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Archive for the ‘Winds me up’ Category

For some unknown reason I had imagined that as the years passed I would find myself myself slowing down and having more ‘me’ time. I don’t know where I got that idea from but I was really way off the mark, my life now is full of commitments. When I increased my work hours I knew that my life was going to need to be strictly organised and that I would need to be religious in using a planner to ensure that all my duties slotted into place. What I hadn’t allowed for was Hubby doing his back in so badly that he couldn’t help out when the going got tough, in fact he became yet another commitment. Anyway, so what with juggling 2 jobs; 1 incapacitated husband; household tasks; gardening and 7 grandchildren I have found little time to blog.

Today, today has been declared an ‘I have no intention of doing anything that I don’t want to do’ day. Yes, I will be working on 2 databases but that is my choice, sort of, because if I don’t get on with them I will look a right idiot on Monday when I have to present the results of an audit. They are work but there is not enough time to do them during work hours and staying late at work would not help with the production of these beasties because, if you are seen then people feel they have to interupt you, plus it prompts them to dump more c**p at your door. Strange mentality in the NHS, perhaps everywhere, I don’t know. If I noticed someone having to work late, and over their hours, to complete a job then I would acknowledge that they had too much work. I may not be able to substantially reduce it, but I would definitely not go giving them more to do, where I work the opposite appears to be the case.

Work. The cut-backs continue, the unhappiness of the midwives and the women increases. We have just passed through a huge baby influx and it appears we should be back to normal levels until December when there is another little blip. May/June next year are bumper months which was unfortunate as the booking of these women co-incided with the bumper crop of newborns, making a double whammy for community midwives. I’ve had a couple of exciting call-outs requiring me to accompany women on blue-light transfers. In both cases the women were not in danger but the transfers were in the rush hour so 2’s and blues were used to reduce delay. One woman had rocked up at the wrong place in quite advanced labour and had received no antenatal care at all, was newly arrived from an African country and spoke no English. The other had turned up at a clinic, having taken her own discharge from hospital 2 days previously, and her blood pressure was through the roof. With the first lady I saw very little of the journey as halfway to the obstetric unit she started to make the sounds you associate with pushing so I was kneeling on the floor next to her trying to convince her with body language that she should breathe, breathe. I was also sliding up and down the ambulance as it braked for which I bore the bruises for quite some time, but which did make her laugh between contractions. As I was safely strapped in with the second transfer I had a wonderful view of the ‘Moses’ effect i.e two streams of traffic parting to allow the ambulance through. I also witnessed how stupid some drivers are, one even trying to outrun the ambulance, the paramedic told me that is not unusual. Unbelievable!

Work, job number 2. The job is thought provoking and challenging, however my dealings with HR and payroll have been even more thought-proking and challenging. After 3 months of being relaxed about not being paid, no contract etc. I lost my calm, laid back demenour and went for the throat. I have recollections of uttering such blasphemies as ‘grievance’, ‘union’ and then the ultimate ‘I’m stressed’. It does seem to have worked in that I received lots of back pay 2 weeks ago, I eagerly await the 24th of this month. Who is behind this bungle? A totally US manager, even more US than my other manager, in fact so US that my community manager is now beginning to take on the mantle of the most amazing manager, ever.

Home. Well Hubby had to be carried off the golf course after resurrecting his old back problem. He was in agony and was unable to feel anything down one leg, from his buttock to his little toe. G.P? Anti-inflammatories, this was a phone-call trige because there were no appointments and it wasn’t considered urgent. 4 appointments later, when I dutifully waited outside, and 7 weeks later, I marched into the consulting room with my drop-footed, unable to walk properly husband and waited until the G.P had told my husband it ‘would take time’, and ‘at your age’ (58) whilst staring intently at his computer screen, not even shifting his gaze when husband demonstrated the extent of his ‘dead’ leg, then I waded in. ‘What’s the diagnosis then?’ Still not looking away from the screen the doc responded with ‘Well, it’s possibly the same as he had before’. ‘Sure of that are you? Are you not concerned that previously the symptoms were not as severe but that he did require surgery?’ Oh yes, then I had his attention. A withering look was sent in my direction. ‘We could try physio, but it would possibly be a waste of time’. ‘It may well be a waste of time but now we are at the point where this is having a detremental effect on our lives. My husband has his own business and is unable to work. He can do nothing, not even pick up his grandchildren. So far you have done nothing, not even attempt a definitive diagnosis. I am thinking MRI to rule out a problem which, rather than resolve, could get worse.’ Over to the G.P, ‘Well the wait for an MRI is about 6 weeks and it may be better by then.’ I am surprised that he didn’t push the emergency button at that point because I erupted. A verbatum transcript is impossible, mainly because anger and indignation took over, but the essence was that if they hadn’t waited so ******long already he would now be having his MRI and physio and we would know what we were dealing with and, just because you are only just out of short trousers, don’t regard anyone who has grey hair as too old to spend money on. Now pension ages have been changed everyone else, except NICE and NHS choices, thinks we have at least 10 years of productivity ahead of us, so don’t dare write my husband off. Hubby now has his physio and MRI appointment.

