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PhD opportunity exploring healthcare workers’ experiences & ethical dilemmas faced during the COVID-19 Pandemic through arts-based practice

6,000 nurses and midwives were recently asked why they had left the profession. …The main reason given was too much pressure leading to stress and poor mental health. This was before #COVID__19

It is now clear that we need to move beyond the narrative of heroes and remember that NHS workers are human.

Something needs to change… and that is #WhyWeDoResearch

🎓…. have you always dreamed about doing your PhD? We have an exciting PAID studentship opportunity for you!

Start your exciting ​#PhD journey with myself & Professor Louise Moody 🎓

“Exploring healthcare workers’ experiences & ethical dilemmas faced during the COVID-19 Pandemic through arts-based practice”

group of doctors walking on hospital hallway

Coventry University (CU) is inviting applications from suitably-qualified graduates for a fully-funded PhD studentship within the multi-disciplinary ‘Well-being and the Arts’ theme within the Centre for Arts, Memory and Communities.

The British Medical Association and Health Foundation have drawn attention to the impact the COVID19 pandemic is, and will continue to have in a variety of ways on NHS staff. The specific focus of this PhD research will be the difficult, ethical decisions healthcare workers have had to make when managing patients during the pandemic. Some examples of this include who to prioritise for treatment, whether to treat if PPE is unavailable, whether to return to NHS roles for those who have left the profession, and the need to separate patients from loved ones.

The project will explore the challenges and emotional impacts experienced by health care workers in relation to ethical decision making. The successful candidate will respond to these experiences through arts-practise as well as developing evidence-based recommendations for the support needs of staff.

The project is anticipated to involve the following activities:
– A scoping review of the literature
– Qualitative research to explore ethical dilemmas and the associated emotional impact using social media
– Arts-based practice to represent and communicate healthcare worker experiences
– Formation of recommendations regarding the support needs of healthcare workers

Training and Development

The successful candidate will receive comprehensive research training including technical, personal and professional skills.

All researchers at Coventry University (from PhD to Professor) are part of the Doctoral College and Centre for Research Capability and Development, which provides support with high-quality training and career development activities.

man in white dress shirt wearing blue face mask

Entry criteria for applicants to PHD

• A minimum of a 2:1 first degree in a relevant discipline/subject area with a minimum 60% mark in the project element or equivalent with a minimum 60% overall module average.
PLUS
the potential to engage in innovative research and to complete the PhD within a 3.5 years
• a minimum of English language proficiency (IELTS overall minimum score of 7.0 with a minimum of 6.5 in each component)

For more information and to apply, CLICK HERE

white Explore flag

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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1 in 20 pregnancies affected by hypermobile #EhlersDanlosSyndrome & Hypermobility Spectrum Disorders

If you’re interested in childbearing with hypermobile #EhlersDanlos syndrome and Hypermobility Spectrum Disorders our new article is out now…

👉 Understanding hypermobile Ehlers-Danlos syndrome and Hypermobility Spectrum Disorders in the context of childbearing: An international qualitative study

Co-authors include Gemma Pearce & Emma Reinhold 🙌🏻

🎓💓

Hypermobile #EhlersDanlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD) have profound and life-threatening consequences in childbearing, and it is now estimated that hEDS/HSD affect 6 million (4.6%) pregnancies globally per year..rounded up, this equates to almost 1 in 20 pregnancies!

 

grayscale photo of woman wearing ring

What did participants describe?

  • A worsening of symptoms during pregnancy
  • Postnatal complications
  • Ineffective anaesthesia
  • Long latent phases of labour quickly developing into rapidly progressing active labours and births (precipitate labour/precipitate birth)
  • Maternity staff panicked by unexpected outcomes
  • Healthcare professionals  lacking  knowledge and understanding
  • Poor maternity care resulting in a disengagement from services
  • Birth Trauma
  • Stress
  • Anxiety
  • An avoidance of future childbearing
  • Difficulties in holding, caring for, bonding with and breastfeeding their babies

Image may contain: text that says "Understanding hypermobile Ehlers-Danlos syndrome and Hypermobility Spectrum Disorders in the context of childbearing: An international qualitative study"

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The blog page for this work can be accessed here

How can you help?

