)
  • Not bragging
  • Getting on with stuff
  • Networking to help others
  • Leadership

The list is endless but this blog is merely to help you catapult yourself out of your own compliance.

How would you describe culture ? There is effective culture & ineffective culture .

I will always be an anti “poor culture in the workplace” agent

That’s what integrity is to me

Thanks also to the change agent that is Heather Gallagher for reminding me about my “be the change ” slide – you inspire many people each day Heather including me ❤️

Onwards 💪🏻❤️

Babies, Bereavement, Birth, Compassion, Dying, Grieving, Helping others, Hospital, Human kindness, Kindness, Labour , birth, MatExp, Midwife, Midwifery, Midwifery and birth, New parents, Newborn, NHS, Obstetrics, Patient care, Post traumatic stress disorder, Student Midwives, Women's health, Women's rights, Working from the heart

A Midwife’s heart and caring for families through stillbirth ❤️

This is a very difficult blog to write . Yesterday someone highlighted a tweet to me about midwives and how they deal with the impact of caring for a family who may have to face the loss of a baby . It was to do with midwives knitting hats for stillborn babies .

I have been a Midwife to many women whilst they birth their baby who has died before labour starts . It broke my heart each time I cared for these families. However I saw the fact that I was allocated to care for them as nothing but a true privilege and joy . I wanted to make the moments they had with their precious child special , full of love and memories . I helped them take the best photos . assisted them through washing their babies and also knew that I had to give them time to grieve and to communicate to them through deeds not words that I was “with them” totally . I cried with them , held them whilst they sobbed , even laughed with them – which may sound strange but it’s true . I cooked for them , made endless pots of tea and I washed their feet . I saw in these women & men a strength that can’t be put into words on a blog . I recall walking a couple through a labour ward to a bathroom with their stillborn son , so they could all be together in the bathroom whilst the mother took a bath – they insisted I sat with them ,so I did – on the bathroom floor – I know these memories are as special to them as they are to me.

Midwives do not routinely get counselling post events like this – fire workers and police staff do so is the NHS missing a clue ?

In 2006 I reflected on an incident at work where a woman came in to be induced and when I put her on the CTG monitor, we discovered that her darling son was not for this world . I was devastated and had to arrange childcare so that I could stay with the woman & her husband post my 21.00 shift finish . Another thing. that also hit me hard was that the friend I asked to help me with my young family had no qualms about saying yes – I later found out that the reason was that she had given birth to a stillborn son many years before (she told me that she felt by helping me she was helping the parents of the stillborn baby ).

As I left the couple to go home much later , I wept from sadness for them and their empty arms as well as emotional exhaustion and was told not to cry by a senior member of staff. I couldn’t go into work the next day .

What transpired was an article about my reflection by Rosemary Mander . The mother became a friend of mine & I helped her with a SANDS event – I went to her sons funeral and this connection helped me to cope as much as it did her to have someone who saw her son like she did – as a beautiful boy .

It’s so important that we see our role as supporting parents through sadness & also happiness . The midwives who choose to knit hats are simply trying their best – they might not know what else to do – it’s s coping mechanism. You can’t train for events like these just like parents can’t prepare for this to happen to them .

I’d like to thank Rosemary Mander for writing around my reflection in 2006 , the mum & dad of the darling son that was born asleep for giving consent to publish my reflection all those years ago (you gave me the courage to show my emotions to other parents) and also to my friend for her kindness in caring for my family whilst I stayed with the family ❤️

Also thanks to @kwelsh1 for showing me this powerful sculpture by Albert Gyorgi called “Melancholy ”

it sums up how any parent who loses a child must feel

Antenatal education, Being a mum, Birth, Caesarean section, Compassion, Courage, Fear of Birth, Giving information, Helping others, Hospital, Human kindness, Human rights, Kindness, Labour , birth, Labour and birth, MatExp, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, NHS, Obstetrics, Respect, Skin to skin contact, Student Midwives, Surgery, Women's health, Women's rights, Working from the heart

Fear of Birth – A Poem

I didn’t want a labour -everyone in my family knew

I did want a baby though

-my desperate feeling was not new.

