Neonatal Resuscitation and Life as a Midwifery Educator

We partnered with the Public Relations team from North West Hospital and Health Service to help bring you this Q&A with one of thier Midwifery Educators! A big thankyou goes to NWHHS for helping showcase one of thier amazing health professionals!

What motivated you to become a midwife?

I had always wanted to be a nurse from when I was 5, I was one of 6 children and I had that natural nurturing nature from an early age. I actually became a Midwife as I had a great interest in caring for women and knew the challenges of remote health.

I started my career in rural and remote locations around the Central West and loved the variety and diversity of the clientele. I also loved working alongside the Midwives who worked in these locations and provided care to women as the sole practitioner with a GP obstetrician was definitely a motivator to work in the field.

However, when I completed my training, I found myself trending towards Emergency retrievals and thus joined the Royal Flying Doctors which brought me to Mount Isa some 16years ago. I found the work of RFDS to be challenging and very rewarding, and I loved the variety of experiences I had in the role.

What is a typical day for a midwife?

A midwife’s day is always filled with excitement for the prospect of a woman experiencing her wishes in her birth journey, but also trepidation that this may not be possible.

We care for women from conception up until 4-6weeks after the birth of their most treasured loves. It involves holding hands, encouraging, promoting and forewarning the progression of the process into motherhood/parenthood. We assist people who have experienced the worse loss imaginable, the fear of the unknown and the promise of so much to come.

In one day we may wipe the tears of a tired, emotional mother who is struggling to keep her eyes open to assist her baby to breastfeed; hug the family who has lost a child due to complications;, and rejoice in the birth of a perfectly healthy child.

What is a typical day of a midwifery educator?

A typical day may be meeting/greeting/orientating a new student/graduate in collaboration with the Maternity Clinical Facilitator; Prepping and training a course such as Neonatal Stabilisation or PROMPT; or I could be driving 6-7 hours to deliver a week of training sessions in the 8 different remote sites that with Mount Isa make up the NWHHS.

The drive is often the best time to reflect, challenge and contemplate the service I provide and how to evaluate to ensure it meets the needs of each facility and team member.

Go here after you read this article, for our interview with Midwifery Educator Jo Masri!

Do you have any other roles and responsibilities?

As mentioned I am dual registered and thus provide education in areas such as ALS/Preceptorship or other courses to meet needs of a small education team with a large, geographically diverse group. I also am involved in many standard committees and developing policies and procedures necessary to ensure safe/ethical/culturally appropriate care to our clients.

Most difficult and rewarding aspects of being a midwifery educator?

Currently, I work in the role of Midwifery Educator for The North West Hospital and Health Service (NWHHS), this role has allowed me to reflect a lot on my own practices and experiences to allow growth in myself and the team I support.

Knowing our strengths and identifying our areas for growth is the most rewarding part of my job. Seeing people grow in their career as both positive and negative events impact on their work practices is extremely satisfying.
Most of all seeing how this allows them to advocate and support their women on their journey to parenthood is why I love my job.

What interested you in the education path and what experience did you need?

Knowing the limitation in resources and support for rural midwives, especially when I have often been that Flight Nurse that arrives, hopefully in that critical time, when staff are most vulnerable is why I like this position. I can not only support staff with knowledge and skills in how to deal with emergencies, but give them ideas on how to develop their environment/equipment to better meet the needs of the clients.

I have a Master in Midwifery degree and have undertaken skills development to run courses such as the Emergency Obstetric course “PROMPT”; Neonatal Resuscitation Perineal Suturing; Imminent birth and due to my dual registration I have also assisted in Nursing Education such as Advanced life support.

What is your advice to best assess and identify early deterioration of a paediatric /neonate?

Most importantly is always listen to the mother/father/family, they know the child best. Also use the tools available to assess. Early Warning tools are your friend. Seek support if uncertain and always take into consideration the gut feeling, even if tools do not currently point to concern, deterioration in a neonate/paediatric client can be sudden and dramatic.

What other factors are pivotal to great patient outcomes in an emergency?

Communication is vital, Closed-loop communication allows every team member to be aware of current situation. This leads into the other vital component of ALS, situation awareness/the helicopter view. ALS is the need to ensure all team members are working to the goal and this involves needing to see the whole picture.

My own reflection, often on the poor outcomes of MET calls has allowed me to better appreciated the non-technical skills that really are the backbone of a resuscitation. Escalating concerns using Graded assertiveness can never be underestimated.

Advice on dealing with a poor outcome from a resus?

A poor outcome is always going to cause you to question your practice/your abilities/your future. However, ensuring that you reflect and analyse and learn from the poor outcome makes you the better practitioner. You don’t know what you don’t know is sometimes true is this situation, not feeling that overwhelming shame/guilt/loss/regret/anger as a practitioner may prevent you from growing and ensuring that your future practice encompasses all the areas you felt you struggled before, eg: Graded assertiveness.

Tips for empowering families when caring for neonates?

ALWAYS BE HONEST, if you don’t know the outcome, don’t promise a good one.
Take time to listen and share in the emotion, it is okay to cry, however, be careful not to burden them. Know that what is said/done in this time is a stressed/grieving family and is not personal!!

What are your tips for nurses and midwives during this pandemic? And how has Covid impacted your work?

Grow from the changes, learn to adapt to new health care and life in general. It is not how we planned, but it is how we proceed, most importantly, take care of yourselves. Fortunately, due to NWHHS being COVID free to date, there has been minor restrictions for us, however, they are still major for a family. For a period of time, there was only one support person allowed in the organisation, including for birth and neonates. This was very challenging for families.

Advice for a student or graduate midwife?

I think the ability to self reflect and be honest with yourselves and others will set a person entering the profession in good stead to develop into a competent and safe practitioner. The expectation that a person can take time to ensure his/her practice is continually evolving as a result of the ability to reflect and seek support/feedback is one that I believe leads to a great team member and future team leader.

Never be afraid to ask for help and always ask for clarification or seek support if you’re concerned. No one person, no matter role/experience/performance is perfect, teams who encourage/support but also question are the teams that excel!

What do you think is key to a successful career in nursing and midwifery?

Work hard, play harder.
Put your whole self into your role, however, you need to make sure that your whole self can also separate from your role, when you can’t separate the two is when you need to seek help/support.

How do you think midwifery will look in 10-15 years’ time?

I hope the trend towards continuity and individualised care that MGP/caseload teams continue and that the dream of birthing on country is realised. However, the workforce for providing these services are still a significant concern. My hope is that the future brings safe clinical care that is family-focused

If you were in charge of Nursing and midwifery in Australia I would change/do ……

I would ensure all women had access to their chosen health care model with the support of professional teams that promoted education and autonomy. A woman could birth her way in her time, but she would be supported and educated on the risks/benefits of any intervention/option undertaken.
Birthing is for her – her way.