  • maternity tool has been co-create to support both professionals and pregnant people in decision making. It is freely available for download and wider use

download maternity tool

hEDSTogether.com is also available to keep everyone up to date with this work via @hEDStogether

If you are using this tool to create an impact in the world, please tell us about it via the contact pages hosted at hEDSTogether.com.

Thanks to everyone who participated in and supported this research!…Let’s keep putting our #hEDSTogether via research!

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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Exploring the narratives and experiences of Healthcare staff working through the COVID-19 Pandemic – Could you contribute?

“Don’t clap for me” “The health service is not staffed by heroes” and “’We are fragile, tearful, afraid, and we are human” are recent accounts voiced by healthcare workers, working through the COVID-19 pandemic (Anonymous 2020; Watson 2020).

clapping

In contrast to the common portrayal as invincible “heroes” or “saints”, it is increasingly recognised that healthcare workers (HCWs) working through the COVID-19 pandemic may be experiencing negative emotions and moral distress related to certain situations (Williamson et al. 2020). These situations may include: Being redeployed, witnessing the suffering of patients or colleagues, ethical decisions related to care, delivering bad news or making the decision to distance oneself from family or children. The wellbeing of HCWs, as well as having an impact on individuals and families, is intrinsically linked to the quality and safety of healthcare services so there is a pressing need to understand more, including how we can help (Pezaro et al. 2015; The Royal College of Physicians, 2015).

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We know that even the smallest demonstrations of compassion can make a difference to individual HCWs: Small acts of kindness, caring language or the opportunity to be listened to for example (Clyne et al. 2018).  Williamson et al. (2020) state the importance of informal support and opportunities for discussion of events that may have caused moral distress to allow HCWs to process and make sense of events.

We are commencing a research study to explore the real narratives and experiences of HCWs working through the COVID-19 Pandemic, as well as where HCWs have experienced self and workplace compassion, using an arts-based research approach which includes creative writing, storytelling & theatre. Participants will contribute to the script for a piece of audio art-work that will creatively depict the emotions and experiences of healthcare professionals contrasted against the social celebration of them as ‘heroes’ during this Covid-19 pandemic. The recording aims to both give a truthful account of the HCW narrative during this crisis, whilst also being relatable, hopeful and human. It is hoped that it will be a point of stimuli for discussion for the general public and inform the development of additional resources to help HCWs debrief and recover.

Aspects of the arts-based research process itself, such as the opportunity to make sense of experiences through creativity, reflection and commonality with other participants, have been noted as “transformative” (Beltran and Begun 2014). Lennette et al. (2019) describe this type of research as an ongoing reflective process, in which the researcher and participants collaborate to expand the meaning of each individuals’ story and find links and common themes with those of other participants.

We are recruiting a small group of 4-6 healthcare workers to explore their experiences and narratives of COVID-19, within a 1-hour online workshop, taking place at the end of June. The group of HCWs will discuss their experiences and work with a writer, Nick Walker and theatre professionals from China Plate Theatre Company to create a piece of creative writing and a script for the audio artwork, which will be exhibited at a digital exhibition for Coventry City of Culture 2021. If you wish to take part, your information will be kept anonymous & confidential. You are under no obligation to take part.

China Plate are independent contemporary theatre producers of adventurous and imaginative new work with popular appeal and a social purpose. Their mission is to challenge the way performance is made, who it’s made by and who gets to experience it. Lead artist, Nick Walker is a Coventry-based writer, producer, and director. He was co-founder of theatre company, Talking Birds whose work has been presented across the UK, Europe, and the USA. He has worked with some of the country’s leading new work theatre companies including Stan’s Cafe, Insomniac, Action Hero and Theatre Absolute. His plays and short stories are regularly featured on BBC Radio 4, including 3 series of The First King of Mars (starring Peter Capaldi), and 6 series of Annika Stranded with Nicola Walker. He has a great deal of experience in writing plays and stories that are based on conversations/workshops with people around their real-life experiences, for example, exploring stories of male suicide with Coventry Men’s Shed. His writing has successfully fictionalised these experiences and made them relevant to a wider audience without losing their essence and truthfulness.

