The Person-centred Podcast - We've all got a place here

In this podcast our lovely guest midwife Anne-Marie shares her story about the loss of her baby, and how that experience and subsequent experiences of having children including a person-centred birth story, contributed to her becoming a midwife.

Anne-Marie also shares how she makes sure to find those person-centred moments in her own work as a midwife, and the importance it has.

For anything mentioned in today's podcast you can find resources and support at https://www.tommys.org/

This podcast is brought to you by The Foundation of Nursing Studies and Listen Up Storytelling.

Transcript

Sheila 0:09

Hello and welcome to the Person-Centred Podcast, Stories from Nurses and Midwives. I'm Sheila McGovern from the Foundation of Nursing Studies.

Caroline 0:18

And I'm Caroline Dickson from Listen Up Storytelling.

Sheila 0:21

In this podcast, we offer nurses and midwives a space to share their stories to support professional learning, identity, well-being, and the creation of healthful workplace cultures. The podcasts are brought to you by the Foundation of Nursing Studies in collaboration with Listen Up Storytelling, and will take the form of different mini-series.

Caroline 0:44

In this first mini-series of six podcasts, stories that shape us, we will share experiences of person-centred moments in practice from nurses and midwives from across the UK, and reflect on how these experiences nurture and shape us and those we care for.

Sheila 1:02

We are very excited to welcome our guest, Anne-Marie, who is a midwife. Hello, Anne-Marie.

Anne-Marie 1:10

Hello.

Sheila 1:11

Hi. Just before we hear your story, Anne-Marie, we would like to highlight to listeners that in keeping with the NMC code and the storyteller's bill of rights, we will avoid using any identifiers of people or places.

Sheila 1:27

So Anne-Marie, it's really great to have you here. I'm really, really grateful. We're really grateful for you coming to talk to us today.

Anne-Marie 1:35

Thank you for having me.

Sheila 1:36

I wonder, um, it's always really nice to hear about people's journey into nursing or midwifery. And I wonder if you could start by just telling us a little bit about your journey into midwifery.

Anne-Marie 1:48

Yeah. So I came into midwifery a bit later in life. I was 34, I think, when I started. And it was a bit of a long journey, really. It was mainly inspired by having my own children. I'd thought about it in my early 20s, but I lost my first baby early on.

Anne-Marie 2:12

I'd thought about doing nursing or midwifery actually, but I just felt like after having that experience, I just sort of felt I couldn't do it just having that experience at the time. So I went on and did did something else. And then later on, when I had my I had my daughter about eight years later, and then my son, and particularly with my son, I had a really good, I had just had amazing care from the midwives that I looked after. No, that sorry, they looked after me.

Anne-Marie 2:54

I mean, when we're talking about person-centred care, like I really felt like they put me at the middle of everything. And I was living in a more rural area then. I'd been living in cities before. And they just ,I felt like they were listening to me, we were a team. Because I was higher risk, I was kind of liaising with the doctors a bit, and I felt sometimes like I was sort of on these pathways of care that didn't really completely fit how I felt about things and make sense really with my history. It was just, you know, high risk, therefore, this is gonna happen, but it didn't really add up. And the midwives really advocated for me with that, and we came up with plans that were safe and but not over the top, you know.

Sheila 3:43

Yeah.

Anne-Marie 3:44

So with so with my son, I had a really I had that amazing experience, and then I decided to do I'd had because of the sort of difficulties I'd had along the way, and I'd had a bit of postnatal depression with my daughter as well, and some breastfeeding problems. So I decided to volunteer and help other people. I just felt like I could use my experiences to help other people, uh, because I could understand it from that side. And then from that, I sort of, I don't know, I just had a moment of bravery, I would call it actually. Yeah.

Sheila 4:18

Yeah.

Anne-Marie 4:18

Because no one in my family is a nurse or a midwife. Yeah. I mean, they're all a bit squeamish, to be honest. So it was really like it wasn't a natural path for me, I suppose. It was, it was kind of a like, take a deep breath and and I just felt like I had to do it really. And my husband at the time said, you know, it's seems like you've just had a calling.

