Calling Midwives for Research Exploring their Substance Use One Year After the first UK Lockdown

A year ago, we surveyed over 600 midwives in the United Kingdom (UK) with regard to their substance use among other things. Data collection was halted early in response to the first lockdown of 2020 to avoid a distortion of results. Our findings are currently under peer review for publication.

Now, one year on, we are again looking for as many UK midwives as possible to complete and share this new survey, so that we may investigate what, if anything has changed.

All UK midwives are invited to complete this survey whether or not they participated in our last survey. They are also encouraged to participate whether or not they use substances. Please share the survey link widely.

Survey Link: https://bit.ly/UKMidwivesPSU

Please note: We will not be able to track or identify you in any way. As such, there will be no repercussions arise from anything you disclose. We are only interested in understanding, so please help us by keeping your responses anonymous throughout.

The aim of this new research is:

·         To identify the rate of problematic substance use (PSU) among midwives registered in the UK

·         To explore the leaving intentions of midwives registered in the UK

·         To explore the help seeking behaviours of midwives registered in the UK

·         To identify health risks among midwives registered in the UK

·         To measure work engagement within UK registered midwifery populations

Survey Link: https://bit.ly/UKMidwivesPSU

Access the entire project page here.

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 🎓

Identifying and Responding to Domestic Violence and Abuse (DVA) in Pregnancy #16DaysOfActivism

The 16 Days of Activism against Gender-Based Violence is an annual international campaign which will kick off on the 25th of November, the International Day for the Elimination of Violence against Women, and will run until the 10th of December, Human Rights Day. #16DaysOfActivism 

During these 16 days we will be launching and inviting people (predominantly health professionals) around the globe to enrol onto our Massive Open Online Learning Course (MOOC) entitled: Identifying and Responding to Domestic Violence and Abuse (DVA) in Pregnancy

Around 1 in 12 people are exposed to domestic violence and abuse (DVA) during pregnancy. This MOOC is free to access and will offer evidence-based training to professionals around the globe looking to improve their skills in supporting those affected by domestic violence and abuse (DVA) during pregnancy. On this course, students will discover the research, guidelines and techniques for screening for DVA. Students will have the opportunity to enhance their ability to support safe disclosure in maternity settings and empower victims of DVA to explore options and seek further support.

To enrol yourself and join the course… click this link

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 

Creating Better Understandings & Care for the Birthing Transgender Community

Following my previous post on How can we support They/Them in the birth room more effectively? We have now been able partner with the Equality Network to launch our survey aiming to create better understandings and care for the birthing transgender community. Please consider completing this survey and cascading it among your midwifery networks…

Project Team:

@SallyPezaro

@abonnieday

@DrAdamJowett

@godfrey_isaacs

@GemmaSPearce

@KongadiSahana

@isaacsamuels13

#TRANSPREGNANCY

The aims of this study are:

·         To explore experience, knowledge and attitudes in relation to transgender issues among UK maternity staff

·         To explore the confidence of maternity staff in relation to delivering maternity care to transgender people in the UK

·         To explore challenges within the provision of maternity care for transgender people from the perspective of UK maternity staff

·         To identify the educational needs and preferences of UK maternity staff in relation to the delivery of high-quality maternity care for transgender people

 

Survey currently open for maternity staff : http://bit.ly/transmaternity

The #DNAofCare …Listening to #NHS staff Stories #Exp4ALL

This excerpt from Patient Voices explains  what this project is about…”Just as care in the NHS is free at the point of need, NHS staff carry within them a vast reservoir of expertise and experience that is free at the point of telling: their unspoken, unheard stories of care and caring.

The intertwined relationship between patient care and staff well-being has been likened to the double helix. And so the stories we tell each other are like the DNA of care, transmitting information and shaping cultures, offering learning opportunities and, sometimes, healing.

There is often a cost to gathering these stories, but… as the wonderful Dr. Karen Deeny (Head of NHS staff Experience from NHS England) explains…

In the first half of 2016, NHS England funded Patient Voices workshops for staff to create their own digital stories about working in healthcare. The intention is that the stories will be used to help other people understand the reality of working in healthcare so we may all learn from experiences, both good and bad; sharing stories in this way helps contribute to healthcare that is safer, more dignified, more humane and more compassionate for everyone.”