The grandchildren are all well, and growing but of them are growing quite as quickly as grandchild number 8, who is currently nestled in DIL’s womb and scheduled to appear at the beginning of May. Yes, another one. See below for how the others have grown.

 

Well. My update is complete. My databases call. Firework night looms and Christmas lurks.

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Over the past few years there has been an escalation in the erosion of the midwifery care provided at home after birth. I have complained, wrung my hands, and generally played the prophet of doom about the impact this could have but, unfortunately, postnatal care is the easiest way for Trusts to cut staffing costs so the resources for this area have been torn away with relief by struggling maternity services. It is the area less likely to produce litigation, and the area where any successful litigation would probably decide on far smaller awards to the claimant so, in the mind of a budget holder, is the safest area to cut services back to the bone.

I was at a governance meeting a while back where the topic of community postnatal care came-up, and I was surprised to hear a consultant midwife back the reduction in care whilst supporting her approach by mentioning ‘a study in the Netherlands’ which found no difference in outcomes between those who had care at home after birth and those who didn’t. Well, I think I’ve found the study, Costs and effectiveness of community postnatal support workers, and if this was the study then she was in error using it to support the discussion as the visits by midwives were not changed, more and longer visits were provided by maternity support workers. Well, today I learned that there is to be a study conducted initially in Scotland by Sterling University into postnatal care. Am I hopeful it will be a positive thing? Not really as I’m not entirely sure that it will be woman centred. At the moment all I have to go on is the BBC report,and whilst I love ‘Auntie’ I am aware that reporting on this topic, maternity care, is not always accurate so I’m just going on their take on the information. What concerns me is that NICE have already issued their guidance on Postnatal Care, which Trusts have interpreted to mean that care is taken away from the home and provided at clinics and this study are also going to ‘develop a best practice package’… ‘which individual health authorities could then adapt to their needs’, (their needs being to cut costs). I will be interested to read their results but I’m really not going to hold my breath.

My previous musings on this topic include; Letting women and babies down? (2010); The Demise of Community Midwifery – part 2 (2010); What now? (2009); A step backwards (2008); An embarrassment (2007). When reading these offerings prior to linking it was interesting (depressing) to chart the real demise of the postnatal care provision in my area, especially my ’embarrassment’ at the care I was not providing in 2007 when we were still visiting at home. Now we ‘triage’ on the first day home and basically, if the woman answers all the questions on our pro forma correctly, she won’t get to see a midwife until Day 5, and then the likelihood is that it will be at a clinic, one of which is 12 miles away. I’m not embarrassed now, I’m ashamed.

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Yep. Sitting here waiting for the phone to ring, I’m on call. On call is really a poor description, ‘in waiting’ would be more appropriate as recently it’s 90% certain I will be answering the phone and driving off somewhere at some point during the night. Last time it was because paramedics were refusing to take a labouring woman in to hospital, even though she was ‘high risk’, because her contractions were too close together! Off I went, in freezing fog, arrived 40 minutes later and discovered that the woman was in early labour. Only problem was that I then had to go in the ambulance with her to the maternity unit, then get back to where my car was, then get home. Nearly 4 hours in the middle of the night, and I’m still not really quite sure why. Then last week it was to the local Birth Centre because they hadn’t got any cover for that night, the week before it was to a homebirth. Once again tonight the Birth Centre has no cover, I wonder what time I’ll be called?

These on calls are starting to stress me out. It seems that as I get older, and perhaps wiser, I dread them and anticipate more problems, mind you, that might have something to do with more women with ‘problems’ booking homebirths. I must be the biggest pessimist as I lie anticipating the phonecall, imagining all the different scenarios I could find myself in, and then, when the electronic ring shrills out my heart leaps into my mouth and virtually flies around the room. That’s the worse bit, the waiting, the trying to get to sleep. Once I’m on the road, in action, and especially once I’ve arrived I’m in the present, no more imagining, or dreading, just a woman to help and support. Yes, things could still not be ‘normal’, but facts are easier to deal with than the imaginings of a sleepless midwife.

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Thank you to those who voted/responded to my request for opinions, the results seem to echo the findings by professional surveys in that the majority considered the same midwife throughout labour to be of most importance. To be honest I was expecting that this wouldn’t be the conclusion. From my perspective as a woman giving birth, I couldn’t have cared who was there, as long as s/he attended to my needs, was competant and treated me like a real person and not just another ‘case’. It does throw up dilemmas though, we are supposed to be aiming at ‘one-to-one’ care during labour, but that doesn’t mean same midwife throughout, it just means that one midwife is only caring for one woman at a time. To then move to one-to-one care by the same midwife throughout is really throwing down the gauntlet, not sure how that could work even with a ‘domino’* system. There are days off, annual leave, sickness etc. and then there is the length of labour itself. Anyway, it has certainly left me with more than enough to ruminate on!

