Reflective Report On Experiences Working As A Midwife

broody composition On Experiences Working As A MidwifeWhile I was on my jump placement in semester one as a student midwife, I met legion(predicate) large(predicate) women, both within the familiarity and in the hospital with dissimilar ethnic backgrounds. For this essay which is a pensive essay, I throw off chosen to write abtaboo a pregnant lady and, in order to protect her confidentiality, harmonise to the nurse and Midwiferys tag of Conduct (NMC 2008), I result refer to her as Zara. In this reflection, I am going to use Gibbs (1988) reflective cycle. This encourages a clear commentary of the situation, analysis of spiritings, evaluation of the experience, and analysis to make sense of the experience and an run plan to examine what to be done if the situation arose again.Description of the answerMy placement at the time was on the midwifery led whole in the hospital of my Trust, and on the day in question, I was on an early shift and, when I arrived, my envisio n and I went in to Zaras agency and introduced ourselves. Zara was in pain and her preserve was alike present in the room. My mentor tried to placate her down by talking to her barely, be engender Zara did non control English, she looked to a greater extent worried and was looking at her keep up to explain it to her. Her husband did not empathize much(prenominal) either so my mentor suggested a translator how ever they ref employ it. We took her notes away, went in to the office and transform through them so that we could plan her condole with according to her sine qua nons. Zara was in her early thirties and unemployed. This was her twelfth part pregnancy, she has had six mis motorcarriages, two still surrenders and three live children. All of her kinds were done by caesarean section including this one .This was because Zara was unable to give birth course due to her being a victim of young-bearing(prenominal) genital mutilation (FGM). They were in like manner req uesting female only anguish translaters and regenerates due to them being Moslems. Zara had also not attended m whatsoever of her antenatal appointments because according to Currer (1991) antenatal care among Islamic mformer(a)s was not jibeing all-important(a) they view pregnancy as a normal condition.Prior taking Zara into the theatre to have her caesarean, my mentor explained the mapping to the husband and he translated to the wife. They manseed all the relevant papers but Zara looked worried. I could tell they did not understand e realthing but to my surprise, they did not withdraw any questions, but they did not want a translator. After a while the anaesthetist came to give Zara the epidural, and it was a male. As soon as Zaras husband saw that, he placed his manus on Zaras raise and did not want it to let go. The module was becoming rattling peeved and frustrated because they kept telling him do not put your hand there, the procedure of the epidural has to be 10 0% sterile but he did not understand that. I stepped in because I still reckoned when I had to learn English and I knew the word choice was punishing for them and it has to be relevant to their screwledge of English. I said to Zaras husband no hand, bacteria, no just for Zara and I was also demonstrated it with my hands and face. He soundless and said ok but I could still see that he was not comfortable. Finally the anaesthetist got the epidural in and we took Zara to theatre to concede her cocker along with her husband. When arriving to theatre, I tried to catheterise Zara but could not do it due to her genital area being managely sawn up, so the doctor had to intervene. Zaras husband was standing by her legs and the stave tried to scarper him to top of the bed but said that he wanted to see what we were doing to Zara and that he was going to stay there. After a long sermon and explanations, he finally moved. Zara and pamper were being monitored and by this time the babys heart and soul was not picking up and we had to act fast. The doctor then have it away Zaras abdominal to deliver the baby but meconium was gushing out instead. I run to call the paediatrician. The baby was floppy and there were no sign of life. Zara was asking why the baby was not crying and the husband looked very worried. Reassured them and explained that, when babies are born in meconium, they forget need pleonastic care and attention. The baby was now on the resuscitaire and the doctors was doing all they could to take out the meconium from the babys mouth and nose, and rubbing the baby to promote. After a little while, the baby started to cry and we all let a relieved breath out. I took the baby and showed it to the parents and explained that the baby had to go to special care unit to tick that everything was fine. Zara was doing well, and after a couple hours we transferred her and her husband to the postnatal cover.FeelingsIn this paragraph, I will plow my feelings a nd thinking surrounding Zaras situation and the care she authentic from the checkup staff. I empathized with Zara and her husband because they could not speak English, Zara endured many pregnancies and which of well-nigh had ended up in miscarriages and stillbirths and was naturally worried about the upbeat of this baby. Because of Zaras and her husbands hold English and their cultural background, caring for them was more difficult and the medical staff was getting very impatient and irritated with them. I knew I could help both the staff and Zara and her husband. I tried to build up a good relationship with them by doing a proper