The #DNAofCare event in London on the 2nd November 2016 was a showcase and celebration of these stories, in a bid to make real change and create new knowledge and understanding within the healthcare services. I really enjoyed the day, made some wonderful reflections and saw some real transformations. I was honored to be there and hear these private, powerful and passionate NHS staff stories shape the DNA of the care that we all give.

We sat in a wonderfully intimate London Cinema patiently waiting to hear the stories and insights from NHS staff in relation to a multitude of clinical and very personal events. The storytellers were able to introduce their stories personally, having created them over a period of 3 days, where they had clearly invested their heart and souls in communicating the greatest joys and pains of their work and their lives as they experienced them.

Thank you for sharing.

All of the staff stories can be accessed here… But for me, the most powerful story was Claudia’s story…’Pieces’..

Claudia has worked and lived in different countries, and different parts of one country. Medicine, healthcare, cannot save everyone and when death, severe illness or harm happen unexpectedly ,a serious untoward incident (SUI) has to be reported. This is one story of one incident and one team in a hospital somewhere.

This story really shows how an entire team of staff can be directly affected by a patient event. This is really poignant when we look at a case from the ‘back door’… the ‘locked door’ that most of us rarely think of or see. When a patient dies….we are patient and family focused. It perhaps feels selfish or wrong to think of the pain, fear and blame that staff may simultaneously be feeling….Feelings of ‘What if’.

Lessons are learnt and improvements are made. But the staff may leave, react poorly or feel unable to go on. They will also be shaken to the very core….their professionalism and competency tested to the limits of idealized ‘coping’. Nobody can take ‘The magic resilience pill’ for this.

As a midwife, I could personally relate to the story graciously shared by Rachel Scanlan (@rgscanlan) – There are no words to really add to this deeply emotive story. To me it was actually an experience to be seen and reflected upon in private silence. The respect and dignity of the events shared are highly personal, and yet I know that many midwives will be able to relate to these same thoughts, feelings and experiences. The tenderness described between those involved is truly heartwarming. I can only wish for greater targeted support for those midwives who share these emotionally laborious life experiences in partnership with colleagues and the families they care for. Thank you for sharing this. I will certainly be sharing this story in order to drive better outcomes for maternity services and the midwifery profession as a whole.

It was poignant that we listened to emotional NHS staff stories on #NationalStressAwarenessDay. There were many strong messages I took from the day.

Dr. @neilgchurchill on the importance of a positive #NHS Staff experience. “It’s not an ‘indulgence’…it drives better outcomes!”

 

Two final thoughts or observations for me were as follows. It was seemingly the brightest and most passionate NHS staff who had been worn down and disenchanted by their NHS workplaces, having been left unheard and unsupported. These bright sparks were then moving into academia where their ideas and talents can be nurtured and turned into really meaningful change. In essence, we are loosing the brightest talent from front line services, as they are told to ‘keep their heads down and get on with the job’. This experience resonates with me personally as I too.

Ultimately it is this message that I took from the day…

It is also this message that I intend to take forward in my own collaborative work projects. The collaborations and inspired connections that I made at this event makes me ever more hopeful that we will all come together with this shared vision and drive to make things better.

The way we intend to make things better is by focusing on the relationship between the NHS patient experience and the NHS staff experience….the #DNAofCare.

As you can imagine, the Twitter activity on this event was fairly inspiring -> Check out #DNAofCare#Exp4ALL for more reflections from this event…

 I have definitely found my flock. I hope you find yours, or join ours. Until next time, take care of yourself, and each other 💜❤💚

Midwives can change the world…what is your superpower?

As I read the latest Executive Summary on Global Maternal Health  from The Lancet’s Series, I (as I am sure all other midwives did) wondered how we could improve the health of women around the world.

Countdown to 2030 Officially Launches

There is indeed a countdown to 2030 to improve reproductive, maternal, newborn, child, and adolescent health and nutrition around the world. #IC2030. I have been working toward the Millennium Development Goals (MDGs) 4 (reduce child mortality) and 5 (improve maternal health) through research and by supporting midwives to be the very best they can be. Yet I am well aware that there is still so much work to be done, and midwives are in the very best position to do it.

