1

Mindfulness and Self-Care in Midwifery

As my main research interests are firmly rooted within supporting a positive staff experience for healthcare workers, especially midwives in work-related psychological distress, I am always looking for new opportunities to share knowledge with others in this area. …The Global Alliance for Nursing and Midwifery (GANM) is a joint project sponsored by the Pan American Health Organization (PAHO) and the World Health Organization (WHO) Collaborating Center for Nursing Knowledge, Information Management & Sharing at the Johns Hopkins School of Nursing. This blog post provides an overview of a webinar session hosted by GANM entitled “Mindfulness and Self-Care in Midwifery:  Review of Current Evidence and Guided Mindfulness Practice.

For a preliminary introduction to this topic – check out an earlier blog post on this topic entitled “Midwife Burnout: A Brief Summary“.

downtimes

Erin Wright, DNP, CNM, APRN-BC, led the conversation…Participants were diverse, and originated from Canada, Peru, US (Baltimore, Urbana, Birmingham, Atlanta, Buffalo), Ireland, UK (Coventry University and School of Healthcare Sciences Cardiff), Brazil, Montserrat, and Trinidad.

The full webinar can be accessed here.

Much of the research covered, has also been captured within my earlier narrative review: Pezaro, Sally, et al. “‘Midwives Overboard!’Inside their hearts are breaking, their makeup may be flaking but their smile still stays on.” Women and Birth 29.3 (2016): e59-e66.

However, there were some new and interesting comparisons made with more recent research here…

“Four common themes have been identified that traverse the different models of care. The NZ study provides insight into how case load midwifery can be sustainable enabling long term sustainability. The UK study highlights healthy resilient practices that enable practice. What remains uncertain is how models of care enable or disable sustainable long term practice and nurture healthy resilient behaviours within the different models of care”.

comparisons

“The notion of resilience in midwifery as the panacea to resolve current concerns may need rethinking as the notion may be interpreted as expecting midwives ‘to toughen up’ in a working setting that is socially, economically and culturally challenging.”

Sources (Crowther, Susan, et al. “Sustainability and resilience in midwifery: A discussion paper.” Midwifery 40 (2016): 40-48.)

So we are now much enlightened as to how and why midwives are experiencing distress, we also have some insights into how they try to cope (or not)…and where this distress may affect maternity services…but what we are yet to learn, is what may be most effective in supporting midwives in work-related psychological distress…although a few clues are emerging….

Mindfulness is coming forward as a potential tool of support..stress management, education and clinical supervision may also be of benefit to midwives in distress…But how, why and how much is not yet clear.

After exploring the literature in relation to psychological distress in midwifery populations, we were all invited to join in some mindfulness practice..What is mindfulness?

Image result for mindfulness

 

Feeling overwhelmed?…TRY….R.A.I.N

RRecognize What’s Going On

AAllowing: Taking a Life-Giving Pause

I—Investigating with Kindness

NNatural Loving Awareness

Source: Mindful.org

relation-ships

Recommended further reading

Youtube presenters:

  • Jon Kabat Zinn
  • Elisha Goldstein
  • Tara Brach
  • Sharon Salzberg

Websites/Audio Links:

Books: 

  • A Mindfulness Based Stress Reduction Workbook (Goldstein and Stahl)
  • Everyday Catastrophe Living (Jon Kabat Zinn)
  • Wherever you go there you are (Jon Kabat Zinn)
  • Mindfulness for Beginners (Jon Kabat Zinn)
  • Real Happiness (Sharon Salzberg)
  • The Mindful Nurse (Carmel Sheridan)

For more mindfulness exercises, visit the UCLA Mindfulness Awareness Research Center.

book-mark

Thanks for a very insightful and informative session!

Until next time…Look after yourselves & each other 🦄💫🎓

Advertisements
1

10 Tips for Success & Self-Care for Academics

cozy-dog

Another guilt trip about the importance of self care and being successful? That is why many people will read blog posts like this. We know we should be practising self care and succeeding, but do we really know how to thrive?

