Improved care for Polish women, Specialised versus generalised, Uniformed?
Improved care for Polish women
FROM: Aldona Morrison, midwife
SUBJECT: Improved care for Polish women
Email:
aldana.morrison@virgin.net
Dear editorIn
Midwives October/November 2008, I wrote about my project to help Polish women, who have problems communicating in English. The project is going from strength to strength. The number of women attending Polish antenatal clinics is increasing and the feedback from clients and colleagues has been extremely positive.
Antenatal care in Poland is managed very differently and involves obstetricians on a daily basis. This is why it is so important to inform Polish women of the antenatal care pathway in the UK. The women have the ability to discuss their fears in their mother language; the medical and obstetric history is taken in Polish, thus ensuring appropriate individual care and allowing informed choice. To help my colleagues in all areas of practice, I have now developed a ‘Helping hand’ folder, which consists of leaflets, information in Polish and English, key terms in both languages to ease communication and promote informed consent, especially in emergency situations and when an interpreter is not available. This has proved to be very successful and the folder has now been implemented in other Trusts, where the Polish community has significant impact on their workload. Please contact me, if you are interested in further information about the folder.
Specialised versus generalised
FROM: Gwyneth Sanders, community midwife
SUBJECT: Specialised versus generalised
Email:
gwynsand@yahoo.co.uk
Dear editorI wonder what other midwives think of the idea that specialisation versus generalised midwifery skills are of benefit to our profession. Specialisation has led to the development of antenatal screening midwives, drug and alcohol midwives, midwives with risk management knowledge, and midwife sonographers – all with midwife at the core of their job description, but with an added specialist role.
If we were to take that further, would we consider the community midwife has her own specialist skills relating to that role, in contrast to that of her colleague working within the hospital setting. After all, there are hospital-based nurses and community nurses, all who operate within their particular area, requiring further training to undertake that role, which are not required to work in each other’s area of practice.
While most midwives might welcome the flexibility that working in both settings gives, will the demands of what is a highly specialised area of practice – the hospital – lead to community midwives feeling underskilled in that setting?
The hospital midwife is a highly skilled practitioner. Many of the skills she exhibits are used regularly and in practising them frequently, she becomes more skilled. Equally, community midwives’ skills lie more in the care of the pregnant woman in relation to her social and emotional background, bringing into play issues such as social welfare and domestic abuse.
Is it possible that all this depth of practice can continue to be incorporated into one single midwife role or is there a place for further specialisation?
Uniformed?
FROM: Name and address supplied
SUBJECT: Uniformed?
Dear editorI work within a community team. Most of us have been working as midwives for at least five years, some with more than 20 years’ experience.
We have worked hard to remain autonomous, despite working for a large NHS Trust. We are proud of keeping midwifery normal and, as far as possible, outside of the medical model of care.
Unfortunately, without any consultation, we have been told to wear a nursing style uniform – dress or tunic and trousers, or risk disciplinary action. The reason for this as explained by our employers (the PCT) is corporate image. What does this mean? That the public will think we are more professional, efficient and clean if we are dressed as nurses. There is no evidence to suggest this. If our aim is to keep birth normal, why are we being forced to wear a medical uniform? Furthermore, to reinforce this PCT’s backward-looking view, we are to be colour coded according to our grade. Can you imagine teachers, health visitors or doctors agreeing to this? If the PCT want a corporate image, then all staff should be wearing a uniform. I have been told that ‘knowing one’s grade is useful for recognition of skill’, but this does not apply to community midwifery, where a certain amount of experience is required before leaving the hospital environment.
Wearing a uniform undermines a number of fundamental principles: a woman’s right to confidentiality – we book in family centres, GP surgeries, clinics and homes; ease of communication and the avoidance of barriers in the community setting; of a woman’s right to see childbirth as normal physiology and not a pathological state.
For the midwife, there are other issues: the compromise of our safety as lone female workers when on-call. The uniform highlights our presence and our status as possibly carrying drugs, such as pethidine. By implication, the wearer is perceived as cleaner, the reality is solely dependent on individual cleanliness. Research shows no correlation between clothing and infection if basic principles are adhered to. In our case, the final point is counter-intuitive – this perception is the reason for hospital staff not wearing their uniform outside the hospital.
We have tried hard to compromise, initially suggesting a blouse and trousers from an established uniform supplier. This was rejected.
We know an adjacent, more enlightened PCT rejected the uniform policy for community midwives on the grounds of lone worker safety. Are there any other community midwives out there taking the great step backward?
You may see this as petty in these difficult times, but our appearance is crucial to projecting an image of normality. I have nothing against uniform in a nursing job; I just don’t think community midwifery is that job.
So what is this about? Control of the workforce, keeping us in our place? Egos with the power to insist? We can’t feel less valued. With the threat of disciplinary action, where do we go from here? What is the union’s position on this?
ResourceJacob G. (2007)
Uniforms and workwear: an evidence base for developing local policy. HMSO: London.
There's more
Want more views? Then please visit:
www.rcm.org.uk/midwives/your-views for more letters and opinions. Topics include:
- Should fathers be present at the birth?
- Are you Margaret Batch?
- Another response to June/July’s Disillusioned and disgruntled too.
