Studying Midwifery at Salford
Kathryn Bond & Lesley Graham with Lucy Surplus (Student Midwife)
Year Planner – September 2019
Overview: First Year • A&P • Community • Quizzes • Labour Ward • Study • PARE • Assignments Self- Clinical Directed Placement Study Clinical Theory Skills • Maternal Observations • Practice Based Learning • Abdominal Palpation • Physiology • Phlebotomy/Drug • Role of MW Administration • A&P • Neonatal Resuscitation
MIDWIFE’S RESPONSIBILITIES NMC Code (2015)
Antenatal Care
The content of the booking history Personal details Medical - pre-existing conditions Surgical history (operations/accidents) Obstetric history (previous pregnancies/terminations) Social (domestic violence) Family (ethnicity) Screening options (blood tests) Current and previous pregnancy Health promotion (Drugs/smoking/alcohol/diet/foods to avoid). Options regarding place of birth Open questions.
Referrals to other agencies:
Intrapartum Lectures
Care in labour:
Postnatal Care
What do women think about their postnatal care? How could we support them? Consider the factors below: (Malouf et al, 2019) After birth women were left alone and had to ask Task-orientated care was Women reported feeling for help, they were also noted with a focus on neglected and unable to told their midwife would routine clinical ask for help as they be back shortly which observations – emotional perceived their midwife made them feel support was precluded by as being too busy neglected and a low the organisation of care priority Conflicting advice,, and Visiting hours are to short lack of support for and restrictive and staff breastfeeding mums interaction, the ward along with lack of privacy environment and BF and guidance support was criticised
Eg What factors would a midwife consider? Rejection, Isolation, Mental Health, Baby Blues, PND, anxiety, self help groups • Think about PTSD • Do they need a debrief? • Referral pathways • Advise what is normal, what isn’t and what to expect. • Hormone changes impact mood as well as becoming a parent – feeding not as planned or unwell
Neonates: Examination of the Newborn
Assess the condition of the baby at birth using the Apgar score Apgar score Sign 0 1 2 Heart rate Absent Slow Fast above 100 / min below 100 / min Respiratory effort Absent Slow - irregular Good, crying Muscle tone Limp Some flexion of Active extremities Reflex irritability No response Grimace Crying, cough Colour Blue, pale Body pink, extremities Completely pink blue
Umbilicus / Cord Care • Advise how to keep the umbilical cord clean and dry. • e.g. position outside of nappy • Antiseptics should not be used routinely. • Early signs of infection – redness around umbilicus, offensive smell, sticky cord.
Other methods of teaching
Teaching approaches • Full cohort lectures • Smaller tutor groups • Clinical skills groups • Simulation suite • Conferences • Directed home study • Online quizzes and revision • Problem based learning • Clinical Practice 50% of the course • Hospital ‘skills drills’.
Quizzes – Labelling, Kahoot & self-directed online study
We encourage creative activities The Brain…An extract from a Poem by Group of First Year Students – Revision Tool “Today we’re here to tell you, and make your brains all full, Of what goes on in the fetal brain, underneath the skull. The brain is split into 4 parts, which match the baby’s bones, They’re called the frontal, parietal, temporal and occipital lobes. There’s 3 more parts you need to know, the medulla oblongata, The cerebellum, pons varolii and that is just the starter There’s also meninges of the brain, split in to three sections, Protecting the brain from bangs and bumps, and saving babies from infections The outer layer is the dura matter, a fibrous tough membrane, It covers the inner surface of the bones, and contains the sinus drains The arachnoid mater is the second layer, it looks just like a web, It helps to supply the blood and stuff and is important to the head. The pia matter is the final layer, it’s the lining of the brain It keeps it contained and keeps it safe and helps it all remain.”
Problem based learning Telephone call to delivery suite: “ I was due yesterday” CONSIDERATIONS BY THE STUDENTS: HOW IS THE WOMAN FEELING? EXCITED? STRESSED? FRUSTRATED? UPSET? PAIN? FRIGHTENED? COMMUNICATION STRATEGIES: • RESPOND APPROPRIATELY TO THE DEMEANOUR OF THE WOMAN/TELEPHONE ASSESSMENT • ALTER COMMUNICATION FOR INDIVIDUAL WOMEN • LISTEN • REASSURANCE (Carolan, 2011).
Diastolic pressure Systolic pressure • This is the minimum • This is the peak pressure of pressure of the blood blood in the arteries and is against the wall of the caused by contraction of the vessel following closure of ventricle which forces blood the aortic valve and is taken into the aorta and around as a direct indication of the body. blood vessel resistance. • The heart is at rest between beats and is refilling with blood.
SIMULATION SUITE Clinical Skills - Abdominal Examination
Abdominal Examination When do we do it? • Antenatal Clinic • Antenatal ward admission • Prior to amniocentesis or other invasive screening test • Prior to auscultation of FH and use of CTG equipment • Prior to a vaginal examination • Labour Caution – refer to senior clinician in the event of premature labour/placental abruption.
Abdominal examination Inspection - what do we look for? Skin – linea nigra / striae gravidarum / surgery/skin irritation/bruising Size – obesity / lax abdominal muscles / multiple pregnancy / polyhydramnious and oligohydramnious – ?fetal size / fibroids and gestation period. Fetal movements - visible, have an awareness of maternal concerns. Shape – may indicate position or presentation eg. “dip” for Occipital Posterior position.
Abdominal Examination Lateral palpation • Assesses the main body of the uterus. Identifies the “lie and position” • Also gives information re: size / tone / fluid volume and fetal movements.
Skills assessments occur in the simulation suite/clinical practice
SIM MOM SKILLS DRILLS FIRST YEAR CARE IN LABOUR COMMUNICATION MATERNAL OBS
CONTROL ROOM FEEDBACK OBSERVATION RECORDING CONTROL SCENARIO
Placement Clinical Setting
Placement Hospitals: Bolton Ingleside St Oldham Marys Wythenshawe St Marys Wigan Oxford Road Stepping North Hill
Extra Curricula Activities • Student Rep • UoS Student Midwives Society • Events/conferences • Volunteers • Free allocation in year 3. • Isle of Man placement • Research • Art • Leisure time every week when in university.
We expect …. • Professionalism • Team player • Commitment • Respectful • Resilience • Adult learners • Attendance and punctuality • Commit to 37.5 hours per week study or placement (NMC Requirement)
Do you have any expectations from us? • Invite questions from you • Review any content you wish to go over again • Explain in more detail/depth • Anything we have missed…that you want to know?
To see what other presentations are available today, please go back to our event hub
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