(I could not find a concept analysis for either success or self care – please let me know if you do)

We must presume that both success and self-care mean something different to each and every one of us. I am no expert on these topics…. is anyone?…But I think I am pretty good at caring for myself now and working towards success…having learnt the hard way. So I thought I would share some of my hints and tips. Feel free to adapt them, use them, completely ignore them, or ridicule them as ‘poppycock’.

Most people will expect to hear things like:

  • Take a bubble bath
  • Watch your favorite film
  • Curl up with a good book
  • Work hard
  • Network

But I am sure that you know about this kind of stuff already. So let’s look at self care and success for the academic, firstly by identifying the issues that some of us may face.

As an early career researcher, I am frequently told about the stereotyping and inequalities experienced by women in academia. I myself frequently worry about the insecurity of, and problems associated with being an early career researcher, especially a female one.…I worry about where I will find my next job, funding or co-author. I worry about whether I am making any impact at all and whether I will be able to reach my true potential as an academic in the current climate. Academic pressures are in no way restricted to those earlier in their career, many more established researchers are also feeling the strain. These experiences will undoubtedly result in some psychological distress for many academics. So what can we do both proactively and preventatively to improve the lives of ourselves and each other.

Research can seem like a lot of hard work for little reward.

Tip One: Keep your eye on the goal. Visualize yourself being happy, frequently. How would it feel to publish that paper? Get that fellowship? Collaborate on that project? Create your own self-fulfilling prophecy rather than focus on a possible spiral of doom.

How to do this? – Identify what makes you happy, or what will make you happy. Then do more of what makes you happy, or have a real go at getting what will make you happy. I personally love my research work. I know that many other academics feel the same way. Happiness to me is succeeding, making a difference  and making a real impact through my work. The stress I feel is associated with this not happening.

This stress and negative thinking serves no purpose unless it positively drives me towards my goal. Yet who wants to be whipped to the goal posts?  I use visualization as a driver for success. I see myself feeling and being the way I want to be…and I allow myself to believe that this vision will come true. This makes me much happier than thinking about the alternative. So I stick with it.

The practice of meditation may also assist you to work through your thoughts, direct them towards a more positive outlook and allow your goals to become meaningful and achievable.

As these tips continue, think about your own goals for happiness…whatever they may be…think about achieving them in relation to these tips and your own experiences.

I behave in the way I want to feel or be… Surely if I continue in this direction. Good things will come…

Tip Two: The problem of job insecurity for early career academics baffles me as Job security for early career researchers is a significant factor in helping research make an impact. Yet this seems to play on my mind recurrently. It is always a worry. However, worry really does nothing to resolve this issue, and only seeks to get in the way of my progress. In order to progress, I will need to ‘work smarter’ and embrace confidence in my own abilities. Worry and negative thinking has no place in this strategy.

Negative thoughts often lie, and so I swipe them away one by one by placing them on a train that is passing the station (Visualization) – I then sit for a little longer, and imagine the way I will feel and be once I reach my goals. My mood and stress instantly lifts once I do this. I am more confident and feel much stronger. I am ready to be happy.

 

Tip 3: Say No and be proactive – We need to look at what successful academics do. From my observations, they often say ‘No’ to anything that doesn’t suit their own focused agenda (they remove the ‘noise’ and toxicity), they ooze positivity, they are confident, they are assertive, they tell people what they need to succeed and they hang around with the most inspiring people. Therefore, the most obvious strategy is for us to do the same. Say ‘No’ to negativity, and to the people and things which do not enrich us as people. Let people know what you need in order to thrive. Embrace those you feel drawn towards as positive people.

Activity: Making the best of me…

1: Ask yourself how others can get the best out of you

2: Offer what you can realistically do

3: Communicate what inhibits your productivity with others

4: Actively describe what you need from others in order to thrive

Getting the best of me

Tip 4: Express gratitude and forgiveness for enhanced wellbeing. Not always easy, but worth investing in. This task not only unburdens your mind, but allows you to see all of the good things currently going on in your life. Regularly write down 5 things that you are grateful for. Also…try to forgive yourself, and others…often.

 

Tip 5: Address your work life balance as a fluid entity. I believe that the idea of a separate home and work life is changing. This is a good thing. It takes the pressure off and allows you to be a whole person, rather than one split in two…See yourself as a whole being, a working, living and family centred being. You cannot slice yourself into pieces.

