'Support/Advice Needed' - A Student Midwife Nearly Gives up but Doesn't

One Sunday back in 2015, I received this email from a student midwife:

Subject Line: Support/Advice Needed:

Hi Ellie,

I'm a 3rd year student midwife and am desperately looking for a bit of general support/advice. I made a pretty big mistake in placement for the first time yesterday, and now I feel terrified that I won't be able to qualify and the last few years of hard work has been for nothing. Nobody was hurt and I did everything I could to resolve the problem quickly.

Essentially, after a crazy night shift with no break and being asked to care for women unsupervised, I was exhausted and run off my feet. I completely forgot about an examination I had performed and handed over care of a woman to another ward without documenting it.

Luckily the midwife I handed over to picked this up via a conversation with the woman, and I remembered what I had done, apologised profusely and documented the exam in retrospect.

I've never had this kind of lapse of memory before, I was so sleep deprived and anxious about being by myself for the first time and now I feel completely incompetent and embarrassed. I've been doing really well for the whole three years of training and was on my way to a 1st degree, I also managed to get a job offer which I'm so excited to start, but now I'm worried that I've thrown it all down the pan.

I reported the incident straight away and am hoping to meet with my clinical placement facilitator asap.

I understand that of course you can't comment specifically on cases that you have limited information about, but I have no idea what the procedure normally is when a student makes this kind of mistake. Is this the sort of thing that could prevent me from qualifying? I handed over care to the labour ward and all the midwives were sat in the office commenting loudly about how terrible this was and how stupid I must be. They also all seemed to think that I had deliberately lied and this is really upsetting, particularly as I have known and worked with some of these midwives for three years and have been told that I have a reputation as a great student.

I just feel completely disgraced and unsupported. The last three years have been the most stressful and draining of my life, but I've always tried to stay positive. Is this a problem you have come across / heard of before? And do you have any idea how this might be resolved?

Many thanks for any advice in advance,

Leanne

I remember that day and I had about 48 hours work to do in 24, so I knew I couldn't give Leanne my full attention, even though I really wanted to. But soon as I could, I replied:

Hi Leanne,

I'm going to write a longer response when I have a second but essentially, I could have written a similar email when I was in my third year (slightly different situation but the same feeling of criticism, lots of staff knew, no harm done and really quite a minor mistake due to sleep deprivation, but I was mortified).

It's ok. Really. I don't think for a moment that this will mean you can't qualify, I think you being able to show you know what to do when you have made a mistake is key to demonstrating you'll be a good midwife.

All my best,

Ellie Durant

Then the next day, I sent the following:

Hi again Leanne

I remember midwives and students who:

* gave the wrong drug and didn't check before doing so
* forgot to hand over
* sent the wrong woman to scan (who didn't speak English and had problems finding her way back to the ward)
* put the wrong name on a baby band!

These were still considered excellent midwives. Mistakes happen. It sounds like you are in a very tricky environment and talking with your tutor is best. Obviously they can't say it's no big deal because midwifery is a job with such immense responsibility. But it is well within typical events.

Did you have your meeting yet? The behaviour does indeed seem very hurtful. I imagine it's because of a certain culture that has crept up around getting everything right 100% of the time. Have you seen this post*? This really is what I try to do when difficult events happen! 

It's so hurtful and horrible when you're going through something like this. Keep the faith in your ability to give excellent care. Keep going. I can tell from the tone of your email that it'll be ok and I don't say that lightly,

Sending all my best thoughts and wishes,

Ellie Durant

*The post I sent Leanne was:

Midwifery Knocks and Coming Back Fighting: 4 Strategies

Leanne responded:

Hi Ellie,

I actually came across your post on Monday and found it really helpful. Particularly the people list. I am having a meeting with my placement facilitator tomorrow, but she, my personal tutor, and both link lecturers have all been in touch and have actually been really supportive.

I feel a lot better now that I know it's not the end of the world! But will be doing a lot of reflecting and hopefully learning from the incident.

Thank you so much for your support, it has really helped.

The shame Leanne was feeling was unnecessary and unproductive.  The reaction she got from this mistake was unfair. And she got herself back on track quickly once she knew this - I'm so impressed with her and her tutors. Leanne and I wanted to publish this because we really hope it helps any midwife or student out there going through something similar.

It's now March 2018 and I woke up to this in my inbox:

Hi Ellie,

A few years ago I went through a really tough time as an almost-qualified student midwife. I made a mistake while on placement and found myself being shouted at by a room full of midwives on a delivery suite after one of the hardest night shifts I had experienced. 
 
I was so distraught and panicked that I wasn't cut out for midwifery and that the world I was about to get into was full of hostility and blame. I had no idea who to go to for support, and I remembered that I had read an article you had written about making mistakes, so I sent you a very desperate email!
 
A few years into my career as a midwife I can honestly say that I love my job and my colleagues more than I could have imagined! That moment was make or break for me, I could easily have just quit there and then, but your thoughtful and supportive response helped me to forgive myself and keep going. Most importantly, you made me feel as though I wasn't alone. Thank you!!! Your response also gave me the courage to reach out to my university teachers for help, and they really rallied round me. 
 
The trust I trained at was one with a very strong culture of bullying, particularly towards students. The trust I chose to take a position with couldn't be more different thankfully. I know there are so many students and midwives out there who are still struggling, and the work you do and support you give will make such a difference to them! 
 
Anyway, I just wanted to thank you and say 'keep up the good work'! 
 
Best Wishes,
 
Leanne

This was a horrible situation for Leanne to have been in, but I can't say I'm angry or surprised.

At this point I know what the culture is like and I know it's not anyone's fault. It does, however, need addressing.

I don’t want to big myself up because Leanne benefited from an email, I didn't even have time to respond properly to her for a few days. I just want to draw attention to the fact that honesty and empathy can make the difference between someone staying in the profession and not. Many students and midwives say they leave over things like finances or needing to spend time with their kids – but I wonder how many are really tipped over the edge by experiences like this.

The smallest acknowledgement that a student or newly qualified staff member is part of the midwifery family can make it simple for them to stay.

It’s the alienation and being made to feel inherently wrong that's an issue. Students often get made to feel that they are a sub-par member of humanity who doesn't deserve to belong, and that gets under the skin. How could it not? We’re a species who have evolved to live in groups. In our distant past, if we were rejected from our people, we would have died.

I am often accused of being too intense about things. Well, sorry, that just seems to be how I was cut out. (My brother is a vegan Buddhist activist social worker; sometimes I worry these things might be genetic.)

I’ll risk being laughed at for being melodramatic when I write: if you scream at a midwife or student or call them stupid, you risk tapping into a part of their brain that is frightened of death. Not conducive to safety or learning.

I’m here to help, always. You might get a faster response from my colleague Kristie on team@midwifediaries.com, or use the Secret Community For Midwives In The Making (email team@midwifediaries.com to post anonymous questions and get support from the 'hive mind').

Also extremely helpful is ‘The Midwives Haven’ run by the good old Association of Radical Midwives – they can often be there for you in real life as opposed to online and understand the importance of being a supportive presence for students and midwives doing basic but scary things like opening letters from the NMC or going along to meetings with your manager so you’re not alone.

There are midwives and students doing amazing things out there and the profession is changing away from a blame culture. It's so exciting - can you imagine Leanne allowing any of her students to be treated this way? Nope, neither can I!

Take care, Ellie.

P.S. all identifying features have been changed. Also, I used the word 'tribe' in this post before. I know better now.