I’d always been nervous,fainted at the sight of blood

told myself time and again that at birthing I’d be no good

My husband eventually won me round

We started trying for a baby but my mind couldn’t rest

So many ifs and buts and a maybe

we were pleased when we found out the positive test,

Inside my body though I felt so stressed

I had a tightness in my chest

I almost wanted to shout & shriek (no one seemed to listen)

I tried to talk about Caesarean birth with health professionals through the weeks

-somehow they didn’t hear me -I felt soft , so ridiculous so weak.

I couldn’t express my feelings, my fear of giving birth

I felt anxiety would pass to my baby -I had no sense of worth .

I went into labour I was scared and full of fear

my husband and my mother were with me it helped me to have them near

I failed to express myself to the doctors that I just couldn’t do it

But it was as if my words couldn’t come out- I truly almost blew it .

What happened next was down to the perception of my midwife

She saw the turmoil I was in recognised my inner strife

She stood side by side with me , told the Drs what I’d said

She was my birthing advocate – my saviour through the dread

A plan was made they’d finally noted every word I’d spoken

I was going to have a Caesarean section it was as if I had awoken

Don’t presume my fear had simply run away

I was worried ,scared and still not quite sure what to say

During the birth I could not look or speak or move

But when I held my baby skin to skin I was overwhelmed with love

My child was born and passed to me – I had achieved so much

And to the midwife that heard me through the tears – THANK YOU – for your listening touch

You really made a difference to me and my family

I don’t know how I’d have coped if you hadn’t stood side by side with me

@JennyTheM 16.5.18

Dedicated to Yana Richens OBE @Fearofbirth on Twitter for raising the profile of women who have fear of birth and for teaching Midwives and future Midwives strategies to help women ❤️ thank you ❤️

12.5 hour shifts, Being a mum, Birth, Breastfeeding, Hospital, Labour , birth, Labour and birth, Midwife, Midwifery, Midwifery and birth, Motherhood, NHS, NHS Systems and processes, Night shifts in the NHS, Obstetrics, Student Midwives, Women's health, Women's rights

Jenny’s mutterings , midwives childcare and 12.5 hour shifts ….

This blog is for #70MidwifeBloggers and I was inspired to write it by my two grown up children . When I look at them and the way they treat other people I always think “you did good Jen”

I have worked in the NHS for almost 40 years , so I was IN IT for ten years before I became a parent .

When my daughter was 6 months old I returned to work as a Ward Sister on a medical ward in Oldham Hospital (now Penine Acute Trust) . Part of the reason for my return to work was to prove to myself that I could be a good mummy and a good nurse. I have always liked a challenge and do I regret my decision ? Yes and No is the answer .

When I first thought about child care for my daughter there was no “on site” hospital nursery. Both my parents had died when I was younger. To go back to work meant I was driving 25 miles each way to start at 7.30am – was I mad ?

I was blessed – I found Gaynor a former nurse who totally understood my predicament. I managed to get my daughter ready put her in the car drop her off at Gaynor’s house and pick her up after work . I chose Gaynor as she was close to the hospital and I instantly connected with her . When I was on a late shift which ended at 21.00 I’d get to Gaynor’s to find my daughter ready for bed and a breastfeed and then I’d feed her at Gaynor’s house , pop her into the car (yes I had a car seat ) and drive home . Lots of times I arrived to find washing done for me / a meal to eat / a cup of tea / a hug and a huge welcome . Gaynor was also a mum and her children loved my daughter as much as she loved them . One particular thing about Gaynor was that her mum and dad owned a nursing home ( we are talking traditional family run home full of love , activities and good food – this was 1989)

Gaynor regularly took my daughter to the nursing home with her and she made the residents day – I also went to the home and felt like I’d grown a new family – his lucky we were .

