Today's post is written by a student midwife who's now in third year but remembers exactly what it's like to get through those first tense minutes. This post will help you survive your first emergencies - and thrive too.
And if you're a midwife mentor, I hope this will take you back to what it's like to be in a brand new crisp white uniform, wondering how you're ever going to be able to cope with an emergency!
Training as a student midwife is three years of incredibly hard work, high and low emotions, major sleep deprivation and stress but it’s all worth it.
When I was a first year, my biggest fear was dealing with emergencies. I didn’t know what I was expected to do and the panic just got to me. This is normal and I promise, will go away, and remember, you’re a first year starting out completely new so you’re not supposed to do much in emergency situations!
These are the 8 main tips I have for you.
1. Observe The Event For Your Own Learning
Remember to begin with you'll likely be expected to do nothing but observe. It's important to see how the teams work together and get a feel for the atmosphere and these events. It’s sometimes quite hard to know where to put yourself but just pick a spot out of the way and watch.
Discuss the emergency with your mentor afterwards to ensure you have an understanding of what happened and how it was dealt with.
And as scary as emergency buzzers are, try to attend as many as you can to build up your exposure to them.
2. Open Doors
I appreciate this sounds silly, but it’s actually not at all. Helping to open doors, push the bed or CTG machine if a woman is being transferred to theatre is seen as such a great help.
Midwives will also be impressed you're taking the initiative.
Sometimes you get so caught up in the heat of the moment that you forget about little things such as this.
3. If You're Asked To Scribe...
This is a hard one – I wouldn’t personally recommend scribing in an emergency as a first year.
You need to be familiar with drugs and dosages and obstetric maneuverers, who’s in the room, who’s doing what, what drugs are given and at what times.
If you don’t feel comfortable, say ‘I’m not comfortable scribing at this stage, how else can I help?'
Ask yourself, what’s more important, me looking silly or making sure these woman's notes, which are a legal document, are accurate?
Two of the most common things you’ll be asked to do are either run and get things from the ward stores or pass things already in the room to the team giving treatment.
On many occasions in my first year, someone said to me ‘quick go and get this’ and I’d say ‘ok’, only to end up standing in the corridor panicking!
In this situation:
a) Find someone not involved in the emergency, possibly a Health Care assistant and say ‘I’m not sure where the (foleys catheters) are yet as I’m still getting used to the area. I don’t want to take a long time as it’s an emergency, could you show me?’
b) Go back into the room, and say ‘I can’t find the foley catheters, someone else needs to look’ or ‘I’m not sure what you asked me to get’.
Remember, the team and woman would much rather you were honest than waste precious time during an emergency.
Every minute counts.
5. In the UK, Dial 2222
In UK hospitals, the standard number for any obstetric, neonatal, or any other emergency for that matter (e.g cardiac arrest) is 2222.
When this is dialled, everyone who needs to be alerted is ‘bleeped’ and a team of specialists will come running in minutes.
When you dial 2222 an operator will answer, you’ll need to state what kind of emergency is occurring and where.
The operator will then repeat this back to you confirm and replace the handset. Try not to panic when doing this, I’ve occasionally been very flustered making it difficult for the operator to understand me.
Keep calm and collected.
6. Reassure The Woman And Family
This is important, and can be a great role for you, especially if no-one else is free to provide reassurance, and you’ve run in to answer an emergency buzzer and now don’t know what to do with yourself.
DON’T say ‘everything will be ok’ as it may not be.
Below you can see a few examples of things I’d say.
For a Postpartum Haemorrhage: “You're having a little bit of a bleed at the moment, more than we would like. Try not to panic you have a very good team looking after you, we’re used to dealing with situations like this.”
For a Shoulder Dystocia: “Baby's shoulders are a bit stuck, this can occasionally happen. Try not to push, keep breathing and try to remain calm, and try and listen to the midwives/doctors instructions."
For a Fetal Bradycardia: “Baby's heartbeat is telling us he/she is not very happy at the moment, this can sometimes happen, we have everybody who we need in here in order to deliver baby quickly if we need to.”
7. Try Not To Touch Anything Sterile
I did this by accident on my first shift on labour ward, nearly got my head bitten off by the anaesthetist and wanted to cry.
Usually, if not always, green sheets mean a sterile field that must not be touched without aseptic technique.
This obviously could vary from trust to trust so make sure you find out. Of course, it happens and it happens to everyone.
(Interjection from Ellie here: yes, it does happen to everyone. I’ve been both the student contaminating the field and the midwife asking the student not to!)
If somebody gets stressed out with you for it just brush it off and don’t take it personally. I once sneezed with sterile gloves on and had to change them, nearly missed my delivery because of it!
8. Try Not To Stress
I remember thinking “oh my god, how on earth am I going to remember everything?”.
The truth is, you’re not going to remember everything. You’re going to have days where you feel like you can’t do anything and you’re the most incompetent person ever, but then you’ll have days where you feel like a ‘real midwife’ and finish your shift buzzing because you’ve finally mastered a particular skill.
You'll get to a point within your training where things start to make sense and you realise you know a lot more than you gave yourself credit for.
You don’t realise how much you’re constantly learning subconsciously.
Finally, try to enjoy your training as much as you can. Take every opportunity you get to learn and practice, practice, practice as you won’t be a student forever.
Good luck to you all!
I wish I could get in a time machine and hand this post to my young student midwife self. A huge thankyou to this student for sharing expertise and insight. Now I'd love to hear from you, leave me a comment letting me know what scares you most about attending obstetric emergencies - and which one of the points in this post will help you overcome this fear?
Or, if you're a midwife mentor, what's one thing you wished every student knew before they turned up on their first placement?
I hope everything is good with you and yours, Much Love,