* Domino – The midwife who has provided throughout pregnancy then accompanies the woman to hospital and stays with her until after baby is born.

I have been laid low by yet another tooth abcess, according to my dentist it is down to grinding my teeth, something I am doing a great deal of recently. Working, whilst coping with tooth throbbing and jaw and ear aching, plus unable to take the pain-killers I yearned for was difficult but I am eternally grateful to one of our healthcare assistants who appeared at my clinic and helped it run to time by doing all the non-midwifery stuff. There is a box of choccies waiting for her to acknowledge her thoughtfulness toward a flagging colleague.

I have a Google alert set up to notify me of news articles, blogs etc which mention ‘midwife’, it also alerts me to posts on sites like Mumsnet where members have included ‘midwife’ in the title. On occassion I have rsponded to threads, generally to give advice but this week I read a thread which, at first, I was just sad about as the woman was not happy with her midwife. Then I read the replies, and I got really irritated by the tone of some of the respondants. What I should have done was clicked away from it but instead I put fingers to keyboard and fired off a reply (I blame the toothache). They gave as good as they got, the original author amended the title, but the tone was still so unsettling from some that I wish I hadn’t done it. It really makes me realise how little people understand the struggles within the maternity services now and are happy to keep demanding more from an already close to disintegrating system.

Memo to self, don’t read these sites, and if you do think once, think twice before replying.

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I’m still not 100% certain but I think that I will be the proud owner of a new fridge/freezer tomorrow morning, all thanks to a wonderful man called Barry. My knight in overalls arrived yesterday, heard about my problems to date, examined the offending white goods and then reached for his phone. My latter day Galahad tore several strips off the supplier and within 5 minutes I could have the choice of a refund or a new appliance, I went for the new appliance as they said that they could deliver it on Friday. On a whim I phoned the supplier this morning to find out if it would arrive in the morning or afternoon, and thank heaven that I did, as it hadn’t been booked! Just as I was about to erupt they assured me that they were, as we spoke, pressing the necessary keys and that I could choose when it would arrive, ‘Morning, please’. Now the waiting begins, will it, won’t  it arrive?

So, now that the winter has arrived, I can keep frozen food outside as long as I protect it from the foxes and badgers. Absolutely bitter outside, not a good time to be on call, frozen windscreens and icy roads are not a good start to a call out. I did have a lovely home birth, after many false alarms and a great deal of head scratching a couple of cold nights ago. It was one of those instances where all the advice to the couple was that baby should be born in the hospital as there were ‘deviations from the norm’, they ignored all the advice. Thankfully all went well though and when I left their home they were overjoyed, and so was I!

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The title says it all. The manufacturer’s engineer, the one the manual tells you to call, wrote it off on Tuesday. The supplier refuses to accept his assessment and are coming out NEXT Wednesday to examine it, not replace it, not repair it, ‘to examine’ it. My diet is going really well now as we have no food in the house!

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Identity issue

One month ago we bought a new fridge freezer to replace our old faithful workhorse who, at 31 years old, was having difficulties keeping food frozen. There was a great deal of head-scratching over which to get as the combinations just didn’t fit our criteria. The old one had a large freezer and a small fridge, excellent for us as this domestic appliance lives in the utility room and the fridge section is only used for storing milk and alcohol and we have a larder fridge in the kitchen for everything else but now all the combinations involve a large fridge and smaller freezer. Eventually we settled on a 50/50 combination, freecycled the old appliance, with the warning that it was rather erratic and settled down to refrigeration in the 21st century.

Yesterday I took the grandchildrens dinner out of the freezer and thought that it felt slightly soft. Hmm, put the thermometer in the freezer to see what the temperature was, put an ice-cube tray in to see if it froze and waited. 2 hours later the thermometer told me the temp was -1, refrigeration level so I turned the thermostat right down. This morning my first port of call was to the white beasty, still the same. I phoned the number in the manual, yes they would come out Thursday. NO! I phoned the manufacturer. Lots of questions and then, ‘Are the door seals inflated?’ Well, I had a look and they did seem slightly flat, certainly not ‘inflated’ so I reported this back to the woman on the other end of the phone. ‘Right. What you need to do is get a hot cloth and wipe the seals to inflate them. If we send an engineer round and they aren’t inflated we will charge you for the call-out. Phone back tomorrow if that hasn’t worked’. I have wiped the seals with a hot cloth and checked for splits, neither action was in the manual as something which should be done in case of malfunction, and so far I haven’t noticed any difference, my freezer still thinks it’s a fridge.

This all seems so absurd that, rather than be irate, I just keep laughing. My freezer doesn’t work, inflate your door seals. My freezer doesn’t work, see you Thursday. My frozen food is all defrosting, well you can’t claim from us, even though it’s only 1 month old and still under warrantee, claim from your household insurance and lose your no claims. I have slipped into another dimension where the customer is always wrong.

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