Thursday, February 21, 2008

Tips for new student midwives: working in clinical placements

Yesterday, I talked a little about how to manage your academic studies. Today, I'd like to leave you with just a few tips for managing your learning in the clinical setting, in no particular order of importance or relevance.

1. Look after your physical self. In particular, take care of your back.

I have written about this before because I know a significant number of 'older' midwives whose quality of life at work and outside is severely affected by back injury. Do not lift women without the proper equipment and training. Make sure that any bending over a sustained time is done in an ergonomic way.

Make sure you have plenty of food and drink to keep you going, especially at long births.

When you are attending a woman who is having a long labour, make sure you have regular breaks even if the midwife isn't. What she does is her call - you will not be able to function properly if you are overly tired.

2. Pay attention to your appearance.

Wear light, cool clothes when you work with women in labour - it gets very hot in hospital birthing rooms. If you wear mufti, keep the g-strings and skimpy tops at home. They look unprofessional and are distracting to those you work with, colleagues and families.

3. Be prepared for the theory-practice gap.

After ten years of being a midwifery educator and post-registration student for 16 years, I still am hearing examples of midwives working in a way that is not evidence-based. I do not want to go into the reasons why, in this post - maybe another time. However, you must be prepared for this. Don't ever stop questioning and leading by example - one of the main drivers behind my move to evidence-based practice was by watching and listening to student midwives.

4. Do not ignore the 'old battle axes' who seem to have been around for ever - I think I am probably in that category now!

I can think of a number of midwives I have met over the years who would fit that category. Sometimes these midwives can be darn-right scary, but invariably they have amazing experiences and stories to learn from. They are great people to learn 'tricks of the trade' from.

5. Make the most of all learning opportunities, both positive and not so positive.

Be enthusiastic and interested. Question, but do not be arrogant or critical. Be respectful and non-judgmental, of colleagues and families.

6. Make use of the support structures that are put in place by your educational institution. Being able to reflect on your experiences and learning away from the clinical environment is an important part of the learning process.


I could go on and on about this but will stop there. What do you think about these tips? Are they fair comments or am I barking up the wrong tree? What tips or comments would you add?

If you are a non-midwife/student, what would you see as being important for a student to consider if she was working with you and your family?

Image: 'IMG_8118'


Kate said...

They sound like great tips to me. I did my nursing degree (OMG it was 10 years ago I started!).. anyway, all those tips could relate to that too. And I agree about the battle axes.. the two most amazing nurses I ever met fell into that category and for a long time I was terrified of them, but they had the most experience, and they were just amazing.. I think I learnt the most from them.

M said...

Hi Sarah - thanks for stopping by to let me know I was mentioned here.

Your tips are great - I would add to that - establish communication and boundaries w/ your placement midwife *before* you find yourself exhausted, burnt out, in the middle of exams and unable to say "no, I need this 24 hours off". It's very hard to do when you're an enthusiastic student, but necessary to find and maintain the balance long before you're practicing on your own. I say this from the perspective of attending 9 births, sitting 4 exams and being in my second trimester all in the space of 3 weeks last June! (and actually I had great communication with my placement midwives - it's just so hard to say no!).
I have more thoughts, but I'm nursing so a bit one-handed here.

Sarah Stewart said...

I remember Sister Butcher, who was the 'sister' on one of the postnatal wards when I was a student nurse...27 years ago!!! She was definitely 'old school'.

We spent a late shift together. I was sitting in the nursery (before rooming-in days) cuddling a baby ( yes, I know....the mother should have been doing it!) and we had such an amazing talk about life. I ended up in tears and decided there and then that I wanted to be a midwife.

Sarah Stewart said...

m - you're absolutely right! Actually, that should really go to the top of my list of tips - probably before the 'leave your g-string at home' tip! Would love to hear more from you with your perspective as student - my perspective is obviously that of lecturer and 'old battle axe'!

rae said...

all very good tips - I think humility is really important - relates to your tip re not being judgmental...always know that your percieved way may not be the only way and if you are really concerned or have an issue with the way a midwife did something, provided the care or with a decision she made - then ask her - she usually will have an explanation and it may be that something you weren't aware influenced the care in some way. i think you should always provide this opportunity for the midwife. Also respect the midwife-woman relationship as the primary one.

Pferdenuts said...

Let the women be your guides, as much, if not more so, than the RMs. They are, after all, the important ones in any pregnancy and birth! I learned so much more from my CCP women than I ever expected.
Never contradict your RM (or MO) in front of the woman or her partner, you don't want to undermine the woman's confidence, however do ask about things when out of earshot - you can then reflect on this later and allow it to inform your own practice. Contradicting will also alienate you from the RM and they might not be so willing to mentor you again. Diplomacy is very important :-) Most midwives are happy to hear new evidence etc, but when they are working with a woman is not the right time!

Sarah Stewart said...

Great advice, Pfderdenuts...thanks a lot, Sarah