This is about swearing.
The conversations I'm thinking about go like this:
‘Oh yeah, she had a PPH, a big one, I went in and there was blood all over the floor and in my head I said oh crap let’s pull the buzzer...’
‘Excuse me? Oh what let’s pull the buzzer?’
‘Swearing’s not appropriate at work.’
‘Oh. Oh, sorry.’
‘Yes, well. Let’s get on.’
The workplace I was at when this conversation happened was well disciplined. I and other midwives I was working with at the time would never swear in front of clients. We didn't tend to swear in front of staff we didn't know either. We also didn't go around effing and blinding all day - we knew the NMC Code point 20.3 which says: 'be aware at all times of how your behaviour can affect and influence the behaviour of other people'.
But we did at times use adult language as part of adult conversations. In this instance I was debriefing.
If I'd thought this midwife manager had been truly concerned about the swearing in terms of safety or it offended her because she was sensitive to the power of language, I would have adjusted my behaviour at once. We're all built differently.
But I think what she may have been saying in this situation was, get your feelings under control. Midwifery professor and researcher Mavis Kirkham has noted that emotions are seen as inappropriate for midwives on labour ward (2009).
With reports of ‘excessive deference', which means when someone more junior doesn't feel able to speak up when they’ve seen a mistake, I’m not sure keeping junior staff members 'under control', or ensuring they're not in touch with what they're feeling or observing, is a good idea.
Midwives need professional discipline of course, but they also need compassion and empathy for the women they are serving, who are going through what’s often the biggest transition of their lives. I'm not sure you can do that when you leave your real self when you swipe your ID at the labour ward door. Swearing is undoubtedly a part of my culture and therefore, my real self.
Think back to times you've talked to someone about a hard life event. The odds are, they swore and strong language has been shown to be helpful in managing pain. For most of us, the odd bit of profanity is a natural response to overwhelming circumstances and we shouldn't be expected to be emotionless robots. If midwives are trusted to manage wards, help women birth babies, and skillfully save lives during emergencies, I think they should get to choose when to use strong language.
It should be tastefully done and not aimed at anyone and not around clients who may or may not be reassured by their midwife swearing. I hasten to add I worked with one midwife who you could practically see the air around and it got a bit wearing and I was concerned about the clients. I'm not advocating this.
But the odd ‘Oh bloody hell I’m still a bit concerned about that CTG’ is a helpful discharge of emotion, with the added bonus that staff around you are more likely to take notice.
Obviously, the SBAR tool is there for the actual communication of concerns and where there needs to be a plan, but you know the times I’m talking about, right?
What are your thoughts?
To kindness in midwifery,
P.S. Remember The Kindness Conference is 11th November 2017 in Bradford.