Date/time for workshop confirmed as: Wednesday 17th June 19:30

To request a Participant Information Sheet please email Kerry Wykes: ad3078@coventry.ac.uk.

HumansNotHeroes Flyer

References

Anonymous (2020) I’m an NHS Doctor and I’ve had enough of people clapping for me. The Guardian. [Online] https://www.theguardian.com/society/2020/may/21/nhs-doctor-enough-people-clapping

Beltran, R., & Begun, S. (2014). “It is medicine”: Narratives of healing from the Aotearoa Digital Storytelling as Indigenous Media Project (ADSIMP). Psychology and Developing Societies, 26, 155-179.

Clyne, W., Pezaro, S., Deeny, K., & Kneafsey, R. (2018). Using social media to generate and collect primary data: The #ShowsWorkplaceCompassion twitter research campaign. JMIR Public Health and Surveillance, 4(2), e41.

Pezaro, S., Clyne, W., Turner, A., Fulton, E. A., & Gerada, C. (2015). ‘Midwives overboard!’ inside their hearts are breaking, their makeup may be flaking but their smile still stays on. Women and Birth: Journal of the Australian College of Midwives, 29(3), 59-66

The Royal College of Physicians. (2015). Work and wellbeing in the NHS: Why staff health matters to patient care.

Lenette C, Brough M, Schweitzer R et al. (2019) ‘Better than a pill’: digital storytelling as a narrative process for refugee women, Media Practice and Education, 20:1, 67-86, DOI: 10.1080/25741136.2018.1464740

Williamson, V., Murphy, D., Greenberg, N (2020) COVID-19 and experiences of moral injury in front-line key workers, Occupational Medicine,  kqaa052, https://doi.org/10.1093/occmed/kqaa052

Further reading…

Watson, C (2020) Nurses are no heroes – they’re just finally beginning to be recognised as they should. The Telegraph.

https://www.telegraph.co.uk/health-fitness/body/nurses-no-heroes-just-finally-beginning-recognised-should/

http://talkingbirds.co.uk/pages/sitespecific.asp

http://saveourstories.co.uk/

 

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New Educational Tools Launched to Support Childbearing with Hypermobile Ehlers Danlos Syndrome and Hypermobility Spectrum Disorders

Lactation Conference

On the 5th of May (International Day of the Midwife – #IDM2020) 2020 – The year of the nurse and the midwife, the @hEDStogether team launched new educational tools to support childbearing with hypermobile Ehlers Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD). Co-incidentally, May is also Ehlers Danlos Syndromes and Hypermobility Spectrum Disorders awareness month. You can view the online launch of these tools along with our other @GOLDMidwifery presentations here at the GOLD Online Education Midwifery Conference 2019/2020.

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Citation: Pezaro, S., Pearce, G., & Magee, P. (2020). New Educational Tools to Support Childbearing With hypermobile Ehlers-Danlos syndrome and Hypermobility Spectrum Disorders. GOLD Online Midwifery Conference. May 5th.https://www.goldlearning.com/ce-library/all-lectures/new-educational-tools-detail

The final tools comprised:

  • An i-learn module launched by the Royal College of Midwives to their members (search under the letter ‘H’ for hypermobility in the online library)
  • maternity tool freely available for download and wider use
  • An infomercial to raise awareness and mobilise knowledge in relation childbearing with hEDS/HSD

download maternity tool

We were also able to launch our own website – hEDSTogether.com and keep everyone up to date with the project via @hEDStogether

We have made these tools freely available where possible. You can visit the project page to learn moreIf you are using them to create an impact in the world, please tell us about it via the contact pages hosted at hEDSTogether.com.

Useful hashtags to follow on this topic include:

#EDSmaternity

 #hEDStogether 

#EhlersDanlosSyndrome

#myEDSchallenge

#myHSDchallenge

#EDSAwarenessMonth

#raisingawarenesstogether

Thanks to everyone who joined us for the launch and co-created these tools in partnership with us!…Let’s keep putting our #hEDSTogether via research!