See this blog -> ‘Work’ is a verb rather than a noun…it is something we do…not always somewhere we go…

Living in the ‘now’ rather than being at either home or work also allows us to enjoy more of ourselves and our lives. Notice where you are, what you are doing…Smell the flowers, look around you as you move, work, play and just allow yourself to ‘be’.

smell-the-flowers

Tip 6: Eat Sleep move, repeat. It really is that simple, but utterly essential for optimum productivity, stress reduction, health and wellbeing. Eat nutritious food regularly, sleep 7-8 hours a night and move…Exercise, walk, swim, run, cycle…Be outdoors as often as possible.

float

Tip 7: Write. Write your thoughts, your feelings, your ‘to do’ lists, your ideas, your goals down regularly. This not only means that they are out of your head, allowing your mind to be quieter, they are also made real…They are good to share..and worth addressing (when you feel able).

Tip 8: Talk about who you are. There is a tendency to talk about work first. What we do, what we are working on and what we are planning to work on. Start new conversations with how you enjoy your hobbies or your favourite music. This lets other people know that you are indeed human, and it also gives you an identity other than your work persona. Be authentic. It is healthy for you, and others to know the real and whole you. You are fab 🙂

Tip 9: Help other people and accept help yourself. Lift one another up, support colleagues, show gratitude, offer support and guidance where you can. Be a mentor. Be a positive role model. Be the change you want to see in the workplace and accept all of this in return. This will not only make you feel good, it will change the culture of your workplace, and bring about reciprocity for everyone’s success.

LiftEachotherUp_libbyvanderploeg

(Image via http://www.libbyvanderploeg.com/#/lifteachotherup/)

Tip 10: Celebrate the successes of yourself and others. Yes. Focus on the great things that you and your colleagues have achieved. However big or small, these feelings of success will snowball into a self fulfilling prophecy, where you feel valued, supported and part of a team that cares. Some people will feel uncomfortable about doing this, and feel icky when they see others wallow in their own brilliance. But what is the alternative? We all talk about how rubbish we all are? How will that make us feel?…

Spend time reflecting on what you have achieved. Write them down…use these achievements to inform your own vision of yourself…This is who you are. You are great.

As long as the feelings of celebration and success are reciprocated and directed towards others as well as yourself….Let the high fives roll.

Image result for the highest of fives gif

I do hope that these tips will resonate with some academics looking for something new to try. In the spirit of sharing, please feel free to add more tips below.

You deserve to be happy – Until next time, look after yourselves and each other ❤💙💜

 

4

20 Ways to Create a Thriving #NHS workforce: #Leadership Lessons from @BSC_CCG

One head of Midwifery and one clinical matron have come to me this week asking for hints and tips about how they can support their staff (Great!) – They reported high sickness rates, clinical errors, high staff turnovers and stressed out staff. I am, as always, sorry to hear this. So I thought I would put together 20 hints and tips which have been proven to reduce mistakes, reduce complaints, reduce sickness and absence rates, improve retention rates, increase innovation and enthusiasm and create positive working cultures where staff are happy to be at work.

I have been on my travels again this week, one leader I met with in particular inspired me to learn more about how every NHS organisation can drive improvement through leading with compassion and actively supporting their staff in the workplace.

Cherry Dale is currently working within Birmingham South Central CCG (@BSC_CCG)….and her journey towards promoting healthy working cultures and staff well being is truly inspirational . I believe that her example now shines as an exemplar model for us all to follow. She doesn’t just talk the talk either…Her sickness rates are currently down to 0.2% in comparison with 4.44% average within the NHS, her staff engagement is high, recruitment and retention rates are high and the way her organisation can now innovate is amazing.

Hierarchy of needs - employee engagement

As I listened to Cherry’s words of wisdom, trying to take it all in…She pointed me to her latest published paper and her transformation journey -> How to get apples, not cactuses: an organisation fit for purposeMeeting the well being needs of staff and community. By Cherry Dale.

Cherry had a dream to create a “Very different sort of service”…Knowing that performance and well-being were “inextricably” linked, she looked to prioritise mental well being, and was keen to make sure that the needs and resources of staff as well as those using the healthcare services were “at the heart” of the way her organisation worked.

