NHS

NHS Change Day 11.3.15

Which change would you like to see ? I know you could think of quite a few I’ll bet – but just try & think of one change that’s simple – it must have a positive impact and should inspire others to take it on board 

The key aim is to think small so that it’s easy for others who work in the NHS to think “we could adopt that idea!” 

Sharing ideas will spread positivity and increase job satisfaction – and research shows that happy staff make happy patients 

Be bold – speak to someone about your idea – it might be a colleague or someone who works in a different department or perhaps your mentor or a senior manager – do research to find out if your idea is working well elsewhere – ring up that place – ‘take a chance on change’ you never know where it could lead to in terms of patient satisfaction and it will give you a good feeling inside. You will also raise the profile of your own Trust which will make everyone feel good.

For this NHS Change Day I’m pledging to become a listening mentor and to really listen to ideas that future midwives have – in a few years I’ll be retiring and so will lots of other nurses and midwives – it’s time to slowly pass the baton and yet to also keep running . 

NHS Change Day -use your pledge to make a difference 💡💡



Midwifery and birth, NHS

Show Your Heart

Last week I was mentoring future midwife Emily Leeder and I wanted to explain the value of “show your heart” 

As a midwife/ maternity care worker would you sit down next to a woman in labour – hold her hand ? Put your hand very gently onto her shoulder and you will connect with her- sometimes silence is more powerful than any words 

Try putting your hand on a colleagues shoulder and imagining warmth and kindness flooding from you – ask your colleague to be mindful for a moment and I can guarantee she will feel calmness and reciprocity in that moment. Now imagine that for a woman in labour in any birth setting – teach her birth partner to do this – you are connecting the human spirit and showing empathy by a simple act like a hand on a shoulder

Could you help a woman to prepare her mind when the obstetric team are about to come into the room on the labour ward round? Or do you wait in the office ? Does your labour ward have privacy curtains inside the door entrance of each birth room – question why and start to make a change – your Trusts privacy and dignity policies & guidance will help you 

…..ever been strapped to a CTG machine  sat on a bed and had a group of health care professionals standing over you discussing …

your baby 

your body

Your pregnancy

 your induction 

your pain relief 

Your progress

Their plans ? 

I want to shake up midwifery and obstetrics so that all women have an equal voice and so that we all have the same goal – I want midwives obstetricians , maternity workers, MSWs  to show their hearts , to care for women like they’d want their own female family members & friends  to be cared for. 

Start today by caring for each other in the workplace – show your colleagues your heart. If you know a colleague is off work do you wonder if that colleague is ok ? Do you send a card ? You don’t need an address you just need kind words and a stamp – take the card to a manager & they will add the address & post for you. – if you find this difficult then imagine how difficult it is for a woman you are with to show you her own heart and explain how she is feeling 

Be kind to one another and from the 6cs I’d like you to use the following three to help you on your journey 

Compassion 

Courage

Communication 

As a caremaker each day I go into work to think how I can improve my kindness rating I try not to be complacent about what I do – I focus on imagining myself as the other person (whether this is a colleague or a women) and I try to think hard about how they may be feeling -this helps me – I tell future midwives that I’m not perfect that I make mistakes & that I’m learning each & every day. I ask future midwives if they have new information to share -they are basking in the depths of learning and we can all learn so much from others 

Be kind 
Thankyou for reading my blog 
Jenny x

NHS

International Woman’s Day 

Yes sisters I’m writing this for you – the sister who lives in a remote place infected with HIV being cared for by her children – feeling pain every day as she knows she is dying – pain which is emotional and physical because what if ? What if ….. ‘What if I lived in a developed country where I could have access to screening and the birth of my daughter would have been planned to reduce  transmission of my infected cruel blood to my child. A place where kind staff quietly knew about my condition but did not mention it to others and where my life would be so different ‘ WHAT IF? 

Yes sisters What if ? What if you’d been held down and told “it’s our way – it’s a celebration” as your female relatives watched whilst the searing pain of female genital mutilation was imprinted onto you forever -a  trauma never lost – a confusion of why love does such things … What if – what if you’d  been born in 2015 when such atrocities are being stamped out by education and law . 

