A Day on Shift... Postnatal Ward

Before I became a student midwife, I always wondered what a true day on the ward would involve. There isn’t too much work experience available for hospital working unless you are actually on the course (for obvious reasons), however I believe it could be really beneficial to understand what being a student on the ward may entail. These experiences come from a little student midwife in Suffolk, so don’t be surprised if they differ in your area as each Trust works in slightly different ways.

Our shifts are usually 12.5 hours long – running from 07:30 in the morning to 20:00 in the evening (a long day, I know right). I begin my day at 06:00 normally, which gives me enough time to put on a bit of makeup and make my hair look less like a bird’s nest before the day ahead. Lunch preparation is key as you will look forward to this for the first 6 hours of the day! I get the sparkly white uniform on (which by the way is super uncomfy and super sweat-enhancing), matched with my beautiful Sketchers shoes, fob watch, black pens, pocket notebook and name badge, and set off on my journey.

At 07:30, handover of care normally takes place. This differs on each ward and presumably between each Trust, however for the postnatal ward, which is the feature of this post, the lead midwife from the previous shift will bring the ward’s paperwork to the office to talk through each woman, her baby and their history. For each woman in our care, the midwife will talk through any deviations during the woman’s pregnancy, what type of birth the mother had, noting any emergencies which may have occurred, the mother’s current wellbeing following the birth including whether she has passed urine and her haemoglobin level, as well as any other concerns, for example unstable or abnormal observations. For the baby, we may be given information such as the gestation they were born at, the birth weight, whether the baby requires any observations, how the baby is feeding and any other tests or concerns to note. Other information provided at handover may include women who would like feeding support, who might like discharging during the day or if the baby may need the NIPE (Newborn Infant Physical Examination) or hearing screening before going home.

Finally at handover, the lead midwife on the present shift will allocate a midwife to specific rooms or bays within the ward; from this, the midwife will take charge of all of the care needs of the mothers and babies in her allocated ‘section’.

As the NMC (Nursing and Midwifery Council) Standards had not yet changed while I was on my postnatal placement, I was still working alongside one main mentor and following her shift pattern. This meant that I also helped with that midwife’s allocated women, and I was even allocated my own bay of women towards the end of the placement! Under the new standards, students will instead work with one of a few ‘supervisors’ (which can be any midwife) and be graded by one ‘assessor’ at the end of the placement.

The shift really gets starting around 08:00 when the previous midwifery team go home. Firstly, it became important to introduce myself to the women I would be caring for in that day – I imagine it to be such a nicer experience for them if they know the name of the person caring for them. Also, I would ask if they were up-to-date with pain relief and check whether any observations needed doing. In my local Trust, a regular observations ward round would be done every four hours for the women that require it at 06:00, 10:00, 14:00, 18:00, 22:00 and 02:00, and this would include testing the woman’s blood pressure, pulse, respiratory rate, oxygen saturations and temperature.

Later in the morning, the obstetric team would perform a ward round to review specific women and determine care plans or plans for discharge. It was definitely an advantage to go with the doctors for this as it highlights a multiprofessional way of working as well as giving you the knowledge about how the woman’s care would proceed that day.

Also, drug rounds are a thing. If you know me, you’ll know that I’m rubbish with drugs – working out dosages and knowing which drug is for what (there are sooo many different ones though!). On this ward I made sure I spent a lot of time doing the drug rounds with my mentor; this gave me plenty of experience in checking women’s drug charts, safely administering medicines and getting to grips with some of the common drugs out there.

One aspect of the postnatal ward I particularly loved was helping mums feed their new babies. Whether this was by breast or bottle, passing on what expertise I had in feeding felt so rewarding. With bottle feeding, it was making sure bottles were appropriately sterilised, still maintaining a good bonding experience for them both and making up feeds with formula. With breastfeeding, there is all sorts a student midwife can help with! Checking position and attachment for example, observing the baby latch on to the breast and even something as simple as facilitating skin to skin. Sometimes babies require cup feeding which you can also help with, and encouraging or educating women on expressing their milk always seemed helpful to them.

Baby care was also a big part of the postnatal ward. This included observations, weighing babies, performing the Newborn Blood Spot Test (only on Day 5 following the birth), observing the skin for signs of jaundice, checking the number of wet and dirty nappies and the general activity of the baby.

While on this placement I also had the opportunity to work with different teams. I worked a few shifts with our Transitional Care midwives who care for women with babies on the Neonatal Unit, as well as a few shifts with our Elective Caesarean Section Continuity of Carer team.

We also can’t forget that each day brings a whole new set of beds to make, paperwork to write in, computer work to complete and an unimaginable number of buzzers to answer! But with each shift, you get to work with some fantastic midwives and meet some truly incredible women. Each shift may leave you wanting to chop your feet off but is as equally amazing every day.

I cherish every single placement and every single experience. If you’d like to know more about my placement, all you have to do is ask!

Imogen x