My son was born 5 years later and I was also lucky with his childcare – he went to Maureen who I met when I had to find childcare in a new area to start my midwifery in 1991 and she became Auntie Maureen to both my children .

My blog is really to raise awareness of working mothers and fathers in the NHS and my question is this —

“Do 12 hour shifts have a negative impact on families NHS workers family love and home dynamics of NHS workers ? In fact if someone works a 12 hour shift they probably get up at 6am and get home around 10pm or later – that’s 16 hours of being up and active / put another day into that = 32 hours then three long days together = 48 hours – do you see where I’m coming from ?

If a child does not see its own parent for three whole days does it have attachment implications ? Has anyone done any research on this ?

IMO the 12 hour shift is seen as a money saving initiative for the NHS – 6 shifts covered in three days – bargain !!

However a bargain ain’t a bargain unles you can prove it saves money.

I hear both many sides to the arguments about 12 hour shifts but I also hear of staff who work 12 hour shifts “pacing” themselves , resting more on shift and I wondered if those working 8 hour shifts ever thought of “pacing” themselves at work ?

More research and evidence is coming out about long shifts , that they can be a contributing factor in thyroid disease, cancer , heart disease , burn out and long term sick . Perhaps it’s time to analyse data on nursing and midwifery sick leave to see if the NHS sick leave has improved or worsened since 12 hour shifts became a “thing” .

I have juggled child care most of my children’s lives and thank fully it’s been ok – even the time I caught one so called childminder pushing my daughter across a busy road by placing my three year old daughter across a pram!! I was actually a driver on that road (working as a community Midwifery student ) , so I went straight to her house and removed my daughter then & there . I rang my community manager in tears and she gave me two days of compassionate leave to help me arrange new childcare, this is how I stumbled onto Maureen – she embraced both my children into her family and like me she loved art and baking , so my children saw her home as an extension of mine .

Anyway I’d just like the NHS to seriously consider why going back to short shifts might be the answer – it also costs more to pay a 12.5 hour Midwife as if she works both Saturday and Sunday her after tax salary can be from £600 upwards more than someone working short shifts – so think again NHS

The 4 days that the long shift staff do not cover need to be covered – whereas when we all worked 8 hour shifts some staff would volunteer to stay late – this is impossible and dangerous on a long day .

thank you for reading

Yours in love and light ,

Jenny ❤️

Midwife, Midwifery, Midwifery and birth, NHS, NHS Systems and processes, Nursing

Happy 70th Birthday NHS: and to all who work in it – go eat cake 🎂 . A blog by Val Finigan

birthday-cake-cake-birthday-cupcakes-40183.jpeg

Happy 70th Birthday NHS:and to all who work in it-go eat cake 🎂
A beautiful blog by @ValFinigan

I can’t believe that the NHS has reached a 70 year milestone and that I have been part of this amazing service for 40 years. I saw the twitter feed asking for midwives to write a Blog to celebrate the NHS and its achievements over the years and I decided that I would like to be a part of this. Of course, I am not a Blog person and so I sought expert help from the lovely @JennyTheM who always like me, says yes (so hugs Jenny and remember “together, we always achieve”). I have been proud to work in the NHS, to wear my Consultant Midwife’s lanyard with pride. Indeed, I am immensely proud of the NHS Constitution and values and of NHS staff commitment to deliver a quality service regardless of demands made on them.
My career in the NHS started in 1978 when I became an Auxiliary Nurse caring for the elderly and my full time service almost ended in 2017 when I retired from position of Consultant Midwife for infant feeding. It has been an amazing journey and a privilege to be part of so many people’s lives, helping women to bring babies into the world and at the other end of life –supporting with compassion and care, those who are leaving.
I have worked in many different roles and positions which I feel empowered me, enabling me to understand everyone’s role and the part they play in the NHS as a whole. Sadly, I am not sure that all senior people have this same journey or focus and not everyone is aware of individual roles and how collectively they underpin NHS effectiveness and efficiency. T