origination of myself, where I was from and to try to put them at quietus. I still remember how difficult it was being in a new country with different kitchen-gardenings. My first attempt was to ask if necessary, whether it will be acceptable if the doctor were male and I explained the procedure in a way they could understand, I was acting as an intermediary between them and the medical staff throughout. I did not speak their wording but because I was explaining as alone as possible, they became very comfortable with me and trusted me. I really entangle useful and helpful as they responded to me as I put myself in their shoes and remembered how it was when I was new in this country. concord to Wold (2004) the empathetic comprehend is in relation to the willingness to know the other(a) single(a) not dear judging the persons statement. I then stood by Zaras bed and when indispensable, I used some facial expressions and hand gestures which could be translated to if she were still feeling pain in her tummy and if felt sensation in her legs. I was also using simple words. She looked at me and smiled and point where she could still feel. I was unsealed whether to continue or not because I felt the medical staff might think I was not being professional, but according to Funnell et al, (2005) bole gestures and facial exp ressions are referred as a non-verbal communicating. So I continued because I knew that would help Zaras family. The language and cultural barrier abnormal the care Zara was receiving because the staff was not communicating with them and did not appreciate that good explanation were essential for this family with their particular circumstances of limited English and understanding. During the procedure, I stayed by Zara and kept my heart contact with her because according to Wilma (1999) direct eye contact could express a sense of interest in the other person. Zara was holding my hands and I was updating her whenever she was asking for it.EvaluationI feel I made the right decision to accompany Zara. Furthermore, I could develop my caring role for clients by understanding that they all will have different needs and will require different care. I think my approach with Zara and her husband was a good approach. The staff and Zara did attain from my effort. It was also my responsibilit y to care for her so that she was getting the best care and understood what was done to her. I was able to better my non-verbal talk skills in my conversation with Zara and her husband during my time with them and I know they were now getting the necessary information that they wanted and necessary in this challenging situation. fit in to OHagan (2001) issues such as cultural diversity, cultural sensitivity and cultural competence had no place in the training of care professionals. To enable this imagination to be implemented, it is significant that health care professionals have the adequate educational preparation to provide culturally sensitive care to those who have a diversity of health beliefs and practices (Aziz et al. 2000). Promoting cultural awareness among health care professionals is believed to improve their confidence and skills in providing holistic care for patients with different cultural backgrounds Also, culturally sensitive attitudes and practices, rather tha n simple knowledge, are likely to contribute much toward achieving the ultimate goal of providing quality care to the patients and their families. (Murphy Clark, 1993, cited Zafir 2002).There are many implications that should be well thought-out when caring for Islamic patients.All procedures, decisions and judgments must to be family orientated and culturally derived. Religious and cultural frameworks give the most complete and holistic perspective for caring and understanding the patient population of Muslim denomination. Practices need to take into account the care constructs of presence, participation and support. In addition, the policies and philosophies of the hospitals and other institutions needs to reflect the cultural practices related the specific care, communication and spirituality. Also, where language is a problem, it is important to have access to interpreters in order to provide culturally competent care for Muslims. Secondly, there are differences in the cultura l and psychosocial forms of expression of the Muslim patients and their families and those of the caress. The process of reflection and clinical supervision could swear out care givers in identifying their own cultural barriers, stereotyping, and ethnocentricity, thus, ultimately improving care. Finally, the circumspection should continually assess whether the staff have the appropriate knowledge and skills to spread over the particular ethical situations needd in caring for the patient and his/her family of Muslim denomination and, with the aim of reducing emotional labour, provide a mechanism, which would care the staff in becoming more competent. Halligan (2005)Zara was also a victim of FGM which is defined by the World Health Organization (WHO 2006) as procedures that involve partial or total removal of the female outside(a) head-to-heads and or injury to the female genital organs for cultural or any other non-therapeutic reasons. Zara had Type IV which includes pricking , incising or piercing of the external genitalia, stretching of the button and or labia, cauterization by burning of the clitoris and surrounding tissue or any other procedure that is performed to cause vaginal narrowing or tightening, and this was why she could not give birth naturally. According to the National