Top 10 tips for student midwives

Before I get in to the nitty gritty here, I just want to set out why I wanted to write this blog post. I've been a midwife for almost 10 years. In my time as a midwife, I've supervised a lot of students clinically, and have also taught, lectured and skills-trained many more. I was also once a student midwife, many moons ago. In this time, I've seen a lot of midwifery students who were fantastic, and then some who seemed hell-bent on destructing their career before it's even begun. So here's a really quick guide to what your midwifery lecturers, educators, facilitators, preceptors and peers really want to tell you, to help you on the road to being a fantastic midwife (in a employment position of your choosing...)

Tip #1: Recognise your worth within the multidisciplinary team

How many times have I heard someone referring to themself as "just a student"? This first tip goes a long way to creating your confidence in your skills in the job - if you can believe you make a real, positive contribution to the team, then you know you belong there. Students, in my opinion, are a crucial element to healthcare. You are exposed to the latest research, best practice, have recent skills training and (hopefully) developing skills in communication, critical thinking and clinical reasoning. Hospital policies and cynicism aren't yet flowing through your blood vessels. This means you can provide a fresh approach to health care practices, you can use the evidence to justify your suggestions, and you can also 'innocently' question clinical staff if you don't understand the rationale behind their practice. In my final year of midwifery training, I was able to perform an ECG when no other midwives on the ward knew how to do this, and in another instance I recognised a problematic heart rhythm (atrial fibrillation) in a 31 weeks' pregnant patient, way before anyone else (thanks to a recent essay on that very heart rhythm!). I'm not blowing my own trumpet - it was only because of my recent exposure to these things that I was able to do this, rather than other midwives with years of experience.

Tip #2: Trust your intuition

One of the downsides to going straight from high school into university is the lack of life experience. As a fresh-faced 18 year old studying nursing and midwifery, I was terribly naive, and judgement was not something I regularly practiced. However, it meant that that uneasy feeling in my gut often got ignored (because it made me uncomfortable) rather than exploring why I was feeling that way.

In time, with more experience and thanks to recent research shedding light on community issues, I began to feel more comfortable working and communicating with women and their families. I began to understand how prevalent family violence is (and intimate partner violence, especially in pregnancy), how rife mental illness is, and so on. And I began to realise - that woman's partner who is giving me a funny feeling...something is not right there, let me explore this more (and with the right line of questions, you uncover more...).

On a slightly unrelated note, on a night shift with several awesome midwives and doctors, we were shocked to discover how many of the team working that night had met their current or previous partners online. But one of the doctors summed it up: "because of our work in healthcare, we are so skilled at that first impression, that more often than not our immediate judgements on a situation are correct. So when we meet someone online, we have a fairly accurate radar of 'this person is good for me' or not". Develop your first impression skills, and learn what your gut is telling you. Then learn to trust your instinct.

Tip #3: Treat EVERY shift as a job interview

Just like my points on judgement are not immune to this. The midwives and doctors are eyeballing you the moment you walk into the unit. Can you be trusted? What are your skills like? How much leeway should they give you? I guarantee there will be some clinical shifts where you don't give a rat's bum about being there (maybe it's day 9 of 10 for you, maybe nothing's happening, maybe it's a week of nights). But your attitude is everything and I can tell you: we remember the terrible students and the excellent students (the average ones not so make sure you are remembered for being excellent). So, how to be excellent? Arrive in time, well-prepared for your shift, but don't be over-confident. Your appearance is important - I was once buddied with an arrogant med student (I say arrogant - he insisted on doing skills that he was clearly unprepared for) who was dressed in a sweater riddled with holes. Your presentation is a representation of your attitude, and this guy was just not deserving of being present at such a vulnerable and intimate moment in a woman's life, nor the privilege of witnessing her baby's birth. Let's just say he went home early from that shift. Be enthusiastic (even if you're not), be accountable - if you make a mistake, own it and learn from it. Don't be slack, roll your eyes, and definitely don't have your phone on you (my pet peeve). I can guarantee you, poor behaviour filters back in one way or another, and things are always changing in hospitals - so the midwife you are buddied with at hospital A (where you aren't enthusiastic to be, because you want to work at hospital B) might be besties with the in-charge at hospital B, or she might get that job herself just as you are applying for grad years. I've also had numerous phone calls and emails over the years from hospital staff after they've had issues with student behaviour - trust me, it is all being noticed, so you need to go in like you're preparing to get your dream job.

Tip #4: Time management is crucial

This is a skill you must absolutely perfect. And I'm not just talking about making time plans for your 8 hour shift. I'm talking being punctual to your shift (even if it means taking an earlier train, etc). It means planning out your semesters so you are well prepared for the clinical hours and assessment tasks. It means submitting your clinical documents and assessment tasks in on time at university. To make a point, a student from many years ago failed to get employment after her course, because she has consistently been seriously late in submitting all her clinical placement documents, requirements etc. So when it came to reference checks, her referees had to be honest about this particular habit of hers, and no manager was prepared to offer her a job - they are only concerned that you are going to be registered on time, pay your fees every year, manage your clinical competencies on time and not be a liability for the unit. If you can manage your time, then time management on the ward will become second nature.

Tip #5: Work out your learning style and build on it

Of course, uni work and clinical work is synonymous with a tonne of study and learning. It can be overwhelming at times, especially when you feel out of your depth. My advice as a fellow learner and midwifery lecturer is - find out how you learn best, and use it to your advantage. Do you enjoy reading, do you find you remember things better after prac classes/lab skills, do you prefer visual things (like images, watching lectures etc) or audio (listening)? Think about your enjoyment and information retention. Then, once you've worked this out, just maximise your engagement with this medium. Watch tonnes of lectures (there's plenty online now) if you are a visual person; get stuck into midwifery texts if you prefer reading, or just visit your university lab rooms as much as possible to practice your skills if you are a hands-on person. And seek out more opportunities to build on this: join the Australian College of Midwives (they have discount student memberships) where you can gain access to e-webinars, books, online courses, conferences and so on. Talk with and work with clinical midwives during your placements who are good teachers for you, and find opportunities to learn on placement (skills sessions, workshops, case studies, seminars, study days...). By working mostly with your preferred learning style, not only will learning become easier, but your marks will likely improve and you'll optimise your practice care of women and their babies as well.