This is important as the large wheel will not turn without all of the little cogs functioning. and that is why all NHS staff must be supported, be valued and be cared for must

This is important as the large wheel will not turn without all of the little cogs functioning and that is why all NHS staff must be supported, be valued and be cared for as in the NMC code ( CLICK HERE TO ACCESS THE NMC CODE    )

 

To achieve this, you must:
8.1 respect the skills, expertise and contributions of your colleagues, referring matters to them when appropriate
8.2 maintain effective communication with colleagues
8.4 work with colleagues to evaluate the quality of your work and that of the team
8.5 work with colleagues to preserve the safety of those receiving care
8.6 share information to identify and reduce risk, and
8.7 be supportive of colleagues who are encountering health or performance problems. However, this support must never compromise or be at the expense of patient or public safety.
I look back with emotional pride; I remember the first time that I lovingly ironed my uniform and then proudly placed the nurse’s cap on my head. I was in Utopia and I had achieved my dream. My parents had saved to buy me a fob watch engraved with my name and a silver buckle and belt and I still have them today.
I was fortunate enough to be given many opportunities to develop. I became an Enrolled nurse in 1978 and worked in paediatrics and infectious diseases. When Project 2000 came in, I re-trained to become a RGN and worked as a staff nurse on cleft lip and palate and also within general nursing roles.
I didn’t understand the political aspects that have driven my career pathways until much later when I entered the world of academia at University of Salford and considered this. Like most nurses and midwives’ my time in the NHS has involved life-long learning and development. Here I went from the Langley dunce to a BA (Hons) and then to a PhD achiever. Now who would have believed that I could have achieved that?
I qualified as a midwife almost 30 years ago and then specialised, becoming an International Board Certified Lactation Consultant, taking 4 hospitals to UNICEF Baby Friendly accreditation and sharing research globally on women’s experiences of immediate skin-to-skin contact from diverse population groups. We celebrated our teams’ achievements in style, with Elle McPherson presenting the award and talking to mothers and cuddling babies.
The emotional context of midwifery is fundamental, midwives need to have emotional awareness in order to deliver care sensitively, and also be able to acknowledge and respond to women’s feelings. Elle McPherson could have been a midwife; I was impressed at her sensitivity and respectful stance on women’s rights to best care. It was impressive to see her give her bouquet of flowers, a hug and a tear shed when a local Asian mother (who had delivered her baby prematurely) was separated from it whilst it received neonatal care.
I helped to care for the first HIV positive patient admitted to Monsall Hospital, Manchester in the 80s(which has now been demolished) and I trained to care for patients that had Lassa fever which was quite a scary thing to do back then and involved caring for the patient in a sealed unit-a bubble.
In my later days (once I had grown a brain) I helped the Manchester HIV team develop the first guidelines to support breastfeeding for HIV positive women and I held the first motion for this at the CHIVA conference in Manchester (which was very frightening as many renowned HIV experts were present). Sometimes we have to be brave (‘Courage butter’, JennyTheM, would say) without courage change will never happen-someone has to be brave enough to take the first step and ask “can we”, “should we”, “what is the evidence for and against”, “how do we start this journey together”, “will this make a difference?” Better Births and the Midwifery Transformation agenda are the new movement where midwives and the government are considering change-change that will fundamentally , hopefully, put women at the centre of ‘personalised care’.
I have seen so many changes come and go in the NHS 70 years ;often to be replaced with similar changes –just with a different name (‘Changing Childbirth’ to ‘Better Births’, being the latest example). Yet I also have proudly witnessed the compassion, care and tireless commitment to the NHS given by midwives and nurses who continue to deliver the best care whilst being under immense pressures and challenges. There is a lack of funding and still we are 3500 midwives short across the UK.
Sadly I have also seen many experienced and talented nurses and midwives leave a service they truly love because they can no longer function well under the pressures of systems.
When I first retired from the NHS, I was adrift. I was shocked at the overwhelming loss I felt and sadly there was nowhere to turn for support. I was angry at myself, all that training, learning and now both it, and I had no value. The problem with being a midwife is that once you take on the role it becomes you, not a part of you.
Thankfully, my story does not end there. Now I am looking back through a different lens and with a rush of positivity embracing my soul. I am back, resilient like our NHS, doing what I was trained to do, and what I do best; serving the public, caring and providing support. The NHS is a UK flagship-I have no doubt it will continue, the scary bit-is what changes have to happen next to allow this.
I now work in the Urgent Care services where I continue to use my nursing and midwifery knowledge and skills wisely. I am working with and alongside of women, babies and families, providing evidence based care and advice in pregnancy, motherhood and for infant feeding and also for a wide variety of other illnesses; and for people of all ages. The hours are flexible and therefore offer a work –home live balance that evaded me in my full time role. In this service I am valued and my talents are fully utilised.
Happy birthday NHS and congratulations to the hard working workforce (cleaner to Chief Executive) that make those tiny cogs turn to deliver such a fantastic service.

