However, I have read a few students' blogs in the past couple of days and I have become concerned about what is being written in open forums. I have seen students write very detailed accounts of their clinical experiences, especially births. Whilst they have not used names, there is always a possibility for women to be identified.
Using stories to learn
Health professionals rely heavily on telling stories as a means of teaching and reflection. Our blogs are not dissimilar to the staff tea room at the end of the hospital corridor where health professionals do so much story-telling. The difference is that the door to the tea room is closed, whereas our blogs are open to all passers-by.
Who owns birth stories?
It isn't just an issue of confidentiality, but also a question about ownership. Whose story is it? A birth story is the woman's story. Do we the right to plaster a woman's birth story all over the Internet without her permission? What do you think?
Reflecting on clinical experiences
I am thinking that the best way to blog about clinical experiences is to write in a general way as opposed to a specific description of events. Make the story about you and your learning, not about the woman.
I also think it is important to consider the aim behind blogging about clinical events and practice. I think it is to help the processing of learning. But it also can be a resource for fellow students and midwives. So I would recommend that you should keep this aim in mind when you blog about your clinical experiences - that will help to focus your writing. If you are a student or midwife, what would be your aim for reflecting on a blog?
Here is a suggestion for how you could blog about a clinical experience. First, read the scenario.
- A student midwife is working on the labour ward (or delivery suite) alongside a midwife who is caring for a woman in labour.
- The woman is expecting her first baby and has had her labour induced because she is seven days overdue. The woman goes into painful labour and ends up with an epidural. After two hours of pushing, the woman has her baby. The baby is a little slow to start breathing when he is born and requires some attention from the second midwife attending the birth. Once the baby is fine, he has his first breastfeed.
- The student has a busy time, getting a chance to do a number of clinical skills like urinary catheterisation and intravenous cannulation (putting up a drip). She carries out a vaginal examination, supports the woman and her husband, catches the baby, does some documentation and even has a go at suturing. She helps the woman with the first breastfeed and watches the midwife carry out the first check of the baby.
There are any number of issues that the student may wish to think and write about, and share with fellow students and colleagues.
- Induction of labour - indication, evidence, midwifery care and responsibilities, outcomes of birth.
- How to care for women in labour so they do not require pain medication.
- How to facilitate normal birth when a labour is no longer physiologically 'normal' ie when there has been some sort of medical intervention.
- How to develop skills of accurate, detailed and contemporaneous documentation.
- Caring for a woman who has an epidural including the 'management' of second stage.
- Feelings of own inadequacies when dealing with the unexpected, such as when a baby who needs resuscitation.
- Acquisition of clinical skills - competency and confidence.
Here are a couple of ideas on how you could blog about this scenario.
- Explore feelings about competency and confidence. Describe what you are going to do to become more skilled and suggest helpful resources that you have found useful eg YouTube video on cannulation.
- Explore the evidence about induction of labour and critically evaluate it. Publish a list of useful references.
- Same applies to evidence about epidural. Formulate a set of guidelines for midwives about caring for women who have an epidural based on the appraisal of the evidence.
- Start a discussion about alternative ways of pain relief for women in labour.
"BORING!" "That's not what blogging is about". "Those suggestions sound like writing mini essays and I do enough of that already"
You may well be right - I'd love to hear what you think.
But writing posts like this as opposed to detailed and personal recounting of events will help develop critical thinking skills, develop resources that can be passed on to other students and hopefully inspire useful discussion.
Message to students
So my particular message to students is to think carefully about what you write in a blog. If you have any doubt, consult with your lecturers before you hit that 'publish' button. And do not forget the stringent institutional and professional rules about confidentiality.
Opening up discussion
I am not saying that this is how you should blog and you may completely disagree with what I have said. The last thing I want to do is be prescriptive about the contents of a blog. However, I would love to hear from you if you are a health professional - how do you think we should blog about our clinical practice? Do you think we should be developing guidelines for blogging? If so, what should they contain? Do you think there should be different guidelines for students compared to registered practitioners? What do you think about all this as students - what would you suggest?
If you are not a health professional, I would also value your opinion. What would you feel about having your health care related in a student/practitioner's blog? What would you like included in guidelines or do you think the content of a health professional's blog should be left to individual discretion?
Reference: Learning through storytelling. Maxine Alterio and Janice McDury. 2002. Dunmore Press, Palmerston North, New Zealand.
Image: Mark's trip 2008 Mark Stewart