Studying Midwifery at Salford Kathryn Bond & Lesley Graham with - - PowerPoint PPT Presentation

Studying Midwifery at Salford

Kathryn Bond & Lesley Graham with Lucy Surplus (Student Midwife)

Year Planner – September 2019

Overview: First Year

• Practice Based Learning
• Physiology
• Role of MW
• A&P
• Maternal Observations
• Abdominal Palpation
• Phlebotomy/Drug

Administration

• Neonatal Resuscitation
• Community
• Labour Ward
• PARE
• A&P
• Quizzes
• Study
• Assignments

Self- Directed Study Clinical Placement Theory Clinical Skills

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)

Women reported feeling neglected and unable to ask for help as they perceived their midwife as being too busy Visiting hours are to short and restrictive and staff interaction, the ward environment and BF support was criticised Task-orientated care was noted with a focus on routine clinical

• bservations – emotional

support was precluded by the organisation of care After birth women were left alone and had to ask for help, they were also told their midwife would be back shortly which made them feel neglected and a low priority Conflicting advice,, and lack of support for breastfeeding mums along with lack of privacy and guidance

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

• r unwell

Neonates:

Examination of the Newborn

Assess the condition of the baby at birth using the Apgar score

Apgar score Sign 1 2 Heart rate Absent Slow below 100 / min Fast above 100 / min Respiratory effort Absent Slow - irregular Good, crying Muscle tone Limp Some flexion

• f

extremities Active Reflex irritability No response Grimace Crying, cough Colour Blue, pale Body pink, extremities blue Completely pink

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

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.”

We encourage creative activities

Problem based learning

Telephone call to delivery suite: “I was due yesterday”

CONSIDERATIONS BY THE STUDENTS: HOW IS THE WOMAN FEELING?

STRESSED? UPSET? FRUSTRATED? EXCITED?

COMMUNICATION STRATEGIES:

• RESPOND APPROPRIATELY TO THE DEMEANOUR OF THE WOMAN/TELEPHONE ASSESSMENT
• ALTER COMMUNICATION FOR INDIVIDUAL WOMEN
• LISTEN
• REASSURANCE

(Carolan, 2011).

FRIGHTENED? PAIN?

Diastolic pressure Systolic pressure

• This is the minimum

pressure of the blood against the wall of the vessel following closure of the aortic valve and is taken as a direct indication of blood vessel resistance.

• The heart is at rest between

beats and is refilling with blood.

• This is the peak pressure of

blood in the arteries and is caused by contraction of the ventricle which forces blood into the aorta and around the body.

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
• f CTG equipment
• Prior to a vaginal examination
• Labour

Caution – refer to senior clinician in the event of premature labour/placental abruption.

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

Inspection - what do we look for?

• Assesses the main body of the uterus. Identifies the “lie and position”
• Also gives information re: size / tone / fluid volume and fetal movements.

Abdominal Examination

Lateral palpation

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

Ingleside

Bolton

St Marys

Wythenshawe

Oldham

St Marys Oxford Road

Wigan

Stepping Hill

North

Placement Hospitals:

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?

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