Placement crisis
Dear editor
I would like to raise awareness of a situation that seems to have been overlooked and is getting worse.
Since my registration lapsed in 2006, I have desperately been trying to return to midwifery, which requires me to undertake a return-to-practice (RTP) course. I had no idea it would take over three years.
My only barrier was obtaining a clinical placement, which proved very difficult until recently, when I managed to secure a placement at Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust. None of the four main hospitals in my area – Central Manchester, South Manchester, Stockport and Macclesfield – could offer me a placement, which was so frustrating and difficult to comprehend.
I would like to ask why units are unwilling to assist people with maturity and experience to return to their careers, after all the investment in training and development? This needs to be addressed, and the reasons behind the decisions need to be explored and corrected.
If the government speaks of increasing midwife numbers, then surely it is far more cost-effective to re-establish trained and experienced midwives, than investing in the training of new midwives. As well as the cost factor, there is a wealth of experience, skills and knowledge being lost, which would improve the quality of care given to women and babies.
As well as the lack of clinical placements, there are also reduced numbers of academic institutes offering RTP courses. My first choice for the course was Manchester, but all funding was withdrawn in 2006. Apart from the RCM’s distance learning course (which I did start, but could not complete because of my lack of clinical placement), there are only three academic institutes in the North West, one being Cumbria which is geographically unfeasible.
This diabolical situation was reinforced when I found out recently that many potential ex-midwives were unable to start on my course, despite meeting all the criteria, because they could not secure clinical placements. This has meant there are only five of us lucky enough to go forwards, which is unbelievable and unfair for those, who like myself have made their best efforts to return to practice, and yet hit a brick wall.
I am extremely grateful and lucky – but luck shouldn’t come into it. There should be equal opportunities for everyone, and I will keep campaigning until more placements are made available.
I am writing to my MP Sir Nicholas Winterton in the hope these issues will be raised at government level. I would be interested to receive any feedback and to hear if you share my concerns.
From
Lynda Boyle, nurse/midwife, then M&S sales assistant, now midwife
RCM response:
The RCM are pleased this midwife has now secured a clinical placement.
There are still midwife shortages across England. The RCM support the fact that return to practice is one avenue of recruitment and helps increase midwifery numbers.
The local supervising authority midwifery officer should be the first point of contact for any midwife wishing to return to the profession and to receive the appropriate advice.
The RCM’s RTP programme is open learning, flexible and based on individual needs. We have been providing courses since 2003 and have enabled a number of midwives to successfully return to practice. The RCM has recruited 30 midwives since January 2008. This year, six have completed the course and been offered posts in the clinical area in which they gained their experience.
Clinical placements for London-based RTP midwives are widely available and well supported by heads of midwifery.
The RCM will endeavour to support midwife members struggling to access a clinical placement.
Why the labour ward first? A response
Dear editor
I would like to congratulate the author of
Why the labour ward first? in the last issue of
Midwives (August/September) on qualifying as a midwife and say....
It is now that you start your career. As a student, you of course cover as many aspects of midwifery as is possible, whether that be normal or abnormal. While training, you should be taught how to recognise abnormal and how to deal with it. But it is only in the latter stages of the training that this is fully appreciated and is of course under direction and the responsibility of your mentor.
I am sorry you feel that you have to justify why you wish to start your career on a birth centre and that you are not a fully ‘paid up’ member of the midwifery profession, but I assume that your colleagues may want to advise you.
I can assure you that being a student and being a qualified midwife is very different, as your colleagues will tell you. All newly-qualified midwives have preceptorships to help them progress from student to qualification. It is when you qualify that you start to learn. Being on the labour ward, you should expose yourself to as many abnormal situations as possible, so that you are
au fait with how to deal with them in an efficient and safe manner. It is with practice and experience that you hopefully become confident in dealing with most situations; for example, resuscitation of the newborn, postpartum haemorrhage, shoulder dystocia, fetal bradycardia, to name but a few – emergencies that you can encounter, even in a birth centre.
If the birth centre is not near the consultant-led centre, all the more reason to be ‘on the ball’, as you will need all the experience you have gained in your career as a practitioner to give safe care to the mother and baby. I fully understand that not all experiences may be encountered in your work, but it is important to gain as many as possible for you to feel confident in an emergency situation, not only for the mother, baby and family, but also for yourself, as you would not want to stress yourself because of a situation where you felt inadequate due to inexperience.
I hope what I have said may make some sense – your knowledge should be good, but remember ‘it’s now that you start learning’, and we continue to learn, when we qualify, we think we have all the knowledge – we don’t. So be patient and enjoy gathering all your experiences that will lead you to be an excellent birth centre midwife with a sound knowledge to cope in any eventuality possible. Good luck.
From
Jayne Greig, labour ward coordinator
Calling all midwives
Dear editor
I am writing to invite all UK midwives to make a contribution to a new book that I intend to write and eventually publish.
It has been a long time since a Jennifer Worth
Call the midwife style book was published and I feel that a 21st century account of the lives of today’s midwives is long overdue, and perhaps even raise a smile or two among us in the process!
I am interested in receiving any funny stories/anecdotes, or questions that midwives have experienced during their day-to-day practice, which they feel would benefit from being included in the book. However, I am also considering making a comparison on how midwifery has changed since the 1950s, within a separate chapter. Therefore I would also love to hear from retired midwives, who feel they would like to contribute to the contents.
From
Alyson Brown, community midwife
callthemidwife2@aol.com
