Saturday, 7 January 2012

A day in the life of a midwife…

This post was sent to me by a midwife I know who for confidentiality reasons would like to be kept Anonymous
A day in the life of a midwife… 
It begins with the alarm waking me up at the hour of 06.30, its cold, dark and wet outside and my bed is so warm, but bring on the 13 hour shift! I throw on my scrubs and eat a big bowl of cereal – not a fan of early breakfasts but this may be the only meal I get for a good few hours so it’s a must!
Shift starts at 07.30 but I arrive 15 minutes early so I can check the board and she what happened to the lady I looked after the day before. I’d spent most of the previous shift with this lovely, yet very anxious first time mum to be, her partner wasn’t great with hospitals so there had been a lot of apprehension in the room for a long while. We’d sat down and had long chats about life, love and babies and I’d left the room at the end of my shift feeling reassured that they were comfortable and more relaxed about the labour process. She’d been doing well when I left, coping without any pain relief and seemed the sort who would ‘get on with it’ so I wished her all the best and said I’d pop over to the postnatal ward the next day to catch up. I was glad when I didn’t see her name on the board the next morning however
my happiness soon disappeared when the midwife on the night shift informed me that she’d ended up with an emergency caesarean in the middle of the night – the naughty baby had decided he’d had enough and just wanted out – I was devastated and gutted as like we always do, I had told her ‘everything will be fine’, ‘you’ll do really well’. I went over to see her, half expecting disappointment on her face but was happily surprised to see a smile. It didn’t matter that things hadn’t gone to plan as she and her dinky little man were doing great – another happy Mummy!! 
I return to the labour ward and look at the board, was it no better than we had left it the night before – every room was full, and with a quick calculation I came to the conclusion that we’d each be looking after at least two women! Ah well, the busier we are the quicker the day goes, right?!
One of the ladies I am allocated to is in the latent phase (aka not yet in labour but still in pain stage)and had been all night, I get pre warned that neither her, nor her partner are happy with the care they have received so far and that she had been demanding an epidural but it hadn’t been given as she wasn’t in labour. The plan had been to commence the hormone drip to speed things up but as the ward had been so busy overnight this had been delayed – it had been agreed that she could have an epidural before the drip started but isn’t it typical that when she finally gets the epidural in, a good 6+ hours after first requesting one, it doesn’t work, as if they weren’t pee’d off enough already. Luckily it was recited and working well by the time I took over, so I walked in to a happy pair?...I feel the tension in the room… this was going to be a long day! Sadly the epidural only worked well for  a few hours and then the pain returned, this naughty baby was in the OP position (her back against mums back) which gave the worst backache, the contractions were no longer felt because now the pain in her back had superseded that….  Mums position was changed a dozen times, top ups of epidurals given and the infusion rate increased but still nothing got rid of this pain. By this point mum was completely fed up, she was adamant that she wasn’t going to progress and that after all she had been through she was going to end up in theatre. Unfortunately with that frame of mind, there was little hope of a normal delivery – no matter what I (and her doula!) or how much reassurance was given there was no way she was going to continue with this labour any longer. so at maternal request a bouncing baby girl was born by caesarean section a little while later. It all went well and both mum and dad were very glad of the outcome – it may not have been obstetrically the best thing to do, but for these parents they left with the outcome they wanted.  
I’m now half way through my shift, feeling pretty emotionally and physically drained and completely starving The ward seems under control so I get told to go for lunch! Wahoo one hour of sitting down doing nothing, usually I get bored on my break, I like to be involved and know what’s going on, so pop back to the ward after 30-45mins to see if anyone needs a hand but this time I needed that full hour was I that lucky? Of course not! As I head out to the labour ward exit I come across a rather stressed dad to be who shouts out that his wife needs help – for a split second I think to myself ‘can I pass as just being a visitor and just slip past and continue to the canteen?’ but quickly my ‘midwife instinct’ kicks in and I follow him to his wife, who is, and I use the word lightly, ‘sitting’ in a wheelchair, although the only parts of her touching the chair are her hands and feet, from experience it is clear that she has a little head sitting between her legs. I get informed that this is their 3rd baby, the last one was quite quick and her waters went in the car on the way to the hospital. I quickly guide them to the nearest delivery room, calmly calling out to the midwife at the desk ‘could we have some syntometrine please’ she looks at me to say ‘I thought u were on lunch?’ I smile and respond with the look which says ‘come on, this is labour ward, we don’t do lunch!’. I just manage to open my delivery pack and pop on a pair of gloves as a beautiful baby boy decides it’s time to slither into the world! The relief on the mums face and the tears in the dad’s eyes just sum it up for me – I love my job! What a lovely delivery, no screaming, no complications, just a very calm and controlled birth, – if only they were all like that! An hour and a half later – it’s now nearly tea time and I get to go for my much needed lunch!
An hour later  I return feeling a little energised to be told 3 women are on their way in, all being sent from their GP with a variety of complaints ranging from headaches, to reduced foetal movements. The first girl turns up, she’s a primip, 8 months pregnant and in her early twenties. She looks well but tells us she’s had a headache for a few days so went to her GP and they’ve sent her to us as she had slightly raised Blood pressure and something in her wee. Quick flick through her notes and we discover that she had VERY high blood pressure and 3+ protein in her wee! To cut a long story short, within and hour this poor girl who thought she just had a headache, had two drips in her arms, a blood pressure cuff pumping her arm up every few minutes, beeping to highlight unrecordable results, a monitor on recording the foetal heart and a urinary catheter in measuring her wee. She was given a variety of antihypertensive (blood pressure lowering) tablets and commenced on magnesium sulphate to prevent her fitting due to the high blood pressures.she is calmly told by the obstetric registrar that she has severe pre eclampsia and that her baby will need to be delivered by caesarean section asap. So not just a headache after all!
Getting near the end of the 13 hour shift, it seems like forever that I had a drink, and since I’ve been at work I’ve not yet been for a wee myself, us midwives must have large bladders! After a quick nip to the ladies and a guzzle of water I spend the rest of my day triaging patients and hunting down doctors to review them!
Come 20.30 I am completely shattered, I hand over my ladies to the night staff and leave the hospital with a smile on my face – just another day on the ward,completely unpredictable and full of excitement! You know it’s been a busy day when your scrubs are splashed with blood, your socks are drenched in liquor and your hands ache from all the writing! I think about the babies I have welcomed into the world throughout the day and hope that everything goes ok with them and the parents leave the unit with positive memories!

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