How can we all ensure that this comes to fruition? 20 Hints & Tips:

  1. Ensure that decision making is shared between all operational staff so that everyone is empowered to “Lead and act upon good ideas”
  2. Adopt the management style, promoted by the concept of the “Sunao Mind” (Untrapped, calm and highly adaptable)!
  3. Ensure that there are “No Dark Corners” – Share all knowledge and cascade it throughout, right from the top….This actively promotes ‘no blame cultures’.
  4. Embrace “Stand up meetings” Where staff are encouraged to share what went well, be down to earth and collaboratively share everything openly (30 mins in length).
  5. Imagine your organisation as a “Jigsaw” in which everyone holds a vital piece of the puzzle – encourage them to nurture this and take responsibility for it.
  6. Ensure there are no “Departments”, instead refer to “Natural working areas” so that boundaries are no longer in force and silo working becomes thing of the past.
  7. Ask “Who has the capacity?” to perform a task and “Who needs help?” – staff may be reluctant at first to share when they are at capacity, but in time the culture can metamorphosise into a supportive and emotionally intelligent culture, where staff are given extra support by colleagues whilst they are stretched to capacity.
  8. Ensure that staff realise that this is how you want and expect them to behave…You set the tone in communicating “This is how we do things here!”
  9. Erase the concept of ‘Grades’ or ‘bandings’ – If someone has the talent, motivation and capabilities to do the task…They can and should be empowered to do it! (Follow this with active talent management)
  10. See leaders as coaches and invest in training… for effective communication, ask coaching questions and avoid simply ‘directing’ people.
  11. Ban internal emails! – (A scary thought!) – This promotes conversations, movement and positive staff relationships.
  12. Promote open office spaces where senior staff are situated in the centre to promote open collaborations and discussion.
  13. Listen with interest and encourage staff to speak openly about concerns.
  14. Develop a ‘Human resources working group’ with members from each of your natural working areas to develop guidelines, policies and strategies with those at the top.
  15. Recognise and celebrate achievements, new ideas and acts of kindness.
  16. When staff are not quite themselves..Snappy…Tearful etc… encourage yourself and others to notice and check it out..”Is there anything you would like to talk about?…Feel free to come over and offload”
  17. Consider training all staff in the ‘Human Givens approach’…from this develop a staff wellbeing strategy, wellbeing days and events.
  18. Movable office furniture and bright colours inspire innovation.
  19. Link with the community and #GetInvolved with local fundraisers, initiatives and activities.
  20. Take this leap, make these changes and believe in them. Ripples will occur, people will notice…and your #NHS organisation can reap the same rewards.

As some of you will know… I have strong feelings about the term ‘Resilience’…But I do like this model below:

Resilience

 

Things to ask your team on a regular basis…

Have you laughed today at work?

Do you have someone you feel you can confide in at work?

Do you feel able to contribute to decision making?

Do you know what is really happening in your organisation?

Do you feel able to influence the direction of travel?

(Discuss your findings and create an action plan in response to results…Monitor progress!)

Spheres of control

“Don’t expect apples when you have sown the seeds of a cactus!”

 

Activity: Making the best of me…

1: Ask yourself how others can get the best out of you

2: Offer what you can realistically do

3: Communicate what inhibits your productivity with others

4: Actively describe what you need from others in order to thrive

 

Getting the best of me

A Sunao Mind: Having a sunao (untrapped or open) mind means being tolerant without selfishness, being open to the teachings of others, and being able to find joy in any circumstances. It also means being quiet yet dynamic, dynamic yet quiet. It is a state of mind that leads to the truth.

I hope we can all learn and embrace these lessons within our everyday lives. We know that the mental well being of #NHS staff directly correlates with the quality and safety of patient care…So let’s all create cultures in which we can thrive!

We are all leaders…so let’s all lead the way and leave our foot prints in the sand for those who wish to follow….

Until next time ❤

3

Guest Blog:Depressed and stressed NHS mental health staff

The following blog post has been written and kindly donated by:

Sarah-Jayne – @OrdinaryMadBlog

Depressed and stressed NHS

mental health staff

————————————————————————–

A charter has been set up to address the startling levels of depression and stress in NHS talking therapies staff.

