Once again I leave my bank midwifery shift today totally saddened by the lack of patient perspective from my colleagues.Why do midwives claim to be advocates for women when there is little evidence that they are in touch with what women want?
My disappointment stems from the unIt is decision to restrict visitors to the ward area following an increase in thefts on the delivery suite.
Women in labour were told that they would only be allowed to have one visitor while they were experiencing one of life's most significant events.
Not long after this rule had been applied an incident occurred that was of interest to the media.
A woman in labour arrived at the delivery suite with her partner and her mother. She had previously been assured that she could have her partner and her mother with her during labour, but the rule change meant this was no longer possible.
Consequently, the woman left the delivery suite choosing to have her baby at home with her partner and her mother beside her.With the care of the community midwife the delivery was safe, albeit emotionally affected by the visiting-rule incident.
The media heard of the story and focused on the delivery suite. Although the midwives felt aggrieved and frustrated by the woman's actions, I felt she had taken the only decision available to her, particularly when she had based her hopes on the maternity unIt is promise, only to be told at the crucial moment that it would not be honoured.
I had hoped that the media coverage was going to encourage midwives to question whether restricting visitors for women in labour was the most appropriate solution to an increase in thefts on the delivery suite. But I realised last night that my colleagues were no more patient-focused than they had been before the incident. This realisation came about when a young woman of 17 was admitted to the delivery suite early in the morning with some of the symptoms of labour. Labour was not confirmed and she was transferred to the antenatal ward.Her partner returned home to get some sleep.
During the day her contractions became stronger and she was transferred to the delivery suite. Once she knew she was in labour she tried to contact her partner but was unable to reach him. In a panic she telephoned an aunt.
When the young woman arrived on the delivery suite she was alone, in pain and tearful. I was with her all the time but knew she needed her family and friends around her. She kept asking if anyone had turned up. I cared for her as empathetically as I could and supported her while she had her epidural inserted.When she was settled and pain-free her partner arrived and we made a joke of his timing.
Not long afterwards her aunt arrived and was informed of the one-visitor rule.
So the dilemma began: two visitors when the rule says there should only be one. She did not want to have to choose between them.Her partner, due to limited finances, had had to get the bus to see her and that was why he was so late.Her aunt had arranged childcare and paid£7 for a taxi to the hospital only to be told she could not stay longer than a few minutes.
The delivery suite was very quiet and I didn't see why the woman could not have her partner and her aunt with her. I knew her experience would have been so much more fulfilling had she had the two most important people around her. But I was up against the rule. I did break it and allow her aunt to come back in, stay a few minutes, and say her goodbyes. I struggled, though, with this lack of patient focus.
Why could we not meet the woman's needs? Why did we have a rule in the first place? Surely there are better ways to deal with increased ward thefts? Had the new rule cut down the ward thefts anyway? If we are really to 'shape services around the needs and preferences of individual patients', as the NHS plan promises, we have a long way to go.
I do not mind pushing the boundaries and breaking the rules in the interest of the patient, but I am fortunate because I only do about two midwifery shifts a month.My full-time job in a different region enables me to promote putting the patient at the centre of decision-making. But my enlightened full-time midwifery colleagues are not so fortunate. They risk being made into outcasts when they challenge traditional views and values in the interest of the patient.
Will we ever get a healthcare service that is centred on the needs of the patient?