I hope you enjoyed reading my blog . with love ,

Val

Against the odds, Anaesthetics, Antenatal education, Babies, Being a mum, Birth, Breastfeeding, Caesarean section, Change management, Communication, Compassion, Courage, Giving information, Helping others, Hospital, Human kindness, Human rights, Intra-operative care, Kindness, Labour , birth, Labour and birth, Learning, MatExp, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, Newborn, Newborn attachment, NHS, NHS Systems and processes, Obstetrics, Patient care, Postnatal care, Respect, Skin to skin contact, Student Midwives, Teaching, Women's health, Women's rights, Young women

Birth imprinting – SkinToSkin contact

As a child is born to a mother there are emotional , hormonal, physical and psychological needs that are satisfied when SkinToSkin contact occurs and these will give both short and long term health benefits to mother and child .

A mother should be the first person to touch her newborn and that is one of the reasons that midwives should wear gloves. The mother’s skin will imprint the newborn with her smell, touch and love – the newborns face, smell and skin will imprint onto the mother and these are processes which are golden moments not to be missed .

If a mother is feeling unwell or anaesthetised the midwife should hold the newborn next to the mother’s skin for her , taking photographs with the mother’s phone or camera will enable the first sight of the baby to be saved and also surpass consent issues around photographs- the parents can then choose what they show to others and what they keep .

A Midwife is the woman’s and the newborn’s advocate and it’s crucial that the Midwife finds a way to involve the second parent in skin to skin contact somehow after the mother has held her newborn for a sufficient time to enable the first breastfeed .

If a woman wants to breastfeed once this has the benefit of giving colostrum as a gut protector and immuniser- colostrum contains immunoglobulin.

In cases of premature birth courage , knowledge, dexterity and skill are needed to enable skin to skin to take place . The value of collaboration (as discussed by @CharleneSTMW at a recent MatExp event at Warwick Hospitals cannot be understated – all members of the team must be aware of the benefits of SkinToSkin contact at Caesarean or instrumental birth .

We must all sing from the same sheet and share the same values so that everyone agrees that skin to skin with mother takes place before any other intervention .

Skin to skin is not an intervention it is something as natural as putting your key into your front door without thinking about it . However it seems that women and newborns are in a postcode lottery – where you live and which hospital you attend for your birth can determine and influence your chance of skin to skin .

I receive many requests from midwives from the NHS and across the world asking me to help them overcome barriers to facilitating skin to skin contact within their workplaces especially in the operating theatre . Some are stopped by anaesthetists, obstetricians , some ridiculed as strange by their colleagues and told “it’s not happening here” . We must remember that nothing is final and show the evidence which is growing by the day that skin to skin contact is not something that can be measured , it’s a primitive response which comes as second nature to a new mother – if that mother is out of her comfort zone she won’t have the strength or courage to question why – that’s OUR JOB !