Yes sister I’m writing this for you – What if ? What if all society totally  understood that birth is an intrinsic part of who we become – what we do. What if ? to the sister who couldn’t tell the midwife why she was so scared of labour and being examined. She is trying to scream it out as she gives birth but all she hears is “don’t shout out” . This sisters screams are releasing years of abuse she experienced behind her own front door. This abuse has never been spoken about before. This abuse was dampened down by a culture of acceptance and by her own true real fear. What if ? If only her mother and her sisters had believed her ……

What if my sister ? What if there was a world where feminism was seen as a human right and all humans would have the same rights ,same pay,same treatment, same life choices, same education , the same health care . A world that where all sisters and all brothers live and breathe equally without fear and in kindness and peace

WHAT IF – yes sister im writing this for you … You’re an office worker and being bullied by other women , they taunt you, talk about you, exclude you , scrutinise your work . “The manager wonders why each month I never quite reach my targets – he doesn’t know any of this , he thinks I’m lazy , truth is I’m scared and I haven’t slept for months . Why are my sisters doing this to me ? What if? What if I had the courage to find someone to help me ? 

Yes sisters I’m talking to you rise up speak out , not for yourself but for women everywhere . Be proud of being a woman have gratitude for the life you have. Every day try to focus on   how YOU make other women’s minutes , hours , days , months , years even better . Help your own sisters and love them dearly , be a sister friend . Hold this thought and imagine all men and women thinking this every day ,” what if ? ” 

what if ? WHAT IF? every single birth was peaceful . We all have one thing in common – we are all born – and we are all born from woman 

International Women’s Day …. What if …. 

NHS

Big lovely thank you to Breech Births

Last week I met with my Supervisor of Midwives – she is a very positive person and sat back as we started my supervisory one to one saying “How are you Jenny ?” I wondered if she dreaded my answer as I launched into non stop chatter – but she smiled and listened intently to what I’d been up to. I tell her about positive occurrences and scenarios as well as any challenges I’ve resolved (or not resolved) and ideas that I want to bring into practice. It’s just wonderful to be listened to and I know that this precious time helps me to reflect on and reassess my own progress . Our conversation moved onto physiology and I expressed my concern at the iatrogenic state that many labour wards seem to be in – I have many midwifery friends who are located all over the world and we debate this topic vigorously .
As a clinical midwife I am a core team member of the Birth Centre based in the hospital. I want to see physiological birth seep like dry ice and drift underneath the doors to have a positive effect on births in all labour wards.
Just recently there has been a national increase in breech births and today I’ve had a lightbulb moment whilst tweeting Shawn Walker (@SisterShawnRM) you’d love her blog click here to read – I was considering the phrase ‘hands off the breech’ which means ‘allow physiology to take place’. The Breech birth position of all fours is also the optimum position for normal cephalic birth as the pelvic diameter is wider – so one day we may wave goodbye to lithotomy position. There is a growing interest in breech birth and I’m happy about this as I know that the resurgence of breech births will cause a new movement to begin on labour wards. Breech births will inspire midwives and birth workers to believe more in physiology for cephalic births as well. This will empower us to question practice and enable the women we are ‘with’ to be involved in shared decision making . The end result will be a dramatic ongoing rise in normal birth and a reduction in the iatrogenic effect . In turn this will lead to better communication more collaboration between women midwives and obstetricians and in the long term a happier more fulfilled society . So let’s praise breech birth and see it as a new change agent 💡

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NHS

The Wonderful Wisdom of Ralph Waldo Emerson

Ralph Waldo Emerson (RWE) has inspired many people. He was born in 1803 and died in 1882. RWE is known as an essayist, poet and wise man. His quotes on how to approach life and its difficulties as well as how to maintain positivity are used worldwide. They motivate us into keeping a happy outlook on life as well as to support us in times of sadness or quandary. RWE writes from the heart and is his own person.
He writes from places of interior depth and does not strive to be like anyone. In his texts and thoughts he promotes a nonconformist attitude but one based on a deep inner wisdom and universal hope. Ralph Waldo Emerson believed in calm and composure; he invigorates us with his words and begs us to reflect on our gentle life and to avoid adopting a brash attitude and or behaviour.

