The Royal Hobart Hospital Factory ...By A MIDWIFE, at the RHHI started work this morning at 0730... The roster shows 3 people off sick. The entire allocated staff for this shift is 11; we've got 8. One of the midwives rostered normally works in the paediatric unit as an educator. She's here to update her skills so she can maintain her midwifery qualification. She is in the middle of a two-week placement on the delivery side. She is given the care of one of the labouring women. She looks nervous. Eight midwives for the entire maternity ward; antenatal, postnatal and delivery;18 beds, eight birth suites, four high-risk delivery suites. There are two caesarean sections booked, two inductions and already two women labouring. I'm supposed to be working in delivery but I'm told to go to the Pregnancy Assessment Centre till the midwife due to start at 0830 arrives. The 0730 midwife is off sick. Before I get there I take a phone call from the roster office. Children's ward is brimming over with kids and the staff are run off their feet, could we spare one of our midwives to help out? You've got Buckley's. I walk in to the PAC to see an ambulance officer. They have brought in a young girl with a potentially life-threatening complication associated with her pregnancy. She's bleeding and has an anxious mother-in-law. I quickly check her, page the resident doctor, run around to labour ward to get a delivery room ready, inform the staff who just look at me blankly and rush back to my patient. Her condition is such that she needs assessment by the obstetric registrar, a person with more experience than the young resident. The registrar is in the middle of another assessment of a woman in the antenatal clinic and he is also on his way to the first Caesar. He comes, he assesses, I put her in a wheelchair and around to labour ward we go. Her condition gradually stabilises. I am standing in the office, (it's now about 0930) when the young ward clerk, (who has never set foot on maternity before this day and was called in because the original ward clerk is sick) comes in and says with a mixture of excitement and timidity, 'Er…..there's a lady out there who say's she's having a baby'. I walk through the doorway. The woman is bent over the desk, hanging on to her stomach. She says, 'my waters have just broken'. We slowly make our way to a spare delivery room where after about ten minutes she gives birth to a beautiful baby boy on a sheet on the floor. Her husband finally makes it after rushing to find a car park because it's Xmas and there's no parking anywhere and their four year old had fallen asleep and he had to put him in the stroller. The placenta is delivered while their four-year-old sleeps on and she climbs into a beautiful warm, clean bed. I start to clean up, then write in her notes. It's now 11o'clock. Another midwife takes over her care while I have a cup of tea. The manager of our unit, a highly experienced midwife, has been looking after my first patient while I am delivering the second. The midwife who takes over the care of my second patient is also supervising the midwife updating her skills caring for the labouring woman plus she also caring for two postnatal women. I have a cup of tea, two pieces of toast, one with vegemite, the other apricot jam and an orange. I sit in the tearoom for 10 mins; it feels luxurious. Back on delivery side it's decided to move my initial patient around to the ward as she has settled down and her condition no longer warrants intensive monitoring. I put her in a wheelchair and around we go. Back on delivery side I'm told another labouring woman is coming in. There are now 5 women labouring, two women have been caesared, one has returned to the ward, and still only eight midwives, two ward assistants, two cleaners and one rookie ward clerk. I take over the care of my second labouring lady. 22 years old, first baby and labouring since 1130 last night, she's doing it tough but she's doing it well. Sometimes in this work I see women who really truly amaze me, she's one of those. She lets her body do what it knows to do. After a couple of hours she's ready. The baby is born at 2.45pm, another beautiful baby boy. She cries as she hugs her baby to her chest. Placenta out, cleaned up, her sister comes in with flowers. I leave to write up the notes. It's now 3.30pm. There's a note on the roster sheet, 'anyone interested in doing a double this afternoon?' and around and around we go. Tasmania's running out of midwives. Average age of Tasmanian midwife; 48. Do I care? Not any more. There was a time when it meant something to me. Not any more. The reason why there are no midwives is simple. People can't sustain a working life in such conditions. We are being worn down. I work in a factory, with an invisible boss, a ballooning mushroom cloud of middle management, and the worker that's me. For every story you read in the Mercury about the Royal Hobart Hospital there are 10 you don't. What am I doing at the hospital? Surviving, and paying the mortgage. And on it goes.
RAPID RESPONSE EMAIL: What do you think? Thursday, December 9, 2004 |