Many ago I recall being told by some midwives “it won’t be happening – it’s too complicated ” and now I smile as I see midwives like @jenistevenssts in Australia studying skin to skin in the operating theatre for her PhD thesis, NICE GUIDANCE CG190 even includes SkinToSkin thanks to midwives like @drtraceyc who campaigned for its involvement and birth activist @millihill writing about it in her book (picture below)

The priceless value SkinToSkin is spreading across the world and if it’s not happening I’d like YOU to question why

This blog is dedicated to my mum Dorothy Guiney 22.2.1925 – 22.9.1978 ❤️

Being a mum, Helping others, Human kindness, Motherhood, NHS, Skin to skin contact

My wonderful mum 

On 22.9.1978 at around 6pm my dear mum died. I was 18 years old and it felt so unreal when it happened . I always imagined she’d come back to me . I still dream about her vividly and feel her presence close to me each day .

My mum was an ordinary mum , she had no airs and graces , I never heard her talk badly of anyone, she was an extremely kind soul who saw the good in everyone . My mum was always making people laugh , she was also a fabulous baker, never learnt to drive and had a great relationship with her sister Hilda who used to take her away on sisterly weekends once in a while  – my dear Auntie  Hilda outlived my mum by over 26 years and she shared many memories of their childhood with me over those years – and I treasure these stories .

I don’t ever really remember my mum shouting at me or my sisters, she taught me how to be a good person and gave me an insight into why being a good mother is so fundamental to a child’s life and how a mothers love can shape the person that we become .

Every year on on the 22nd February (my mums birthday ) and the 22nd September I celebrate her life by buying flowers and writing about her in one of my journals .

My mum gave me a good life , because we lived in a shop she was always there every morning , every afternoon when I got home from school  – I didn’t realise how lucky I was until just recently .

One thing my mum used to say to me was “if you really believe in something try to stand up for it and don’t let it it go” I see now that believing in skin to skin is not something I am ever going to let go of .

My mum gave me a firm foundation in my life – and this blog is my way of thanking her

Thank you for reading,

With love & kindness

Jenny 💛

Dedicated to my mum

Dorothy Guiney 22.2.1925 – 22.9.1978

Babies, Birth, Breastfeeding, Community, Community care, Compassion, Discharge from hospital, Giving information, Helping others, Hospital, Human kindness, Labour , birth, Labour and birth, MatExp, Midwife, Midwifery, Midwifery and birth, Motherhood, New parents, NHS, Obstetrics, Postnatal care, Skin to skin contact, Women's health, Women's rights

Lifting the lid – my life as a midwife PART ONE 

 

This blog has a few aims and I’d like to set them down before anyone panics about what’s going to be said

  • To try and encourage other midwives why it’s ok to bend the system – but only if it benefits the woman and her family
  • To inspire others to be different and think outside the box 📦
  • I’m telling my journey and not only what led me into midwifery but what keeps me there
  • I want to show the media that midwives do care about women
  • There will be no breaches of confidentiality
  • The blog is of my thoughts and feelings

My life as a midwife began in 1982. I was a student nurse and on placement on a maternity unit learning about midwifery. I was sent into a room to watch a forceps birth – this was not in an operating theatre where complex forceps births take place nowadays but in a simple birth room – I can’t recall anything apart from the woman screaming and the way the forceps were used – it marked me for life so I don’t know how the woman progressed from it . I put off any thoughts of having my own children because of the way this woman seemed to suffer. Back then I was learning about life in the NHS , how to become a patients advocate , running my dad’s newsagents , continuing with my student nurse course which was run by the nursing school attached to the hospital . I was in shock afterwards and decided then I would never be a midwife . 

Fast forwards to the birth of my beautiful daughter in 1989 . I was admitted at 0.5cm dilatation and refused permission to go home because that’s how it was then – I was given a cervical sweep without being asked or consented for it and felt violated after the event asking the midwife “what did you just do to me ?” .