The quotes below are taken from his renowned essay “Self Reliance” We offer some reflections on each.

Peace.
‘Nothing can bring you peace but yourself’

This is so important as we often seek peace everywhere except in our own hearts and minds. It points out the golden key we all possess. That is the key of choice. We can see, own and use our power to change a world. If we don’t have peace we cannot expect it to turn up and knock on our door. It will flow from the choices we make.

Comparison
‘Roses make no reference to former roses or to better ones they simply exist’

RWE focuses on why it is important to
believe in yourself. He reiterates several times that comparing ourselves to
others is not a favourable approach to self belief. This analogy of flowers to
us is very potent as it tells us to be the amazing and wonder-filled people we
are. Comparing doesn’t develop us. Growing into who and what we are does. We are all different, by embracing our own diversity and uniqueness we can go forwards with our ideas and dreams in order to better ourselves and to improve humanity as well as making the most of this precious life. By continuously learning about how our fellow humans want to be treated and imagining ourselves as them we can give compassion and kindness and display ‘courageousness’ when we are required to do so. In life we do however tend to compare ourselves to others – humans generally like to fit in and not stand out from the crowd. This culture is very much challenged by RWE – to march to the beat of your own heart is difficult when you are working in a traditional setting where risk and planning take precedence so it is important to challenge our own behaviour and reflect on this at the end of every day. It is good practice to seek support from others who will listen but it is just as important to reflect as an individual

Life Calling.
‘Instead of a gong for dinner let us hear a whistle from the Spartan life’

This is a challenge to shake up our thinking. To lose traditional ways of thinking and acting. He is saying get back to basics in life and once in a while embrace simple pleasures – not focusing too much on material goods and truly value friendship.
Do not feel you have to conform to be like other people but be true to your own self. Do not the world and its gongs call us. Rather a life and spirit which is free and clear. Not to be slaves to routines and other externals. To find an inner compass that will guide and lead. This of course doesn’t replace gongs and timetables but rather gives them their proper place.

Making the Change
‘With consistency a great soul has nothing to do’

This is gently critical of monotony – a life that is the same every day is not challenging. Memories are made by days that bring emotions such as extreme happiness or deep sadness – an uneventful day is rarely recollected – imagine if each day of our lives was the same? We would become complacent – variety and the reflection of it aids us in our development
and resourcefulness. It changes us from learners to leaders. RWE is telling us that changes will happen. Some good and some bad. We all have them. Yet in them great souls can grow. If nothing changed nothing would grow. We would live as frozen statues not living beings of incredible possibility.

Being Misunderstood.
Is it so bad, then, to be misunderstood?…….To be great is to be misunderstood.’

Here RWE calls us to a fundamental lesson. The greatest figures in history were misunderstood. If we do not we will be neither great nor misunderstood. To stand for something is to be opposed for something. This doesn’t mean we will not have many allies and friends. It does mean not everyone will cheer us on. Maybe we save ourselves a lot of stress and upset by knowing this.

Principles
‘Nothing can bring you peace but the triumph of principles.’ This is the last sentence of the essay. It tells us why integrity matters and how it marks us. If we hold to our good principles and values and walk that line we will have peace. It’s when we betray them that we lose peace. When we spoke of choice RWE orientates us to choosing the right. To choose to let our principles triumph in our work and exchanges. This is not always an
easy thing but a possible one.

Ralph Waldo Emerson has, like us all, his faults but his writings make us consider our place on earth and that has to be a good thing. Even in this is a liberating insight. All of us with our human flaws can offer something. He looks at the way we act, materialistic goods, kindness and adversity. He inspires us to consider ourselves, peace, principles and not following the crowd. RWE calls us to be the unique and special person we really are. It’s sad that sometimes people never hear that message when we
all need to.
That’s why this blog was born.

Jenny Clarke and John Walsh

NHS

My first year of blogging 2014

The WordPress.com stats helper monkeys prepared a 2014 annual report for this blog.

Here’s an excerpt:

A New York City subway train holds 1,200 people. This blog was viewed about 4,300 times in 2014. If it were a NYC subway train, it would take about 4 trips to carry that many people.

