So, as I mentioned in my “Where Am I Going On My Elective Placement?” post, I had three weeks of elective to do as part of my second year. Two of those weeks were taken by my placement in Tanzania, and that left one more.
That final week I arranged to spend working at the hospital where I was born. I wanted to try to do this remaining week at a UK hospital, so I would have had experience of working at a different trust and seeing how practice differs even between the different trusts in the UK (ready for when I qualify in a years time – eek!), and then when I started thinking of where in the UK, I thought of how nice it would be to try to do a week at the hospital I was born in – like everything was going full circle! I’m a soppy sentimental really!
I made contact several months ago and after sending references and signing digital contracts etc it was all agreed. So, a couple of weeks ago, just after we got back from Spain, I worked the week at my birth hospital and it was a really fab experience – so I thought I share a few of the highlights and differences!
On my first day, I ended up in theatre with the lady myself and my mentor were caring for, and I was introduced to Cell Salvage; something I have only heard of before on tv shows.
In this case, instead of the suction from the caesarean going into normal containers, in cell salvage it all goes into a special filtering machine, where the blood cells are filtered off, then washed with sterile saline and then the clean salvaged blood cells are bagged up and re-transfused to the woman – just returning her own blood! It’s so clever!
At this hospital cell salvage is carried out as routine in the majority of caesarean sections. This results in a huge reduction in anaemia for these women – it’s just such a brilliant process!
Cell Salvage is also used in other surgery too, and just imagine the fantastic work that it could do to people who don’t want to receive blood products during surgery, for example Jehovah’s Witnesses; I’d love to see this in more hospitals!
Following the NICE guidelines, each trust will have their own guidelines for practice and one of the things I found really interesting about working at a different trust for the week was the subtle differences in these policies.
I suppose when you learn all in one trust, you aren’t exposed to these differences so it was really interesting seeing these differences in action.
For example, I have never seen a vaginal examination be repeated in 3 hours – in my trust it is normally 4 hours, or 2 in special circumstances, but in the hospital I went to, their policy suggests 3 hours instead of 4….just different practice but interesting to see how it changes things – I’d be interested to see if this affects the rate of intervention too.
Slight Differences in Abbreviations
Any medical field has incredibly long terminology – it just comes with the territory – and so health professionals tend to use abbreviations.
In my trust, Spontaneous Rupture of Membranes (waters breaking) is referred to as ‘SROM’; on ward boards, notes, documentation, handover etc. In this trust, they referred to it as ‘SRM’ – again just a teeny slight difference, and it makes absolutely no difference to the care, but it was something that stuck out to me as a difference when working somewhere new…
One thing that really struck me as the major difference between this hospital and the one I’m training in was the staff dynamic.
This trust has one big staff room for all the doctors, midwives and care assistants, and everyone wears the same colour scrubs with a big name badge. This meant that there was a really lovely dynamic between all the staff, without any seniority between doctors and other staff. Their ‘roles’ were left at the door and in the staff room everyone was on an even keel – it was really lovely.
In the trust I’m training in, this wouldn’t really be possible, purely due to the size of the hospital and the number of staff members but I could really feel the difference in working environment because everyone got on so well, and it’s certainly given me something to bear in mind when I am considering hospitals to interview at! (scary just to put that in words – interviewing in less than 6 months – eek!)
I imagine this probably isn’t something that can be achieved every day, but this trust also made sure that every midwife got a 20 minute tea break mid-morning (in addition to a proper lunch break) which was lovely. It makes such a difference and it really does show that the trust are trying to look after their staff by enforcing things like this, and I’m sure it does affect the quality of care you can give too!
The trust that I work in at the moment is almost entirely computer based. It meant a lot of training when I first started work, but now that I’ve got used to it, its quick and easy and seems to make things much more fluid (I imagine at least, I’ve not known anything different!)
The hospital I was working at for the week, however, is entirely paper based – for observations, antenatal notes, labour care, postnatal notes, blood results, everything – which was a totally different experience. I’m not sure which I prefer to be honest, but I think that training in a hospital that is computer based will probably do me favours in the long run as that is the way that most things seem to be moving, even if I do end up working in a paper based trust when I qualify.
Overall, the experience of working in the hospital was very similar to my current hospital, with only some small differences. It hasn’t made me view either hospital as “better than the other” but rather it has made me more aware of the differences that there can be between trusts and the kind of things I would like from a workplace when I start thinking a bit more about where I might want to work.
I like the idea of working in a hospital where there is a friendly dynamic between the staff and where everyone talks and acts equally on their breaks etc so that is definitely something I will consider when the time comes, and possibly will consider a smaller unit to find this.
It also made me realise that the size of the trust doesn’t necessary affect the facilities or cases that you will have, which was nice to see too.
I got to stay with my parents for the week too which was lovely – my mum even made me packed lunches and hot dinners when I got in, bless her!
It’s a bit scary to think about working in a different hospital in just a years time, but this experience has definitely prepared me more for the change and the potential differences – and I feel quite excited to see where I will end up!
Image by Nathan Riley
To read my last Midwife Mondays post, click here:
TashaOctober 9, 2018 at 10:23 pm
When I had my daughter my waters broke first at 38+1 abs in my notes they had it down as PROM – premature rupture of membrane. Guessing that’s the same thing as you mentioned but another variation.
Rosie | A Girl On A JourneyOctober 12, 2018 at 4:58 pm
Generally PROM is short for “Prolonged Rupture of Membranes”, when your waters have been broken for more than 24 hours before delivery (dependant on hospital policy, sometimes its 18 hours, sometimes 12…). 38+1 would be classed as term so I doubt it would be for “premature rupture of membranes” – depends on the hospital though as to which abbreviation they use…