I can’t believe the last one I wrote was at the beginning of second year. If anything it only goes to show you how busy it can come of being a second-year student midwife! The last blog I posted, I had completed 2 blocks of theory and then my first block of placement on Central Delivery Suite (CDS).
The next block of theory that I completed was on the day assessment unit (DAU), antenatal clinic (ANC) alongside the triage unit. This was a 5-week block that consisted of all aspects of antenatal care. DAU and ANC hours were 5 days a week 8.30-16.30pm and triage was long days or nights 7.30-20.00pm. DAU involved women attending timed appointments for Glucose Tolerance Tests at 28 weeks gestation if they have any risk factors of gestational diabetes, episodes of reduced fetal movements, blood pressure checks in women who have/or are symptomatic of pre-eclampsia toxaemia etc. Furthermore, in the same unit, midwives would be involved in advocating women during antenatal clinics, whereby they have appointments with consultant obstetricians.
The clinical skills involved are blood pressure checks, urinalysis and fetal heart auscultation. A lot of the midwives in this department are also trained in ultrasound scanning to confirm the presenting part of the fetus i.e. whether or not the baby is head down – although additional training is required, this is certainly an advantageous skill for a midwife to have.
Lastly, the triage unit consisted of non-timed appointments; simply triaging telephone calls and assessing whether they need to come in or not. This was different to DAU as they were only open 8.30-16.30pm, whereas triage provides a 24-hour service. However, they do see women for the same conditions i.e. reduced fetal movements, blood pressure checks, assessing whether a woman’s waters have broken at term/prematurely, and they also see women postnatally if they have any risk factors of deep vein thrombosis.
After 5 weeks on placement providing antenatal care I went back to CDS; revisiting the skills I had learnt in my first block such as artificial rupture of membranes, fetal scalp electrodes, Cardiotocograph monitoring, catheterisation, inducing labour, suturing and high risk care. I also had the opportunity to assist one of the registrars with a caesarean section which was so interesting! It really expanded my knowledge on the anatomical structure of the uterus. Throughout this block I was also working on my 4000-word patchwork text assignment that I had chosen to do on a woman with severe sepsis. We had to include the pathophysiology of the condition and how this affected the woman, critique evidence-based research on the topic, provide a comprehensive care plan taking into consideration factors antenatally, intrapartum and postpartum, then finally an overarching reflection which details what we have learnt from the experience. I found this was an essay that I got really stuck into, as I had provided care first hand to the woman with sepsis, and learning all the additional information on the pathophysiology was incredibly useful.
After this 10-week block we had a much needed 3 weeks off then went back to university for 1 week for more theory in preparation for our objective structured clinical examinations (OSCE’s). My last placement block was then on the maternity ward where I was able to provide both antenatal and postnatal care – however, it was predominantly to provide care postpartum. Antenatally, I learned much more about the induction process, which was really useful as due to being on CDS initially – I had only induced women using a synthetic oxytocin intravenous drip, rather than experiencing the initial methods of propess and Prostin.
Postnatally, I was able to build my knowledge on observations, catheter care, maternal postnatal checks, discharges, neonatal observations and acting upon risk factors for neonatal hypoglycaemia. Although I really enjoyed my placement block, it also made me realise the harsh realities of how many women just one midwife is assigned to. My mentor assigned me my own case load of women to look after, which was manageable – however, in reality I would have double the amount of women to look after as we would split the work load equally. Again, reinstating the importance of prioritisation and organisation within the midwifery profession.
Finally, once this placement block was completed we had 4 weeks left of theory and our OSCE’s. The four emergency scenarios that could be given are: Shoulder dystocia, postpartum haemorrhage, Breech birth and cord prolapse. You have 15 minutes to ‘act out’ the emergency, and then you have to write a 45-minute care plan rationalising what you did and why, then further postpartum management. I had a breech birth for mine which I felt well prepared for – and showed in my mark as I managed to get a first! The last assignment that we had to complete was on service improvement. Throughout our last placement block we had to attend 2 conferences which were inclusive of collaborating with other healthcare students to dissect what we can do as healthcare practitioners to improve the services that we are providing within the NHS. This was a difficult module to complete/organise as there were only 2 cohorts out of over 1,000 people who were attending that were January cohorts.
As a result, we were on placement and attending them in between long day/night shifts, whilst everyone else was in theory blocks at university. It was incredibly difficult to prioritise our work load at the time as during placement I was mainly focusing on OSCE’s, then after we had completed those I only had 2 weeks to complete a 2,400-word essay. However, I made the deadline after living in the library for the final 2 weeks!
It feels so strange finishing second year, as it still doesn’t feel that long ago I was writing a blog post on completing first year! I hope that this post has given you more of an insight with regards to just how busy second year can be. Now we have 9 weeks off, although this is inclusive of a 5 week retrieval period to catch up on any shifts/work that needs completing, then a further 4 weeks off for Christmas. On our last day of university we had our third-year lecturers talk to us about dissertation (gulp!) and all that is required of us for the final year, I will be sure to make it one of my new year’s resolutions to blog more! Thanks for reading.
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