Click here to see the complete report.

Midwifery and birth, NHS

Why positivity matters in the NHS

This week I’ve been in Uni all week – as a more mature student I’ve loved meeting young people and some of them weren’t even health care professionals . I’ve met artists , maths geeks , musicians and engineers , psychology students and many more . In the lift in the media building a young man was wearing headphones – I asked “are they Dr Dre!” His face was a picture – I told him my son has a pair that I regularly wear around the house connected to my iPhone when I need “me time” but I have stuff to do like moving items from one room to another , cleaning , cooking – it’s escapism hearing my favourite music as I work . However I could never study with music on like both my children do and I love that we all are different and we use various techniques to help us to work. We are all different and that’s what makes us the same.
Just the other week at work someone said to me ‘we need more staff ‘ and started to complain- I was teaching a new midwife about intravenous antibiotics and the time it took me to show the reference book , work out the dose and consider how to prepare in an ultra clean environment the person moaning continued to ‘chunner’ – I then emptied a box of pharmacy drugs and thought if no one moaned at work how much time could we save ? If every single person was on a ‘positivity push’ and negative comments or actions were banned could we save time ?
I am very positive at work I don’t stand in the office complaining as I veer away from crowd culture – I might sometimes feel irked at another night shift but believe me as I leave the threshold of my front door I say positive things to myself – I put Jo Whiley’s programme on my radio (a very positive woman!) and I say to myself “you are going to be with women who are giving birth to the children of the future tonight – how amazing is that!” (Rhetorical as no answer required) At work I smile and I like to tell corny jokes , I involve the partners in care – if the woman is in the pool I show her partner how to maintain the temperature and christen them “PoolTech” they offer me a cuppa when they have one and I genuinely feel lucky and privileged to be doing something so fantastic as well as meeting new folk . So I say this to you – yes we would like a payrise it would be amazing – but please remember we must switch off thoughts about pay when we are caring for women and families and we must shine smile and be happy that we have the NHS , we are employed and we are helping others in the great big universe of life – positivity matters 💛💛💛
Shine loud Be proud 🌟💡

Midwifery and birth, NHS

WaterBirth

I am a physiological midwife . I promote the use of water in pregnancy, labour and also birth . I have not always been this way – I’ve read and studied the effect water can have on us as humans and in the past ten years I have developed a belief and understanding about the benefits of using water to calm, relax and strengthen. Some women are uncertain about the role that water can play in their labour. I discuss the benefits and try to imagine myself as a future mother listening to my views and my passion for birth in water.
At no point do I ever force anyone to get into the water. However I always admit a woman to a room with a pool and try to have the water running as she enters the room . There is something calming and reassuring about the sound of running water – memories of bath time as a child are evoked. Water has long been used to cleanse, relax and prepare for rest as well as helping us as humans to start our day . Washing and bathing are such a huge part of our lives that we give no thought to them – water is primitive . Think of lakes pools, rivers- places where our ancestors would wash, play, perform ritual, religious ceremonies and do chores- water is embedded into our psyche. Water makes is feel good and this is highlighted in the following article.
http://www.theguardian.com/sustainable-business/impact-sea-lakes-rivers-peoples-health
We are drawn to water – the Lake District is named after water , there are many places in the world infamous because they have involve water – hot springs , falls, rivers and streams . We marvel at the strength and beauty of a waterfall, at the gentleness of morning dew on a spiders web and how many of us have stared at the sun setting on the horizon and disappearing from view as if appears to submerge itself into water.

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Being in a pool gives a woman her own environment – mammals seek a safe place to birth away from other mammals, predators and noise . They seek somewhere secure, warm and calm- a protective place. The pool environment fits all these criteria and more – compare a pool to a bed – there is in fact more privacy in the pool – once inside the pool a woman is covered by water and her private areas are away from view. Consider this in relation to a woman on a bed with a sheet over her and feel her vulnerability in this position. Staff stand over her and instantly the inequality begins – whereas in a pool a midwife will sit on the floor , kneel down and bring herself to the woman’s level – if you are with a woman who is on a bed then gets chairs for other HCPs who may enter the room , make sure the correct door is opened to maintain privacy and dignity , make the bed higher so the woman feels at a positional advantage or help her to get off the bed off the bed http://www.rcmnormalbirth.org.uk/ten-top-tips/

