Foundations of Midwifery Practice - Session 1 Questions and Answers

Foundations of Midwifery Practice - Session 1 Questions and Answers What does 'midwife' translate to? With woman What are the essential roles of a midwife? - To provide evidence-based, individualised care - Promoting normality in pregnancy, labour, birth and the postnatal period - To be an advocate for birthing people's choices - Roles differ in each country Define autonomous practitioner It is entirely possible to go through an entire pregnancy and labour without seeing a single doctor. Midwifery is a practice where multidisciplinary intervention isn't necessary unless a case is complex What are some other healthcare professionals we might see? Neonatologists, obstetrics, doctors. it's good to speak to and learn from other colleagues, for the best care for the birthing person Why might a specialist be needed for a client? They may have an existing health problem and need referrals for support and further care during pregnancy. Why will we as midwives be forever leaning? Because the practise is ever evolving and changing for the best, so we must continue to train and work hard to uphold the best standard of care What are the 5 things that documentation must be? - Comprehensive - Contemporaneous - Objective - Timed and dated - Signed Why must documentation be so upkept? - If it isn't written down, it didn't happen - Accountability and safety - Improvement and communication - Justification of actions - To prevent poor drug administration - For birth reflections/trauma services How long are notes kept for? 25 years What can poor documentation lead to? - Trauma being exhumed (reliving a stillbirth) - Loss of trust in medical professionals - Lack of care and treatment - Delays of care and treatment - Misadministration of drugs/doses/methods define evidence-based practice - Knowing the most recent guidelines to make the best decisions for care - Promoting the best policy - Allowing birthing people to make informed decisions about their care plans Benefits of Evidence Based Practice It is objective, meaning that no midwife or doctor can implement opinion to sway a client's choice for treatment. There is reason and rationale behind the proven methods What are the four P's of professionalism? - Practise effectively - Prioritise people (objective care) - Promote professionalism - Preserve safety (competency, inquiring) Define consent to treatment An informed decision made by the patient as to their treatment plan What do we do if a client refuses treatment? Either offer them more information and time to consider their choice or discontinue the current care plan What qualities must the gained consent have? - Informed: client has been told of the pros, cons and alternatives of the treatment, as well as the outcomes of no treatment - Voluntary: client must be under no pressure from a medical professional or a family member to make a decision - The person must also have the capacity to give consent How do we test for capacity to consent? There is no official test but we must always assume that someone is capable of comprehending and making a decision. What is voluntary consent? Consent which is not pressured or affected by bias or persuasion from anyone, be it a family member, medical professional or partner. Who can consent for the patient? No one but the patient, ever. When do we take consent? Before anything. Big or small, invasive or not. we must ask for consent for all procedures. Define tacit consent. Implying consent but not actively saying so What are the consequences of treatment with no consent? - Disempowerment - Lack of control and autonomy - Feeling coerced - Disrespect and feeling unsafe Explain how obstetric violence can affect a client and their family - Traumatic - Leads to a loss of trust or hope for health services - Psychological abuse and guilt on their behalf for 'choosing wrong' -Feeling of mockery or bodily invasion/violation Why is it so important to gain trust from our clients? To empower them and gain rightful consent from them where necessary. This allows for true consent even in high pressure situations where intervention (emergency c-section, pain killers, instruments) is necessary. Why must we remember that midwifery is often a very invasive practise? Because its often that the birthing person will only go through this once in their life, meaning that it should be a positive and safe experience for them and their family. why is it better to discuss the possibility of intervention during labour with a client? So they can be prepared for the possibility and have all the information they would need to make an informed decision on the day Why can't we accept consent from anyone but the birthing person? Because someone may be putting the words into their mouth and it may not be their true decision Give some examples of how you can get a client away from a partner to as questions of true consent - Urine sample - Putting the scales into another room - Finding other ways to take the client for an examination without the partner being present Why must we use translators from the trust rather than a family member? So the correct message gets across to the client and there is no coercion of words or meanings. How do we identify the things most important for the client? by listening to what they say and acknowledging what makes them safe How should we be reflective on the practice? Always be prepared to offer an apology for something that went wrong. Know what you could have done differently and recognise that not everything is the same for every client