“I swept and stretched your cervix , you’ll labour now” was the reply – I didn’t know what to say and I was in pain but I accepted it and just felt lost .

I did eventually give birth 22 hours after my admission and struggled with the pushing part – the consultant was called in and I recall him shouting at me how to push and threatening me with forceps if I didn’t push harder . I gave birth on my back , semi – recumbent – no-one encouraged or suggested a change of position . I was GIVEN an episiotomy without consent and cannot recall any conversation about why this was DONE to me . More or less straight after my birth I was left alone with my daughter she was in skin to skin contact with me . This wasn’t because I knew about the benefits of skin to skin contact at all , but because I just didn’t want to let Jane  go – my mums death when I was just 18 years old had impacted on me massively and I saw something in my daughter Jane’s face that reminded me of my darling mum , I was so emotional I couldn’t put Jane down – despite being encouraged to .

After the birth I developed bladder problems so had to be kept in for 5 days . I recall feelings of loneliness , sadness , especially when my partner and visitors left . There were strict visiting times in those days , no rule bending , no partners staying overnight allowed .

Once home I felt more relaxed but my partner was only given one day off work . I had no one, both my sisters were in high profile jobs and both my parents had died when I was younger . A friend came for a few hours a day and tucked me into bed with Jane , I slept whilst she tidied up , cooked and was there for me , I didn’t know what had hit me .

My community midwife Jean Duerden was amazing , I felt unwell had terrible perineal pain and couldn’t walk far – I accepted this as normal – I was a medical ward sister – I knew nothing about babies and / or petineums . My speciality was caring for men and women with medical conditions – a world apart .

My community midwife Jean realised something was wrong and I was quickly fast tracked and diagnosed with a perineal haematoma – my sutures were subcuticular and very difficult to release so I had to persevere with analgesia and antibiotics .

The visits from Jean my community midwife were the highlight of my days – she would bring a student midwife with her and we would talk about how I was feeling , the importance of rest and nutrition and emotional support . Jean also gave me brilliant Breastfeeding advice . One day I blurted out to Jean about my birth experience and she was amazing . I felt from my moments with Jean that she inspired me to become a midwife . Although my labour experience wasn’t great , my postnatal care was so different .

Almost three years later I started my midwifery training and I have to say despite the ups and downs , staff shortages , media portrayal of midwives , the difficulties I’ve gone through in my career I love being a midwife . My own experiences have shaped me and taught me to listen , act and trust women .

When I started my midwifery there were no computers – we wrote everything and risk management was very low key . I recall the Fire Officer teaching my group that the most important thing was to keep corridors clear and know which extinguisher to use in the event of a fire . This has stayed with me through my career and I get very upset when I see corridors with obstacles , I make it my mission to clear them .

I kept a diary and was so thankful to form a life long friendship on my course with another nurse called April . My tutor Anne Ivill suggested that we would get on and we are still good friends to this day . April went to work on neonatal unit as soon as she qualified and is now a health visitor working with children who have congenital illnesses and special needs . We don’t see each other as much as we should but when we do it’s like we’ve never been apart .

I’ve always been quirky and don’t like discipline or rules that restrict creativity, I was the same at school and used to get into trouble for standing up for friends who were unable to stand up for themselves . Once at high school a friend asked me to wait for her after a detention as she was scared of walking home on her own . We were barred from doing such things but I had a plan ! One of the teachers saw me on the corridor and asked what I was doing, I explained that I was waiting for Mr Heathcote to give me extra maths (a total lie).  Mr Heathcote was found and my cover was blown – I had to stay late all week and clean all the desks in T6 (one of our classrooms) . I made those desks so clean and using my anger with myself as energy to get the job done – the relief was that I didn’t get extra maths I suppose ! 😂

So how has my life affected who I am as a midwife and a woman ? The most influential part of my life was growing up in a newsagents shop , talking to people from all walks of life and respecting them all as valued customers . I worked in the shop from a very young age because I mithered my parents to let me . At first I was only “allowed” to sell newspapers or one item sales . The best day was DECIMALISATION DAY . I had learnt a lot at school about this and was determined to help in the shop but my parents said no . I was so upset – then around 7.30 my dad called me into the shop they were struggling – I was to be allowed to help ! I recall elderly people asking me “how much is that in old money ?” And I dutifully exchanged prices bank to pounds , shillings and pence to help them understand . I can recall if I was off school that day or not but if I was in school I still went in as for my parents not to send me I would’ve had to be really unwell .