I call the pool the “watercave”and women I have talked to after the birth say they felt safe strong and protected by the walls of the pool , they felt they could move and choose their own position and in control of their own movements . As the birth process begins I’ve noticed that more women feel for the babies head in the pool than on a bed – I never ask a woman if she would like to feel her newborns head prior to birth as it should be an instinctual choice – once we say , are we interfering? I talk to women and their birth partners about the physiology of birth in the pool, how it happens and about physiological third stage . I feel as health professionals we should not presume prior knowledge and that discussing birth choices builds on the relationship between the family and the midwife . We should feel equal and the same – this will facilitate a two way process of communication and care and will also embed the 6cs in order to give the best experience to the woman primary not the midwife .
The most wonderful thing about the pool is that the midwife learns to sit on her hands there is no need to touch anything and this is just amazing for the woman .
To see a woman reach down and lift her own child out of the water (or for the father / second mother / grandparent / partner / friend to
do this) is just so beautiful it is the land of goosebumps the place where birth belongs and when you facilitate this you are giving birth back to women. Midwives are “with woman” WITH suggests equality – we are not superior to women and we should rejoice in the power of the uterus and the power of womanhood in its own right.

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Midwifery and birth, NHS

With woman

💛Midwife means with with woman .
There is so much depth to this word – it doesn’t just mean that as a midwife you are present at a birth but so much more.
To me “with woman” means you are “with the women of the world with your every breath” – it means you believe in compassion, feminism, women in society , the future of humanity and life itself
Today I started thinking (ooh look out when Jenny The M starts to think!) what if…….
There were no womankind
no births
no midwives
where would the world be?

Women are the backbone of society but somehow in its own delusion society has slightly forgotten all this. Emily Pankhurst fought with her comrades to get women the vote – yet female authors hide behind a male name

Being with a woman in labour who is single and labouring alone -you take on the role of a friend as well as a midwife and I defy any midwife not to feel like this.
Midwifery is all about women and that doesn’t mean that male midwives can’t be feminists too after all they like us were ‘brought up and raised’ in the organ that rocks – the female uterus
Does society truly value the fact that women give birth? Do midwives realise the implications that a child’s birth has on the mother and the child ? Does society see the effect birth has on the earth?

See the strength and courage in women who suffer from domestic violence- imagine the fear a woman feels in such a relationship and her shame to admit it to anyone

Embrace the power of many women who support their female friend whether she is grieving, being bullied , giving birth or facing challenges – women rush to other women’s aid.

We are one voice and we have to remember this every single day
So each day I get out of my bed I say to myself ” I am a strong woman, I am proud to be a woman and know other women who are strong. I will help any woman who may need my help and support today ” help and support may just be a chat, a reassuring hand on a shoulder or it may mean a hug , a way to help change a situation or a way to get help from someone else . So if you are working with women , as a midwife or in a role where you are in contact with women – just focus on how amazing women are and where the world would be without them – give support – be womankind

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This post is dedicated to my friend – a strong courageous woman

Midwifery and birth, NHS

Birth by caesarean

I’m writing today about birth by caesarean . I want to try and make everyone who visits my blog arrive with an open mind and leave after reading it with a fresh perspective. 💭

“If we do what we have always done there is no change there is no development things stay the same” (by me 📝)

Operating theatres have to be sterile, organised and have processes for risk in place – safety is paramount . At the heart of the operating theatre is the patient – the staff do their job every single day it is a routine to them – running an infusion through, ensuring the sterility of instruments, making sure that the staff present are trained and that the correct checks have taken place. Al these things take place prior to the patient entering theatre.
I would like you to consider this – we come to work to do our job, we love our job and if not for the patient we would not have a job – do we see the patient as our employer ? In an indirect way the patient is our employer and yet simultaneously our customer . If our customer and employer has a good experience they will not always shout it from the rooftops as much as if they have a bad experience – so we must put this thought into our heads daily – a bad experience is more likely to be shared than a good experience.