@Countdown2030

The current challenges to address:

• Lack of evidence-based guidelines
• Lack of equipment, supplies, and medicines
• Inadequate numbers of skilled providers
• Women delivering alone
• Lack of emergency medical services and delayed interfacility referrals Too much, too soon
• Unnecessary caesarean section
• Routine induced or augmented labour
• Routine continuous electronic fetal monitoring
• Routine episiotomy
• Routine antibiotics postpartum

Women often left out of good quality care:

• Adolescents and unmarried women
• Immigrants
• Refugees and internally displaced women
• Indigenous women and ethnic or religious minorities
• Women living in poverty
• Women living in informal urban settlements
• Women living in fragile states
• Women affected by humanitarian crises

Whilst reading the reports, I saw that a number of global experts had been invited to share, build and deliver new innovations. This is wonderful. However, we as midwives are right at the mouth piece of change. We are there at the beginning of new life. This is a time where the opportunities for change are most prevalent. People are looking to bring new life into a better world, and we are a part of that. How amazing!

And so looking at the challenges listed, what will you tackle or address? Women and their babies trust us, they are ready to be led toward a brighter future…they look up to us..Being able to influence change at the very start of human life is a both a gift and a super power.

Midwives are superheros…what is your superpower?

With Fab Change Day coming up on the 19th October 2016…there has never been a better time to make your pledge for change (however big or small)!

(Please note that although this post is predominantly about midwives, obstetricians and other birth attendants are also a huge part of the superhero team!)

You may think that you are a small fish in a small pond, but I am telling you that there is a global pond where you, as either a small or big fish, can make a real difference!

One charity (close to my heart) is really making a difference to mothers and babies around the world ->> Maternity Worldwide. I often give them a shout out, because they really are awesome (and a fun bunch too!)…#GetInvolved with them here and here -> @maternityww.

I will continue to contribute towards evidence based guidelines and research in my quest to improve the well-being of women, babies and midwives around the world. So until next time, be the superheros I always knew you were 💛💙💜💚.

Reflections from a session in the @empathymuseum at #Expo16NHS #WalkAMileInMyShoes via @HealthFdn

One of the best things I experienced at this years NHS Expo 2016 was the @empathymuseum …where I was invited to #WalkAMileInMyShoes via the @HealthFdn. It was rather strange to be invited into a giant shoe box, but nevertheless… Just like Alice in Wonderland I found myself uttering….’curiouser and curiouser’..

As I wondered in to the cozy shoe box to sit on the sofa, I was asked to put on a pair of shoes.. Theatre shoes…(See below)…

I walked around and listened via headphones to the man who had kindly donated his shoes and his story to this project. He was a specialist nurse working in A & E. He spoke about how he had to face the reality of death at work every day. Not only did he have to do this, he then also had to engage loved ones and relatives in incredibly difficult conversations and help them to make the best decisions in the darkest hours.

This nurse was able to celebrate the incredible gifts people were able to give as organ doners, and see joy in how a family was able to see a part of their departed loved ones go on… All of this was very uplifting…and there was no doubt in my mind that this nurse was indeed a superb example of the profession. However…as I walked on…I found my self wondering whether anyone asked the nurse how he was? How long could he maintain this uplifting approach whilst dealing with death and emotional pain on a daily basis? Would cracks start to appear?

I often see examples of how we celebrate this service and self sacrifice…and to nearly quote Paul Simon… every generation throws healthcare hero up the award charts!.. and so we celebrate this eternal culture of giving. I certainly empathize with this nurse, and greatly admired his approach to his work… He is a hero..but he is also very vulnerable, both psychologically and physically as he continues to give all of himself to provide the best service possible.

My worry is that the more we place service and sacrifice upon a pedestal…the further our heroes have to fall…

 

As you can see from the film above…this really is an amazing and thought provoking project, as those who visit are asked to write messages to those they now share a new found empathy with.

I would have liked to have walked a mile in all of these shoes…and perhaps some day I will have time to…as you can soon also experience this project online here. So as a lasting thought on this amazing project…I would like to repeat my mantra…which is…always be kind to yourselves… and each other….

Until next time 💛💙💜💚❤

Grumpy Midwife has given birth

Such a great and innovative project to support maternity staff in practice! – Had to share 😀

The Founders Network – The Birth of Creating a healthier NHS

The Founders Network was founded in July 2014 on the initiative of Clare Gerada, Lambeth GP, Medical Director NHS Practitioner Health Programme, and Rex Haigh Medical Psychotherapist and Institute of Group Analysis Board Member. I am a proud member of this network and I can see it growing from strength to strength.