Depressed and stressed NHS mental health staff

A report by the British Psychological Society (BPS) shows that burnout, low morale and mental illness has increased over the last few years within in a workforce that is trying to treat similar difficulties in the general public.

The report asked staff to comment about their working lives, 90% of these comments were negative:

“•           “IAPT [Improving Access to Psychological Therapies] is a politically-driven monster which does not cater for staff feedback/input in any way. All we are told is TARGETS!!! And work harder.”

  • “Being target driven is the bane of our lives.”
  • “I am so disappointed I have just resigned.””

Following this report a charter was launched with the aim to support the mental health of mental health professionals.

Several MPs and government ministers have commented on the charter, highlighting the positive impact it will have, including the Cabinet Minister for Mental Health, Luciana Berger MP:

It is unacceptable that the dedicated psychological professionals, who provide vital support to those in need, are themselves increasingly suffering from stress and other mental health conditions. The Charter will play an important role in helping employers promote and improve the wellbeing of their staff.”

Norman Lamb made a link between the mental health of staff and its impact on Parity of Esteem or equality within the NHS for mental health services:

 “Quite apart from the clear moral argument for taking staff wellbeing seriously, we cannot hope to achieve equality for mental health unless the psychological workforce is properly supported.”

A new target will soon be set for the amount of people accessing psychological support to increase from 15% of the population to 25%, these people should then be seen within 6 weeks. Without a huge increase in funding and resources this target is unmanageable, the pressure on NHS staff will increase further.

It is clear from this report and from conversations happening in the front line that this problem is significant and doesn’t appear to be improving, which begs the question: what is being done about it?

Psychological Wellbeing Practitioners make up a large part of the work force, last week they had their annual conference. Disappointingly there was no mention of the charter or a recognition of the pressure and strain being experienced. Instead the focus was on getting people off benefits and back into work, which only served to lower the morale of an already burnt out group of bright young professionals, who care about the people they are trying to support.

Professor Jamie Hacker Hughes president of the British Psychological Society wrote in the BPS magazine about how the charter can be used to help the situation:

“The Charter actually provides a new opportunity for people working in psychological therapy services to raise the issue of the stress involved in this sort of work, the consequence of this work and the effects on work life balance, simply by referring to it in meetings and promoting it in the bottom-up way to their organisations.”

While it is understandable to feel beaten down by the situation, we do all have a responsibility to raise this as an issue in as many levels of front line staff and management as possible. Without having conversations about this issue change is unlikely to happen. Just saying “I’ve just read this charter about our organisation, what do you think we could do to help ourselves and our colleagues?” is a way to take a small step towards tackling this issue.

Sarah-Jayne – @OrdinaryMadBlog

————————————————————————–

I would personally like to thank Sarah-Jayne – @OrdinaryMadBlog for this stimulating and important contribution to my blog. Let us all continue to share and learn from one another as we all look to improve the staff experience in healthcare for a healthier and safer service for all.

Until next time, take care of yourselves, and each other.

 

6

Midwife Burnout: A Brief Summary

This week I have seen midwife burnout rear its head more than a few times. This is an issue close to my heart and one I dedicate my research to on a daily basis. Being a registered midwife and having practised through turbulent times myself, I know how it feels to give all that you have and yet forget to put yourself first at any time. You become a burnt out midwife, unable to give the highest quality or safest maternity care.

Here’s how it may happen…

 

The recent National  Maternity Review highlighted that midwives were more likely than any other professional group to report feeling pressured at work. Also, levels of staff stress in the NHS are the highest of any sector and staff consistently report a lack of compassion shown to them from leaders and managers within their organisations.

I find this incredibly sad…. We want to care so much for women and their babies…yet we fail to care for ourselves and each other.

The latest  work-related stress guidance cites one of my paper’s, which claims that “Midwives are entitled to a psychologically safe professional journey”… This is wonderful to see…but will we ever see midwives being cared for in equal partnership with the women and families they care for?

A colleague of mine recently noted that ‘as soon as we say that patients come first…we immediately devalue the staff’….

This got me thinking….and writing this blog post.