As an independent human you access food, drink and warmth whenever you want it – you are thirsty so you get a drink you need food so you eat – if you ever become a patient the ability to do this stops or reduces – you cannot access food immediately, you have to ask for a warm drink and also you may have to ask to use the toilet 🚽. Your have to ask to satisfy your basic needs. These are some of the hard parts about becoming a patient – to access these things that you took for granted which you never considered you have to call another human by pressing a buzzer or asking permission. Add to this the fact that you may have had an operation or an illness which has compromised your ability to mobilise , access pain relief and compromised your high standards of hygiene . I’m not trying to influence your thoughts I just want you to think about these things.

Who does an NHS Women’s Unit theatre belong to ? In my eyes it belongs to Women so this means that NHS staff are the guardians of it . The theatre environment is very white bright and clinical because it’s always been that way – hang on “because it’s always been that way ?” Well let’s try to change that – why can’t we have paintings on the walls which are part of the wall ? imagine lying on a theatre bed staring into a blank void or imagine looking at a beautiful scene above you – which would you prefer?

A woman enters theatre knowing this will be the birthplace of her child. Her individuality has been removed by placing her into a generic gown removing her jewellery and make-up All the people in theatre will share the event of her child’s birth. The first thing that she sees are staff in pale blue gowns, masks and hats with only eyes peering out. The ability to communicate is lessened and there is a sense of stage and routine . Instruments on the trolley been arranged in place neatly ready for her operation to begin. If the woman is wheeled in she feels vulnerable and compliant on her hospital bed whilst others look upon her .

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“All the world’s a stage,
And all the men and women merely players;
They have their exits and their entrances,
And one man in his time plays many parts,
His acts being seven ages. At first, the infant
…….”
William Shakespeare

We have one thing in common we are all born we all die . I am passionate that women who give birth in theatre either by Caesarean section or by forceps or ventouse are facilitated to feel as positive about their birth as women who give birth without intervention. I also want you to question your own units practices – do women who may require a manual removal of their placenta hold their babies routinely ? Do women who may have to have a repair of perineal trauma in theatre routinely hold their babies ?

The culture of the staff in the operating theatre is one of the largest barriers to skin to skin care taking place after a woman has undergone a Caesarean. Several clinicians have reported the implementation of immediate skin-to-skin care (within 30 minutes after birth) in their hospitals’ operating rooms (Smith, Plaat et al. 2008; Hung and Berg 2011) The authors noted that operating room staff members were initially skeptical, reluctant, and afraid to change their routine habits and behaviors. But after seeing the benefits of this family-friendly procedure, staff became supportive of the change
– read this link for further references http://evidencebasedbirth.com/the-evidence-for-skin-to-skin-care-after-a-cesarean/

If every HCP in the theatre setting considered the promotion and facilitation of skin to skin in theatre as intrinsic part of their role – rates would soar and women and babies would be shouting from the rooftops . Patchiness is no good – just the other day I asked about the “Theatre list” and was sad to hear that two women and their babies did not have skin to skin discussed with them – Jenny The M can’t be everywhere – if only I could be like a fairy and zip into theatre with my wings and dust skin to skin thoughts on everyone around – imagine 💡.Read the following about cHange by Helen Bevan and Steve Fairman

NHS Change and transformation – Helen Bevan and Steve Fairman </a.

the NHS thrives on change it’s time to lose tradition and focus on the new – this is a slide I made for a presentation about optimal and appropriate use of an area – to do with Competence and the 6cs and it applies to any area involved in Women’s Health

It can be applied to the theatre setting and also to the process of skin to skin contact – so please please if you work in theatre and come into contact with a woman who may have to have a caesarean ask her if someone has discussed skin to skin contact and if they have not make it your goal to do this

Be rebellious for women out there – we are a crucial and core part of society and humankind – being rebellious for a woman’s cause shows courage and will have a profound effect on that persons life and first experiences.be a rebel
You might fear rejection but eventually you’ll get noticed and people will start to follow your lead and do the same 💡

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I know where the skin to skin fairy lives

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If you think you can’t make a difference just search #skinToSkin on twitter – 💕

Skin to skin

@JennyTheM