So I hope you enjoyed part one of my lifting the lid blog – in part two I will be referring to my student diary and how hard it was being the only one on the midwifery cohort with a young child.

To be continued ….,..

Thank you for reading

Love , as always
Jenny x ❤️

Birth, Communication, Compassion, Helping others, Human kindness, Labour , birth, Labour and birth, Learning, MatExp, Midwife, Midwifery, Midwifery and birth, Newborn, NHS, Skin to skin contact, Student Midwives, Women's health, Women's rights, Working from the heart

The future midwife and the midwife 

A few weeks ago I was working with Emily Leeder a student midwife who has since completed her training and has now finished her time at my trust . I really like Emily she totally gets me and my sense of humour and she has picked up some of my traits – which is strange but lovely to see – I feel that when I do retire I will leave a little bit of me within Emily’s practice .  Emily also inspired this blog CLICK HERE TO READ about the importance of appropriate touch in midwifery . 

We both saw the positive effect of a small glass of a well known energy drink (NOT Redbull!) made flat by stirring profusely and how women who hadn’t eaten in labour felt better after it . We christened it our ‘chemistry set recipe’ for an energy boost in labour .

When we worked together we automatically shared roles and I think that neither of us felt controlled or ruled by the other – we were there for the women and supported them but we were in harmony as future midwife and midwife . Emily taught me the true meaning of mentorship as she messaged me for support and also wrote me lovely feedback for my revalidation.  I gelled with her and never felt judged by her or unable to ask if she knew something I didn’t . 

A few weeks ago we were with a woman who was at the start of her journey to becoming a mother . With this wonderful woman was her partner and her mum . We were having a discussion about skin to skin and delayed cord clamping and I asked the woman’s mum if she had experienced skin to skin contact at birth  with her children. The mum said “not really , my baby was born then weighed , measured and checked by another midwife , whilst the birth midwife was helping me to birth my placenta and check if I needed stitches – which I didn’t – so then I was told to have a shower . Within half an hour I was transferred to the postnatal ward ” 

My reply was off the cuff and I didn’t realise how funny it was until Emily had to leave the room crying in laugher . 

I said “a shower ? You gave up skin to skin contact because someone told you to have a shower ?! We are mammals – imagine other mammals giving birth and being forced to wash within an hour of birth . In fact right here right now let’s just imagine an elephant giving birth to a baby elephant cub and one of the female elephants shouting out ‘Get into that river now & wash !’ It just wouldn’t happen would it – no one would argue with a newly birthed elephant mum would they ? ” 

It really doesn’t seem as funny now but it’s left a great memory for me , Emily and the family – and the woman gave birth and did NOT get pushed into the shower at all . In fact she chose to have a wash a bout three hours later , after LOTS of skin to skin with her newborn ❤️
Thank you Emily for helping me with my journey as a mentor – I’m always learning and I wish you well at your new NHS trust – keep in touch 

This is my first ever scheduled blog and it’s for three reasons 

1. Today will be the third anniversary of the day I started presenting to raise awareness of skin to skin contact – you can read the storify of the day HERE or just search #MAMMevent on Twitter 

2. I will be presenting at Coventry midwifery Society today the # will be #CovBF17 

3. To thank Sheena Byrom OBE for believing in me as a public speaker and also for friendship and kindness when life was tough for me . 

I am proud to be a midwife 
Love from Jenny xx 😘