My Thoughts 1 month into being a Newly Qualified Midwife!

I can’t quite believe it’s been a whole month since I qualified as a midwife and started my job. I’ve had so many mixed feelings throughout this first month working and I just really wanted to write them all down in one place so I can look back on these memories. 

Fist of all, I just want to say that I think it’s perfectly normal to feel that way, and having talked to other newly qualified midwives (NQMs), many are in agreement. I've had some of the highest highs but also some of the lowest lows. It's so strange and can quite literally change at the flick of the switch. My mood really does depend on how the shift went and it's hard being so emotional. 

The standout moment so far has been a shoulder dystocia for me. For those that don't know, a shoulder dystocia is an obstetric emergency that needs immediate action to prevent morbidity and mortality. It happens after vaginal delivery of the head, when (usually) the baby's anterior shoulder gets caught behind the mother's pubic bone. It was my first instrumental delivery as a qualified midwife and I was just so glad another midwife was able to be present with me. She completely rocked whilst I followed her lead, and I'm so glad I wasn't alone. The team worked so well together when the emergency buzzer was pulled, and it gives me a great experience to reflect and look back on to be better in the future. 

Having my first normal vaginal delivery qualified felt surreal and I was completely elated. I planned the care, handed over, was in charge of the whole case and completely independent. I honestly loved it but then there's also the difficulties with things I can't do, such as suturing, cannulation and IV medications. As a NQM, you undergo a preceptorship programme and part of my preceptorship programme includes observing two and then being supervised for five of each tasks prior to being allowed to do them myself. 

I've found most of the staff and team so incredibly supportive. They've always been there for me, offering support, asking if I'm okay and going above and beyond to be present. However, there have also been a couple of cases where I've been made to feel pretty rubbish. Once at handover during quite a complex case, I was so proud of the care I'd provided and I left questioning all my decisions. Another from an experienced midwife who passed comment over things I wasn't allowed to do, due to not being signed off for yet. 

It was even harder when I was pre-pin because the boundary between competencies and expectations was very vague. I spoke about this briefly before I started here, but I was so lucky in that I only ended up doing 2 full shifts at band 3 because my PIN Number came through so fast! However, even as a registered midwife, limitations can still be frustrating, such as waiting to complete my IV package, as currently I have to be supervised to give IVs which means waiting and asking for someone else to help. I can't wait to get everything signed off so I can give the gold standard care I truly want! 

It's also such a strange time to be practicing right now, so I don't think that's helped. It's the middle (hopefully closer to the end) of a pandemic, and I actually started at the peak. We've got so many Covid positive women at the moment, and despite shielding being advised, it's defintely not being take as seriously as it was in lockdown 1. Back then, the trust had only a handful of cases in total, but now, it's a daily occurrence. It's so hard to provide the best care, whilst following protocols and wearing so much PPE it's sweat inducing. 

Another component which I never struggled with as a student is sleep. I really struggle to fall asleep at the moment, but especially before a day shift. I've actually found night shifts better, but for a day shift I find myself constantly overthinking decisions or picturing everything that could possibly go wrong. It's scary the amount of pressure I feel sometimes and I also feel like as a student I wasn't prepared at all. I felt I was a great student, and my feedback didn't disagree, but I was shielded from a lot. I felt like I must have been the only one, but having spoken to a number of other students in my cohort, we all feel the same. From simply ordering and sending tests, updating the co-ordinator or drawing up IV drugs...multi-tasking really is hard at work! 

Overall, it honestly depends on the day as to how I'm feeling. I'm hoping I'll get more and more comfortable as time goes on. I think familiarising myself with the guidelines is a good place to start, and luckily, the last few shifts have been nice, which means there is someone around when I need a bit of further support. 

For anyone else going through this journey, you'll get there! Make sure you talk to your team and especially debrief if you've been in a tricky situation. You can also escalate it to your co-ordinating midwife, your manager and then your Professional Midwifery Advocate (PMA). Also, speak to other's in the same boat. Even though I was the first to start as a qualified midwife in my cohort, other's are all around the same point and it's nice to share with each other because no one understands it better. If you don't feel you can do that, I'm always here to speak too. Just drop me a message or leave a comment below and get the conversation going to normalise sharing feelings openly and honestly.