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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THE CIRCLE OF TRAUMA FOR PARENTS & PROFESSIONALS #ThinkTraumaNow

Today, ‘Make Birth Better’ (@birthbetter) published it’s new report outlining the circle of Trauma for both parents and professionals. I am immensely proud to have contributed to this report and to work with other esteemed colleagues looking to make a difference in this context.

THE MAKE BIRTH
BETTER SURVEY 2019:
THE CIRCLE OF
TRAUMA FOR
PARENTS AND
PROFESSIONALS

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The full report can be found here

#ThinkTraumaNow 

It really is so important that we recognise the trauma birth workers can experience as a result of their work. Many midwifery and obstetric staff are affected by vicarious trauma because of the events they have seen, the conditions they are working in and a lack of emotional support. This is significant because as well as birth workers being entitled to a psychologically safe professional journey, such psychological distress can also result in poorer maternity care.

As a result of this report, the following calls to action have been made:

1. Address trauma prevention for maternity staff and parents.

2. Think long-term about trauma treatment for maternity staff and parents in the future.

3. Act on the requests from Birthrights and The Royal College of Midwives (RCM) for maternity services to be ringfenced and for all women to be offered a safe and positive childbirth experience and ensure that new NHS England clinical guidance is followed

#thinktraumanow.png

Click here to read more about this work and the #ThinkTraumaNow campaign

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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EXPLORING PROBLEMATIC SUBSTANCE USE AMONG REGISTERED MIDWIVES – SURVEY

Due to #Coronavirus #COVID19 and this additional pressures this has placed on NHS staff, we have now closed this survey (earlier than planned). Thank you to all of those who responded. We hope to publish results as soon as we can.

recruitment poster PSU survey

There is a united level of concern for the health and wellbeing of midwives in the United Kingdom (UK), where recent research has shown that many experience work-related stress and burnout. Such experiences may lead to midwives being at particular risk of substance use/misuse. In fact, in a recent review of fitness to practise (FtP) cases, a number of those put before the Nursing and Midwifery Council (NMC) related to alcohol (n=208) and drug misuse (n=131).

Such episodes of addiction, alcohol and drug use are classed as individual health concerns. Yet, whilst they can leave a variety of healthcare professionals depleted, and both workplace safety and the safety of care compromised, relevant literature has thus far been largely dominated by the experiences and care of physicians. Consequently, researchers from Coventry University are now conducting the first nationwide study of registered midwives in relation to this issue.

Project Team:

The aims of this study are:

  • To investigate substance use among midwives registered in the UK
  • To explore the perceptions of midwives registered in the UK in relation to midwifery impairment
  • To explore perceptions of midwives registered in the UK in relation to organisational support
  • To identify incidents of midwifery impairment
  • To explore the help seeking behaviours of midwives registered in the UK with problematic substance use (PSU)
  • To identify health risks among midwives registered in the UK with PSU

We are very grateful to the Royal College of Midwives for supporting recruitment to this study.

 

For further information, or if you have any queries, please contact me, the lead researcher, Dr Sally Pezaro (sally.pezaro@coventry.ac.uk).

Twitter handle: @SallyPezaro

We are also very grateful to UNISON for sharing this survey with their members

@unisontweets

If you would like to follow the progress of work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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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:

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

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The History of the Midwife

 

The following post is a guest blog by Nicole Allen:

woman carrying newborn baby

We all know the process of childbirth, but it’s no less magical. Advances in science make the procedure very safe for both the baby and the mother in most countries. It’s routine for most hospitals, except in rare cases when the patient experiences complications. But this wasn’t always the case.

There are countless faces of midwives whose knowledge was passed on from generation to generation. Even today, there are would-be mothers in some parts of the world with no access to doctors who rely on midwives to deliver their babies.

“Midwife”, the common term used for a birthing assistant, comes from Middle English and literally means “with a woman”. In France, they call her (or him; there are male midwives) a “sage-femme” or “wise woman.” The profession predates the medical and nursing professions.