In the midwifery news this week:

I have come across the following articles in one way or another…

The experience of professional burnout can be one of extreme personal pain which some midwives feel they may never recover from. Despite global recognition of the destructive phenomenon of burnout, midwives may not understand what was happening to them. They can feel judged as managing their practices poorly, experience isolated feelings of shame, and feel unable to disclose their escalating need for help.

Young, C. M., Smythe, L., & Couper, J. M. (2015). Burnout: Lessons from the lived experience of case loading midwives. International Journal of Childbirth, 5(3), 154-165.

My 3 latest papers have addressed the issue of midwife burnout and psychological distress in great detail…I shall be publishing more shortly… for further reading see:

Pezaro, S. The midwifery workforce:  A global picture of psychological distress – ARTICLEinMIDWIVES: OFFICIAL JOURNAL OF THE ROYAL COLLEGE OF MIDWIVES 19:33 · MARCH 2016

Pezaro S (2016) Addressing psychological distress in midwives. Nursing Times; 112: 8, 22-23.

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. In press.

Midwife burnout is rarely understood…Yet one thing is clear, we really do need to find new ways to support each other and look after ourselves for the benefit of all midwives working within midwifery profession, and the families we care for.

This week I will continue to write my systematic literature review which aims to identify the nature and existence of interventions designed to support midwives in work-related psychological distress, and their effectiveness at improving the psychological well-being of midwives.

Once this is complete, we will be one step closer towards effectively supporting midwives in work-related psychological distress.

Until then, look after yourselves…and each other.

1

#IDM2016 – Celebrating #Kindness to other #WeMidwives & Ourselves with @WeMidwives @world_midwives & @MidwivesRCM

I am blogging today in order to celebrate the International Day of the Midwife hosted by @world_midwives. This event is going from strength to strength, am I especially excited about some of the themes being highlighted this year!

The @WeMidwives community is celebrating the fact that “Kindness to others & yourself -does improve workplace health” – They ask that we share how we care for ourselves and one another as midwives.

The International Confederation of Midwives (ICM – @world_midwives) are also on board with this, announcing that we all must: Nourish the support system among midwives » Have a celebratory event where midwives can meet each other and learn about each other’s challenges and achievements and share coping mechanisms to support each other.

Also, @world_midwives have promoted another great activity: ‘I Am A Midwife, This Is What I Do’

They are inviting midwives to share the work they do using the “I am a midwife, this is what I do” activity on social media as a celebration of midwifery around the world. In their example they show a “Technical midwife adviser” – It is wonderful to see a wide range of midwifery roles being celebrated. This reminds us that you don’t have to be on the front line to contribute greatly to the profession. Research midwives, technical midwives, midwife educators and policy advisers all shape and contribute to the midwifery profession in their own unique way. The important thing to do is to embrace our diversity within the profession and unite in camaraderie and support for one another.

Last week, just ahead of #IDM2016, the Royal College of Midwives (@MidwivesRCM) launched their new guidance on ‘Work-Related Stress’ for heads of midwifery and individual midwives themselves.

RCM - ‘Work-Related Stress’.

I was thrilled to have our latest paper cited and referenced within this guidance as follows:

All this [Work-related stress] damages productivity and can affect outcomes for women. The research paper ‘Midwives Overboard!’ states: “Midwifery care aims to support optimal outcomes in childbearing. If, when caring for women, the potential consequences for midwives are ignored, we risk their capability to provide midwifery care to the high levels they aspire to. This threatens the very eminence of midwifery as a profession.” It also says: “Ethically, midwives are entitled to a psychologically safe professional journey… when maternity services invest in the mental health and wellbeing of midwives they may reap the rewards of improved patient care, improved staff experience and safer maternity services.”

Click here to see the full paper

So it really does seem that this topic I feel so passionate about is really gaining some much needed attention, and I am thrilled to influence guidance from my professional body is this way.

For made their theme “Workplace Stress: a collective challenge” free to read! Everyone is getting involved 🙂

Our own research project which explores what  for health care staff continues to thrive via @NHSStaffExp Please use the  hashtag to contribute your thoughts.

See full details here →  ..Please spread the word 🙂

Also, please check out The Virtual International Day of the Midwife     A great 24 hour conference for  – Catch up with the seminars online when you can!

