I returned to work yesterday after my weeks holiday and was immediately plunged into deep gloom. One of the midwives in the office gave me a memo to read, I should have been suspicious when everyone went quiet and looked at me, they were waiting for the eruption and they are still waiting. So what important information did this memo from on high contain………..
‘Due to the Trust’s financial position a skill mix review is in place and this means that as band 7 (me) vacancies in the unit occur they will be filled by band 7 community midwives fulfilling their rotational contract and moving into the unit. The effect this will have on the community team is that we will have Band 7 team leaders and the other team members will be Band 6.’
Another cost saving exercise, as this will gradually reduce the number of band 7 midwives. I do not hold a ‘rotational contract’, mine states quite clearly that I am employed as a Community Midwife, that was the post I applied for, and that is the post I was given. When I bought this up with the HoM before she told me that since Agenda for Change all our contracts had been amended and that since the larger proportion of midwives in unit had signed their contracts then mine was automatically changed. Once again they have me by the short and c******’.
I wish I was a tube driver. They seem to have an incredibly protective union, I want a protective union. I don’t want to be tossed around like flotsam and jetsam, I want to be left alone to get on with the job I was given/earned.
What the Trust are doing is putting all their experienced midwives in the unit and filing those community posts with less experienced practitioners. Several problems here; community midwives are experienced in the community. Teach parentcraft, dab hands; run an antenatal clinic, sometimes stressful but second nature; homebirth, used to the autonomous working concept, an entirely different world to the hospital, not better, not worse, just different. Should I be in the unit on a band 7? No. I would be as good at being a co-ordinator on Labour Ward as I would racing around a racetrack, enthusiastic but not up to speed. The reverse applies, but in this case doesn’t need to as the band 6 they will be replacing me with will be applying to work as a community midwife.
Looks like I am going to have to take a cut in grade if I want to continue providing care in the community. Totally, totally unfair as in reality I have far more autonomy, responsibility and pressure than if I were a band 6 in the unit. I don’t mean to denigrate those midwives on the unit. They work their socks off, their working life is certainly no easier than mine but they do always have another opinion 30 seconds away, there is always help available if it is needed urgently, on the community the buck stops with me.
So the gloom is the state the maternity services are being forced into. The doom is me either having to take up a quasi-managerial role in the unit, or being downgraded and continuing to carry out the same role as I do at present.
The joy. Still with work, but actually my job rather than the evil machinations of those holding the purse-strings. One of my women, L, is great friends with my neighbour so our midwife/client ( I hate that word ) relationship has always been very laidback and full of banter. Just before my weeks break I saw L and told her that, since she would be 41 weeks by the time I was back at work, if she hadn’t had baby then I would go round to her house to discuss induction and, if she was for it, a stretch and sweep. L agreed but told me to leave my gloves and KY jelly in the car as she was not having that done to her! Thursday came and L was still heavy with child so round I went. The house was swarming with builders, the works had overrun and they were frantically trying to finish before babe appeared. Chatted to L, checked her over and then talked about induction of labour, basically how and when. We live in a selective education system and the children are due to take their 11 plus exam in two weeks so L was eager to avoid hospital/early days with baby and her eldest taking the exams ( If you have never experienced the trauma of 11 plus, for child and parent, this may seem an over-reaction but the competition is cut throat). We settled on Monday for her admission to hospital and then, out of the blue, L asks where my gloves are. I admit that they are in my bag but that is where they are kept. ‘Just do it. Lets get it over with’. I took this an an invitation to do a stretch and sweep, so with L’s Hubby keeping the builders away, a large box infront of the door, to stop any wandering builders bursting in, and L with a pillow clutched firmly to her, I did a stretch and sweep. Whilst I’m doing one of these invasive procedures I always chat away, telling the woman exactly what I am doing,’ I can feel baby’s head, cervix is just in the best place’ that sort of thing and I was doing this when L lowered her pillow and asked if I could talk more quietly because of the builders being just outside the door. I couldn’t help but smile at the thought and L went off into a major fit of the giggles, please don’t even try and picture the scene, it was surreal but really lightened the moment and made L really relax which was good as I could do a really ‘good’ sweep. Since I’m working on Sunday I told her that I would come round then and repeat the process, ‘Then that’s and end to it’, she replied. At 11pm that night I received a text from my neighbour ‘ What did you do to L today? Membranes ruptured. Kids on way to me’. I zoomed round to neighbours and requested an update and from the sounds of it L was in labour. I went to bed happy. First thing in the morning I texted neighbour for any news, baby boy born at 4am, all well. It’s the little things like this, caring for someone throughout their pregnancy, helping a woman avoid induction, that make me love my job and will ultimately force me to take a pay cut.