A day in the life of a labour ward coordinator

Midwives magazine: Issue 1 :: 2012

Name: Chris Berner
Occupation: Labour ward coordinator
Lives: Brentwood

I work for Mid Essex Hospital Services NHS Trust. The trust’s maternity service covers a fairly large geographical area supporting around 4500 to 4800 births per year. The service aims to meet the individual needs of women and their families while promoting normal birth. As well as being a coordinator, I have recently undertaken the role of team leader on labour ward, a position which facilitates the development of managerial responsibilities for band 7 midwives. The labour ward consists of numerous challenges, and the coordinator is constantly confronted with diversity and uncertainty.

A typical day

8.00am Formal handover from the night coordinator. I allocate midwives to the women. General room and equipment checking carried out. I’m updated on any operational issues, and the controlled drugs are checked. Pharmacy levels are scanned and further supplies ordered. I visit the antenatal ward to enquire about the ongoing and expected inductions.

8.30 A multidisciplinary handover meeting is held. There are seven women on labour ward, one of whom has experienced an intrapartum death. Any anticipated impediments to the day’s plans are addressed.

8.40 As three elective sections are started, I escort the obstetricians and anaesthetists to the high-risk women.

9.30 A primiparous woman whose labour has prolonged needs transfer. Continuous fetal monitoring is started. I request a review and a plan of care by the obstetric registrar. She recommends an oxytocic infusion but an epidural is requested before it begins. I assist in cannulation and taking routine bloods.

11.00 On request I undertake a ‘fresh eyes’ review of a cardiotocograph (CTG). Much of my day is spent evaluating and disseminating CTG findings.

12.00pm I receive a call from a woman who wishes to undergo VBAC. She reports regular tightenings and believes her ‘waters’ have ruptured. She is advised to attend for assessment.

12.30 I begin to organise lunches. By being aware of each of the women’s progress of labour, I am able to designate timely lunch relief.

1.00 The midwife discusses the analgesia of the woman who has undergone an intrapartum death. We decide an intravenous morphine infusion would now be required. I inform the anaesthetist.

2.00 I participate in a case review session – both midwives and obstetricians are encouraged to analyse CTGs and discuss any decision-making processes.

3.00 A quick glance at any emails while reviewing another CTG and checking some drugs. Unwanted bags of blood are returned to the laboratory.

4.00 Discussion with antenatal midwife. She wishes to transfer a woman to us. I will inform her when a bed is available.

5.00 Support midwife following birth of baby in the bereavement suite. Bed available for antenatal induction. Night obstetrician now present so updated on activities.

6.00 Assist with instrumental delivery of transferred woman from co-located unit. Perform cord blood gas analyses.

7.00 Accept a transfer from antenatal ward of a woman who needs an oxytocic infusion.

8.00 Night staff arrive, responsibilities handed over. I can head home.