The Prehistoric Way of Giving Birth

Our many-time great-grandmothers birthed their babies with the help of midwives dating back at least as far as biblical times and probably before recorded history. The earliest evidence of the existence of midwifery can be traced back to an ancient Egyptian papyrus (1550 BC). This shows that midwives assisted women in child delivery for more than 2,000 years without assistance from trained professionals.

pregnant woman holding petaled flowers

The American Way of Giving Birth

In the early American colonies, children were birthed with the help of skilled and practised midwives who came from Britain, who in turn transferred these same skills to other women in an informal manner. Later, when West African midwives reached the shores of America to be used as slaves, they assisted in birth too.

After their emancipation, African-American midwives offered their care to poor women,  in the rural parts of the South and were called “granny midwives.”

The American Indian tribes women continued to practice their own cultural birthing tradition, too, which sometimes included a midwife, female friend or relative.

The family experience of home birth narrated by Dervla Murphy in the book Untangling the Maternity Crisis supported the fact that most childbirth during the early 1900s was done at home. She was delivered at home in 1931.

Childbirth then was a regular occurrence at home and did not stimulate anxiety. Midwives were a familiar neighborhood figure who carried a big black bag during the birth of a neighbor.

person touching person's belly

The Medical Way of Giving Birth

In the last half of the 1800s, when medicine was professionalized in the US, midwifery became threatened as laws requiring formal education were slowly extended to midwives. Even though there were few midwifery schools, midwives were still needed and could not be totally eradicated since some doctors were unwilling to cater to poor populations. Some midwives continued to practice until the 1920s without government control.

It was in the 1910s and ’20s, the doctors started to lay down the foundation of a pathology-oriented childbirth medical model and usurp the traditional roles of midwives.

First, two studies found that the training most obstetricians received was poor and that hospitalization during birth would improve it. The poor, who most needed midwives, could go to charity hospitals instead. This would give the doctors more practice as well.

Then, in 1914, “twilight sleep”—delivery where the woman is anesthetized with a combination of morphine and scopolamine—was introduced. It was intended to relieve the pain and remove the memory of giving birth. This was widely accepted and desired by upper-class women.

About this time, a Dr. Joseph DeLee described childbirth as a destructive pathological process that damages the mother and the baby, and the only way to minimize this was through medically attended childbirth.

This claim made it impossible for midwives to facilitate child birth and made the use of ether, sedatives, forceps, and episiotomies routine. Child birth went from a physiological process to one in which the course of labor must be tightly controlled.

The value of midwives is being relearned, but there are new concerns.

Help for trauma

In more recent years, an aspect of the midwifery profession that is being looked into is the difficulties the midwives themselves experience during delivery. For instance, if s/he attends a traumatic birth, oftentimes s/he alone is there to handle it.

A 2015  study on the emotional and traumatic work of midwives and the commonly adversarial relationship with obstetricians (aptly titled “Midwives Overboard!”) shows that midwives may end up developing psychological and behavioral symptoms of distress, including compassion fatigue, post-traumatic stress disorder (PTSD), and secondary traumatic stress.

The United Nations Population Fund (UNFPA)’s increasing interest in the role of midwives underscores their importance in delivering children. Midwives play an important role in the achievement of its millennium development goals: reducing child mortality and eradicating maternal death. Midwives are a key element in the delivery of sexual, reproductive, maternal and newborn health (SRMNH) care worldwide, especially in rural areas.

To improve the delivery of patient care as well as the staff experience, maternity services must invest in the mental health and the well-being of all midwives, including nurse-midwives and obstetric nurses.

blue and black USB cable

Also check out this article: Oh baby: seven things you probably didn’t know about midwives

Author Bio:
Nicole is a freelance writer and educator based in the Michigan and believes that her writing is an extension of her career as a tutor. She covers many topics like travel, mental health and education. She is a key contributor at Chapters Capistrano where she covers topics like addiction recovery, holistic treatments and health education. When she isn’t writing, you might find Nicole running, hiking, and swimming. She has participated in several 10K races and hopes to compete in a marathon one day.