I was anticipating an horrendous return to work, but it really wasn’t that bad. My morning was taken up with my antenatal clinic, 10 women, all of whom were 28 weeks, or more, pregnant. There were the usual irritations, no room left to write anything in the notes following a visit to the hospital clinic where the a) thoughtless or b) ignorant staff had not had the intelligence to add a continuation sheet, readily available on their desks in the hospital, non-existant in a G.P’s surgery. The woman who arrives late for her appointment and then goes to the loo to produce a urine specimen. The amazement from them that their hospital labels should be kept with their notes, not on the dining table at home (I have no idea what they plan to use these labels for). The woman who requests ‘one of those forms for my husband to claim paternity leave’. What forms, I’ve never heard of them, let alone have one in my possession. I phone up the ‘Job-centre’ who helpfully inform me that there is a form, SC3 , which can be downloaded from the HM Customs and Revenue website. I turn to the woman and relay the info. This is not enough, I must download the form. Prepare for a rant………….I’m sorry, I have certain responsibilities but there are just a few tasks I expect these soon-to-be responsible for another human-being adults to perform and one of them is to sort out their husbands/partners lives. Whilst I’m ranting, Fitness to Fly letters. One of my ladies arrived with one of these letters which her G.P had provided for her, at a cost of £15, and I ended up having to add all the relevant details to it as they had been omitted. I don’t charge anything for these short communications, and if I did, or could, I would not have the gaul to ask £15 but I would ensure that it was fit for purpose. Next to last woman, now 34 weeks pregnant, 3rd baby, poor obstetric history, even worse psychiatric history, burst into tears as she walked through the door. We sat down, had chat, I glanced at her notes and saw that she had been seen by the obstetricians yesterday. ‘Hey L, you saw the Docs yesterday, is there a problem?’ Floodgates opened. L doesn’t trust the Doc. He hadn’t read her notes, didn’t know what had happened before. Didn’t use a tape measure to measure her bump, just walked his fingers up it counting. Didn’t listen to baby’s heartbeat, ‘I felt it move. That’s good enough for me.’ He then advised L that she should remind the staff in theatre that after her previous caesarian she had developed an incisional hernia as they ‘might not read her notes’. I tried to read what he had written, illegible. He had signed it, but that consisted of a curved line. No identifying his name, grade, nothing. Thanks to this anonymous numbskull I then spent 50 minutes reassuring L that she would be quite safe during her stay in hospital. One quick glance at her notes should have alerted him to the fact that here was a woman who required extra thought to be put into how anything was communicated to her, instead he behaved with a total lack of insight and was obviously refering to himself when he mentioned doctors not reading notes.
This afternoon one of my visit was to a Mum who is an insulin dependant diabetic. This is her 3rd baby born by caesarian section, and her third baby to have been born by an emergency CS due to fetal distress. With all her babies it was her vigilance that ensured a happy result as she had noticed reduced fetal movements and taken herself into the hospital, where monitoring had revealed that baby was no longer happy coping with her diabetes. With this pregnancy the caesarian was scheduled for 38 weeks but at 37 weeks, once again, baby’s movements slowed right down. In she went and 2 hours later a baby boy weighing 9lb 12ozs was born (heaven only knows what he would have weighed if she had reached 40 weeks), large babies are a feature of mothers with diabetes. This time though baby has another problem associated with maternal diabetes, cardiomegaly (enlarged heart) combined ith polycythemia (too many red blood cells). The condition was only discovered when they conducted a scan due to him experencing minor breathing difficulties, they will be going to a cardiac unit on Thursday to have a detailed assessment. Baby is now 14 days old, he did appear extremely pink, verging on red, but was feeding well and was breathing normally, I really hope that he is going to be well but I have to say that I have a ‘feeling’ about him. I hope I’m wrong.
So my first day back, full of listening and reassuring mixed with a smattering of midwifery, or is that what midwifery really is?
A Midwife's Muse 