An Update on my Community Rotation

Back in June I started my community rotation part of my preceptorship as a newly qualified midwife. Last month, I shared my thoughts one month in, but due to the fact the entire month was supernumerary, I wanted to share how my first month alone and working independently went too. 

Well it's been just over a month now, and I can honestly say, I'm actually really enjoying the job. I really didn't know how I would feel going from the hospital to the community, because I loved the hospital so much and of course, I'd been there for over 2 years straight. I love the continuity of looking after my women and being able to provide that consistent care. I also think it's so lovely to be able to develop that relationship with women. Even though I've only been doing my clinic for the past two months, I've seen some women every two weeks, and then 3+ times at home as well which is lovely. 

Speaking of home visits, they are absolutely lovely. I love seeing the new little families together in their own spaces. It's quite interesting to see people in their own environments and of course, being nosey, also seeing where women live. I've been to some not so nice flats and some incredible mansions. The area where I work, has such a huge range of women and their social backgrounds are really variable. It's also lovely to give care at the home because it's where they will be caring for their babies long term. Sometimes it can be quite difficult to do breastfeeding support in a hospital, because the set up just isn't there. At home, they can get comfortable, have plenty of pillows and get used to where they will actually be feeding. It's just very different.

For the most part, I absolutely love it, however it does have it's downsides. As many of you probably know, I don't love driving. I don't mind driving on motorways or in areas I know really well, but unknown places or city centre driving is not my favourite thing to do. Unfortunately, my base happens to cover the city centre...yey! Not only does that mean I have to drive in the city centre, but also so much of it is permit holder parking only. Sadly, because I am only in community for 7 months, I don't get a permit. Apparently as you have to pay for the whole year, it's not worth the cost to the trust. This means I often have to park on road with the risk of getting a ticket that I can't claim back the cost of, or pay for a parking ticket from a machine which is quite a hassle. Plus, if a visit ends up taking longer than expected, I have to go back to put more money on and then restart the visit. For the most part, this hasn't been too much of a problem as of yet.

So far, I've only had a small minor car crash and of all the places it was in my base's car park into a gate. God knows how I did it to be honest, I just ended up getting myself into a right state and did it not once, but twice before asking someone else to drive. In the end, there wasn't too much damage but I did feel awful for scratching the gate. Thankfully the manager and maintenance said they didn't want me to pay for anything. Other than that, I've only had a couple of difficulties parking at women's houses because I just can't parallel park instead. Oh the joys!

The only other difficult aspect I've found so far is some technological aspects. The community has recently moved to the hospital systems which are admittedly great, however the internet connection is just too slow in community and there are far too many pages for each appointment, meaning the majority of the time is spent doing admin. On top of that, phoning the hospital ends up being a huge ordeal. When you only have 30 minutes - or 20! - per woman, waiting 10 minutes to get through to someone is difficult. Also, a lot of the numbers get diverted so you have to keep hanging up and calling an alternative. It can also be quite embarrassing in front of the women. Except for urgent issues, I have now started to call women back the following day with times and appointments but it's not the most ideal situation. 

Other than that, the main issue is the time. We're a couple of staff members down at the moment with long term sick leave, so we've been keeping up with their work at the same time which is a little stressful but we've just got a temporary replacement, who is amazing and gets through things so quickly! Plus, apparently we have a new admin person starting which will be interesting. It's just finding time to do the non-urgent aspects, such as discharges, claiming expenses and going through caseloads. I've actually ended up doing quite a lot of that in my own time. On the few days off I've had, I've done a few discharges on the phone and luckily I did go through my caseload and manage to organise it a little better. 

On the other hand, it's really nice to work somewhat independently. Although I'm a part of a team, I can somewhat control my own working day. For example, I have a two clinic days with a full day on Tuesday and a half day on Wednesday. I ended up managing to get this switched to a booking clinic on the Wednesday afternoon which is absolutely lovely because I can then concentrate on just one aspect, and set my clinic up on Tuesday for antenatal appointment. On the same wavelength, for visit days, you can organise your day around your visits and admin etc. 

Overall though, despite the downsides, when I'm with the women and their family, my time is dedicated just to them and the other stresses just fade away into the background. It is really lovely to just enjoy being with them and being able to provide that care that is unique to them. Sometimes it can be a little stressful to keep on top of it all, and I feel like sometimes I ask too many questions from the rest of the team, but it's slowly getting easier as time goes on. Here's for the next 5 months!