build of Clinical Excellence (NICE 2008) guidelines suggest that women who have experienced FGM should be identified early in the antenatal rate of flow through sensitive enquiry. I read through Zaras note but it was not recorded that she was a victim of FGM and the special care that she needed was not given.AnalysisMy communication skills were very important when I was providing care for Zara. I noticed that my non-verbal communication skills helped enormously while caring for Zara. She could understand a few words when I was asking her questions but the overleap of language hindered good communication. As the patient was not using her first or second language, I tried to beam in a way she could understand. I still could manage to communicate in a way the other staff members could not because they had not the knowledge how to communicate with someone that does not speak English. White (2005) recommended that a care supplier should learn a few words or phrases in the prevailing second language to put a patient at ease for better understanding. Although, it was quite difficult to demonstrate certain things, Zara managed to understand and she was tell me by nodding her head when she was understood and also by her body gestures and her eye movement. Zaras husband was also asking me questions that I had to make the staff aware ofAccording to Zafir et al (2000), Muslim patients should have a healthcare provider of the aforesaid(prenominal) sex. Exposure of the patients body parts should be limited to the minimum necessary, and permission should be asked before gently uncovering any part of the body. Even more care should be taken when exposing pr ivate parts, and attempts should be made to avoid such exposures unless absolutely necessary. Zaras husband did ask for a female doctor but his request was declined because the ward was very busy and it was not possible. I think if this had been included her birth plan, it would have been arranged for them Zara and her husband may have felt discriminated .If communication is a problem for one or both parties in an exchange, they will have an interest in improving it In Zaras case, the lack of time, did not permitted this. Discrimination is usually due to miscommunication however this should be lower in hospitals especially when the relationship between the medical staff and patients has been sustained for a longer period. Furthermore, the gap will be even more difficult to bridge since learning and communication are can be more costly for the hospital such as when providing a translator. Balsa et al (2003)ConclusionWriting this reflection has made me aware of my approach to car for clients who have language difficulties and have a different cultural background. Zara needed a lot of support and personalised care. It was vital to deliver this baby in a good condition due to her previous stillbirths and also, it was important to recognise that Zara and her husband came form a different culture and their value and belief were different to us.The beliefs and practices of Islamic patients may have an effect on the patients health care in ways that are not patent to many health-care professionals and policy makers internationally. Intercultural misconceptions and misunderstandings of many healthcare professionals have potential consequences. Therefore, health-care professionals need to be better equipped to meet the needs of their patients and Interpreter should of all time be available when knowing the patient does not understand. Halligan (2005).Action endMy plan for my future role as a midwife, if I ever come across a client like Zara who was not verbalise Engl ish, had dramatic birth experience and had different cultural background, I would know how to deal with it. I would prepare my self better, I would try to learn some word in her language and doing some reading regarding her culture and write down her expectations. I know that communication is a very important part to build up a good relationship. According to Payne (2007) communication and information provision play key roles in ascertain whether people engage in recommended health behaviors and whether the behaviors have a despotic outcome. Health communicators may want to achieve any of a minute of goals, including providing information, instruction or reassurance, influencing opinions and attitudes, and changing behavior. So an excellent communication is necessary in order to identify the patients wellbeing. I should not pre-judge my client by first assumption and impressions but I have to make her feel appreciated as an individual. I have also learned the splendour of listen ing because when I was listening to Zara, I was watching her gestures as the same time, even though I did not understand when she was talking, I could read her gestures. I should also able to respect their basic principles, beliefs, culture and individual means of communication.In conclusionI have used Gibbs (1998) Reflective Cycle as my support for this essay and I was able to discuss every stage in the Gibbs (1998) Reflective Cycle.REFRENCESAna I. Balsa a, Thomas G. McGuireb. (2003). Prejudice, clinical uncertainty and stereotyping. Journal of Health Economics. 22, 89-116.Aziz S. Abdul R. G. (2000). Caring for Muslim Patients. Radcliffe Medical wedge Limited, Oxford.Currer, C (1991). Understanding the mothers viewpoint. Buckingham, Open University Press.Funnel, R Koutoukidis, G and Lawrence, K (2005) Tabbners Nursing Care 4E Theory Practice, Australia Churchill Livingstone.Gibbs G. (1988). 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