Tip #6: Free, easy marks for your uni assignments!

My students will be rolling their eyes at this one, because they're always complaining that I'm on at them for referencing, spelling and grammar problems in their assessment tasks. Yes, I'm a (not-so) closet grammar nerd, and I have high expectations when it comes to this. But in most assessment tasks, there is a decent chunk of the grade allocated to referencing/spelling/grammar. If you can learn these skills, then there's no reason you won't get full marks for this part of your work. Referencing is actually pretty easy, especially if you use an automatic referencing tool like EndNote (usually the software is available through your university's library as well). You barely have to think about referencing with EndNote! Spelling and grammar can be a little harder for some - but it's a critical (life) skill: your documentation in your clinical practice is what's going to protect you or expose you in near-miss or adverse clinical events, so it's worth developing your writing skills to ensure your written work is legible/understandable/comprehensive/concise. When you're writing, utilise the spellcheck option (but know that it's not foolproof), but also read aloud to yourself at the end (or get someone else to) - you'll hear if the grammar is not right, or if the sentence structure sounds a little awkward.

Tip #7: Be proactive

The most impressive students are the ones with initiative. They seek out opportunities to learn and improve. They use reflective practice to examine clinical incidents and their own practice to identify gaps in their knowledge or care. Likewise (and this is like tip #3), the most unimpressive students act bored, use their phone, sit at the desk/on the computer during the shift and don't ever use initiative. You should be using your time to build your competence in the role of a midwife. This means planning your time/work over the course of the shift, and anticipating changes in care. So, really think about what's happening. Are you busy helping one mum learn to breastfeed while another mum is buzzing your buddy midwife for help? Initiative would mean you offer to stay with the breastfeeding mum, while your midwife goes off to help the other mum. Offer your skills where your scope of practice and confidence allow (i.e you can't administer medication without supervision, but you can do a full postnatal check after you've been supervised with this a few times). If you are new to the unit/skills, then think more simply: you can offer to make beds/fill water jugs, help with showers/baby baths, or just simply be with woman (this is the biggest luxury of being a student midwife; you don't have a patient load so you can just be with her). You might find these tasks boring or unstimulating, but I can tell you - the midwives and the mums appreciate help where it's offered and done willingly, and it will go a long way in securing your employment in a good position.

Tip #8: Acknowledge the privilege of being with woman

I have always said, the moment that I am not enjoying the work of a midwife - it's time to leave the profession. Luckily, I adore it still (hence this website!). Being a midwife/with woman is a huge privilege. You need to recognise that not just anyone gets let in to this intimate moment of a family's life. Sometimes, women don't allow close family members into their inner circle for days or weeks after birth, but she's happy to let you (sometimes a perfect stranger) into her experience. Be grateful for this. If you don't appreciate it, move on. Anyone can catch a baby - ask the police officers or good Samaritans who catch babies at a moment's notice on the side of the road. Not just everyone can provide excellent, woman-centred care in pregnancy, labour, birth and postpartum. Respect the privilege.

Tip #9: Make sure you're a good memory

One thing I've learnt - women will remember the good and the bad of their maternity experience (but usually not the mundane, inbetween...). I know this because women my own mum's age will stop me to talk about their fantastic midwife/OB, or the senseless comment from a midwife/OB. Birth stories are littered with fantastic examples of maternity care, and also gut-wrenching, awful, embarrassing examples. Every time you interact with a woman is an opportunity where she may remember you - make sure it is for the right reasons. Many of the birth stories on this blog include student midwives - and in the majority of cases, the mums really, truly appreciated their care. It goes without saying that this point applies to already practicing midwives (and other health professionals) too!

Tip #10: Learn how to balance your life

This skill is underrated and under-discussed. Sure - we all know that work-life balance is important. But we don't teach this skill, so you need to actively discover how to achieve the right balance. Why? Because nurses and midwives are leaving the profession in droves - because they are burnt out or disillusioned. How can you stop yourself from reaching this point? Self-care is a big thing: recognise when you need some me-time and do things that bring you peace. Read a book, watch a movie, eat a block of chocolate, do yoga, do a HIIT workout, walk your dog, have a long drawn-out coffee, plan your next holiday, bake a cake or fresh loaf of bread, have a bath, burn a candle... Do whatever will relax you. Then - if you encounter a stressful situation at work, or you're feeling overwhelmed - make sure you talk with someone. If it's uni work - talk with your lecturers about your workload, I guarantee they are well-trained in managing and negotiating this! If it's happened at work - seek out a debrief with a midwife you trust. Perhaps it's a midwife you were buddied with, a preceptor, or your midwifery lecturer back at uni. Debriefing is part of reflective practice, and helps you to process and move past difficult events. Finally, work out your warning signs that things are becoming too much. These might be withdrawing, lack of interest, lack of energy, insomnia (funny how these are all synonymous with anxiety/depression/PTSD...) and take some leave to seek medical help with your GP, a uni counsellor, whatever (even a Netflix binge session over one weekend can be enough).

I hope this has been a helpful read for you - and don't forget to share with your fellow midwifery students. Please feel free to contact me privately if you want to ask questions or follow up on anything about this post. Or just drop a comment below! If you want to read more, check out the related topics below!

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