Lastly, my favorite charity – is hosting many Muffins for Midwives events and is asking people to tag themselves and their muffins in photos for  – YUM!

Until next time….Take care of yourselves, and each other.

0

A reflection on the #MaternityReview & #NHSStaffSurvey

I just wanted to take an opportunity to reflect upon the Maternity Review published this week by Baroness Julia Cumberlege, Chair of the National , and colleagues. I will also couple this with a reflection on the NHS Staff Survey in England, also published this week 

See the full NHS Staff survey here

See the full Maternity Review report here

 

Overall, I think the National Maternity Review report, ‘Better Births’ was received very warmly by all, including the  community. You can read the #RCOG response to National Maternity Review here. I certainly welcome the core recommendations as listed below:

Recommendation 1: Personalised care, centred on women and families. Genuine choice, unbiased info.

Recommendation 2: Continuity of carer: safe care, a relationship of mutual trust and respect

Recommendation 3: Safer care, working together across boundaries, leadership for a safety culture.

Recommendation 4: Better postnatal and perinatal mental health care – funding and provision

Recommendation 5: Multi-professional working, breaking down barriers to safe and personalised care

Recommendation 6: Working across boundaries to support personalisation, safety and choice.

Recommendation 7: A fair and adequate NHS payment system for high quality NHS care

Also, please see  for a great summary of  here-> 

However, there were a few sentences which had me a little worried, and helped me to reflect on my own work.

Firstly: “Providing health care is by nature demanding and stressful, but the NHS Staff Survey provides evidence that this affects maternity staff more than most.”

Here, it is wonderful to see the emotion/stress work done by midwives being acknowledged. It is recognised, and so we can now begin to respond to this. Also, the evidence that maternity staff are affected more than most highlights that perhaps the midwifery workforce is more in need of support than others? or at least that we should support the midwifery workforce as a priority group? It was always my vision that the work I would do would start with midwives, and then disseminate to other staff groups….Now we have evidence that this could be a wise choice.

The report also states that:

“Midwives are more likely to report feeling pressured at work than other NHS staff, with almost half recording having suffered from work-related stress”

Does this mean that more midwives are coming forward and reporting the consequences of these pressures? Psychological distress too? At the very least, we are seeing more recognition of the reality of midwifery work environments.

Lastly, we see that:

“More midwives and trainee obstetricians report feeling unsupported in the workplace compared with other clinicians, although midwives report feeling slightly more supported by their managers than in previous years”

This tells us that midwives are in need of support. The question remains to be what type of support is required? wanted? needed? By the sounds of things, any intervention of support could complement the current systems, as long as it is there!

This reassures me that I am working towards at least one sound solution to support midwives in psychological distress. An anonymous, online intervention…. In future, we may have more opportunities to illuminate how midwives are really surviving, thriving or diving in an evermore challenging profession.

We all want to put women at the centre of maternity care. However,  I remain convinced that this can only happen if the well being of midwives is also made a top priority.

Also this week, an annual staff survey answered by nearly 300,000 people

I was delighted to hear that in response to this survey, NHS England’s chief executive, Simon Stevens had said that “The best NHS employers know that staff well being and high-quality patient care are two sides of the same coin,” he said. How refreshing 🙂

Sadly,  about a quarter of the total NHS workforce found that a third felt they had experienced work-related stress. Yet there were also many encouraging improvements noted.

Danny Mortimer, chief executive of NHS Employers, said: “The variation in staff experience across the NHS remains a real concern for employers and boards will want to do more to address this.”

Chris Graham, director of research and policy at the Picker Institute and the survey’s chief investigator, said: “Too many staff complain about inadequate resources, staffing shortages, and the deleterious impact of their work on their own health and wellbeing. We call on all employers to closely review their results and take action to ensure staff are supported and listened to.”

With these new learnings in place. Lets hope that we can all create new narratives where the staff experience is prioritised alongside the patient experience. My intervention cannot come soon enough…I just need to finish this PhD first!

In terms of my own practice. I continue to reflect upon the same part of the NMC code in that we must all “be supportive of colleagues who are encountering health or performance problems”. The staff experience falls in line with this, in that we must all support staff well being in order to promote excellence in healthcare.

So until next time. Look after yourselves, and each other.