A day in the life of... a smoking in pregnancy specialist

Midwives magazine: Issue 6 :: 2011

Name: Vicky Almey
Occupation: Smoking in pregnancy specialist
Lives: Hinckley, Leicestershire

I originally trained to be a midwife ten years ago, but during a spell on maternity leave in 2009, I took a big decision and applied for a role as a smoking in pregnancy specialist within a local primary care trust.

We offer all pregnant smokers in our locality a specialist stop smoking service. This involves flexible home visits, partner/family support to quit and the use of nicotine replacement therapy (NRT) in line with the NICE (2010) guidelines on smoking in pregnancy. I work closely with the local midwifery team in my area to support the midwives in referring women into our service.

A typical day

8.00am I set off for my first home visit of the day. All my referrals are sent to me electronically from our offices so I can book the women in to see me as soon as possible.

8.45 Arrive to see a very anxious woman for a first appointment. I spend an hour reviewing all her details including her obstetric history and full smoking history. We both feel she would benefit from NRT to improve her chances of quitting. A follow-up visit is booked for one week’s time, and I arrange to call her on her quit day. She seems much happier and motivated when I leave.

10.00 My next visit is to follow-up with a couple I assessed the week before who are having their fifth baby. They greet me with huge smiles and can’t wait to tell me they haven’t touched a cigarette in ten days. The nicest thing I hear is that they feel the whole family is benefiting because they now have the energy and motivation to go for walks with their four little children. I leave feeling that my job is very rewarding.
 
10.30 My next appointment is not at home, despite me texting her to confirm. This is a frustrating part of the job.

10.45 I sit in my car with my laptop (and a latte) to catch up on emails. I reply to urgent messages and also reflect on where we are with our quarterly target for numbers of people quitting.

11.20 Arrive at Leicester Royal Infirmary to meet a colleague. We are delivering a training session on the midwifery mandatory study day. This is a new commitment and we are delighted to have this opportunity to update all midwifery staff.

12.30pm The next visit is to a young mother with a complex social history and history of drug abuse. She really opens up to me and we make a plan to help her quit smoking. I find that women are a lot more open in their own home and this really helps the quitting process.

1.15 I quickly grab a sandwich and drop in to a local children’s centre. A group is held there each week for vulnerable parents so I am piloting a project to see if our service could be used to reach this particular client group.

2.00 Arrive at another children’s centre for a monthly smoking in pregnancy strategy group meeting to discuss strategies for reducing smoking in pregnancy rates. We have lots of discussion around the Commissioning for Quality and Innovation targets that are now set locally for smoking in pregnancy.

4.30 One last visit to follow up a woman who has not smoked for four weeks now. She is coping well and is no longer using NRT. I issue her with a congratulations certificate. She puts it straight on the mantlepiece for everyone to see.

5.00 Arrive home and ring a few new referrals and book them in. I also plan to spend a bit of time in the evening completing a training package from the National Centre for Smoking Cessation training. Then start all over again tomorrow. I love my job!