The collective network recognizes that there are serious problems with working life in the NHS and these must be urgently addressed if the NHS is to have a secure future. This sentiment provides the basis for my PhD work, and I am extremely grateful to Clare Gerada for advising me on my project as it moves forward. The infamous paper compiled by Clare introduces the succinct notion that “If the NHS were a patient, it would have Depression” and as such, we have much work to do in order to ‘fix’ this.

It became apparent that action was needed. A series of active listening events collectively named as the Creating a healthier NHS project, facilitated by the Founders Network and the Institute of Group Analysis were arranged as a platform to hear NHS staff and explore solutions to remedy the toxic cultures within the health care system. I attended three of these listening events and as a result, have met many inspiring people with illuminating stories to tell!

The most poignant idea that stemmed from these for me personally was this:

(I have added some extra thoughts to this!)

• The NHS is the burnt out and overworked mother of the nation, her internal struggles are endless.
• She is not kind to herself.
• The father of the nation is our government.
• Father may well want a divorce, but the alimony payments would be too high to bare.
• Mother is having to care for more and more children with more complex needs, but with less resources. She is constantly adjusting her purse strings, but someone always loses out.
• The father is frustrated and entertaining a mistress (Privatization) – shes alluring and dangerous, so he keeps quiet about her.
• The children continue to tug at mothers apron strings, demanding more and more.
• There is only so much more mother can take before she breaks. SHE is the one who needs to be cared for.

And that is why I feel passionate about this drive to value NHS staff. They need to be cared for if the patient is to receive quality care. Staff may not be very good at caring for themselves, and therefore it is imperative that we keep this conversation going, take action via the Founders Network and move towards appointing a national lead for NHS staff health and wellbeing. Please consider joining this network if you feel able to.

Here are some of the videos from the listening events if you could not attend, I will share the outcome of these listening events as soon as they become available to me and open to public viewing.

If you have been affected by any of the issues discussed within this post, please visit the support page.

#mybluelight Campaign

Today, Mind Charity published its Blue Light Campaign to provide mental health support for emergency services staff and volunteers from police, fire, ambulance and search and rescue services across England.

One quarter of a million people who work and volunteer in the emergency services are even more at risk of experiencing a mental health problem than the general population, but are less likely to get support.

As usual, they found that it was stigma that was the biggest issue in staff seeking help. Stigma truly is the real killer, and I will be writing a blog on it soon. The campaign will do the following to help our emergency services:

• An anti-stigma campaign, working together with Time to Change, and guidance for employers to improve the way they support their staff
• A bespoke mental health training package for managers as well as frontline staff and volunteers across the emergency services
• A pilot approach to build the mental health resilience of emergency services staff and volunteers
• An information helpline and resources just for emergency service staff and volunteers, and their families.

The support will be available from April 2015 and the Blue Light Programme will run until March 2016. It is being developed in consultation with individuals from across the emergency services.

The Twitter hashtag for this campaign will be #mybluelight

It is so refreshing to see this issue (which as you know I feel super passionate about) being addressed. Although I hope this project will extend to all health workers who may all at some point be exposed to the same psychological traumas. A great perspective on other Blue Light professions is given by The Mental Health Cop who was also part of the advisory board for this campaign.

Although this work is amazing, it also involves empowering staff with resilience, and this concept concerns me. It may suggest that there are some who can cope and others who are weak. It may imply that if you have resilience, then you will not be affected. In other areas of work based psychological distress, you shouldn’t have to be resilient. For instance to bullies, blame and scapegoating cultures, it should just stop. We will always be affected by traumatic incidents, and I know that this anti stigma campaign and valuable resource guidance will improve the mental health and well being of NHS Staff.

Why not ask your NHS Trust to sign the Blue Light Time to Change pledge and develop an action plan. Commit to support better mental health in your workplace – get in touch with Mind and give your name, job title, the service you work for and your contact details.

Email bluelight@mind.org.uk with your name, organisation and contact details and Mind will send you updates on the programme.

If you have been affected by anything discussed within this post please see the support page on this blog.