Sheila 4:42

Yeah, yeah.

Anne-Marie 4:43

To do it. So and I I can't believe I got on the course actually. I managed to place first time, and I I actually couldn't believe it because my background was in creative, creative sector. So got on the course, and then it was like, oh well, I'm I'm doing it now.

Sheila 4:58

That's lovely. Lovely to hear your story about your journey.

Anne-Marie 5:03

Mm-hmm. Yeah, so it's really from person-centred care that I've come to do it myself, I suppose.

Caroline 5:10

That's it's such an amazing uh story, and thank you for for your honesty in sharing that with us, Anne-Marie. I was wondering, looking back on that, can you tell us a little bit more about that teamwork that you were talking about?

Anne-Marie 5:25

Yeah, I just really I just have a really strong memory of the midwife saying, Well, she came to speak to me. So I've been in the hospital, I'd I was living almost an hour away from the nearest hospital. I'd started to have some cramps, but there was the distance that's difficult. And I work with that where I work now is quite rural as well. And we have the, you know, it can be a big, you know, it's a big thing to take into account if people have to travel a long way. And obviously in maternity, you just can't predict, you know, when things are going to happen.

Anne-Marie 5:58

So so I'd gone in and with these cramps that weren't really amounting to much, but I'd then I ended up in the hospital for about 24 hours before anything really started. But it was a bit like I well, I didn't really want to go home, really, because I was I wasn't sure, you know, yeah, if something would happen, you know, at home, and I wanted to be in I did want to be in the hospital.

Anne-Marie 6:24

So, but this midwife came on shift and she just came in to have a chat with me, and we talked about what we would do, and we decided I'd have my waters broken because it was just time's just ticking on, and I needed something to happen, and it it was a possibility. So we just talked through all of that, and I just said, and she I just remember her saying to me, We're your team, me and my husband at the time, you know, the three of us, we're a team, and we'll, you know, we're gonna do this together. And I just felt like my whole nervous system just relax.

Sheila 7:02

Wow,

Anne-Marie 7:03

Like it just felt like yeah, just it just felt like we're all we've all got a place here, like we've all got a part to play in bringing this baby into the world, and it was brilliant, it was a really good birth experience. I absolutely loved having my son, it was great.

Caroline 7:24

So, what was coming into my mind as you were talking there, Anne -Marie, was that sense of being committed to walk alongside you. But it's actually more than that. What you're saying is we're we're all equals in this relationship. And as you say, each of us is playing a part to get us to that goal. That's lovely.

Anne-Marie 7:47

Yeah.

Caroline 7:48

Yeah.

Anne-Marie 7:48

Yeah, and I didn't I didn't feel like I was being that my part in it was being downplayed because we were all equal. I just felt like, you know, we're humans, aren't we? So we need connection and we need other people. We can't really do things on our own. You know, even if someone is maybe, you know, the center of it. We work best when we're when we work in teams, I think.

Caroline 8:09

So absolutely, absolutely. So therefore the commitment to building those relationships is so important, isn't it?

Anne-Marie 8:17

Yeah, yeah, absolutely.

Sheila 8:20

And you know, what you shared about your nervous system, you know, that's such a powerful image. And and you know, the minute you said it, I thought, oh gosh, I can just imagine like your nervous system just relaxed. And that was just from from that one thing that person said, well, obviously she was she was she was doing a lot more as well, but just being able to let you know that she was part of your team.

Sheila 8:50

And I'm just thinking about what you said about connection. And I think I've just I remember a statement I think by Dr. Gabor Mate, he talked about safety is not just the absence of threat, but the presence of connection. And it feels like that connection really helped you be in a safe, feel in a safe space.

Anne-Marie 9:15

Yeah, definitely. And it helped uh my ex-husband as well, because he felt he had a role as well to play. And it wasn't just, you know, he was just sort of sitting at the side. It was like, you know, she was getting him involved as well, and showing him where he could be helpful and what he could do to help, because there is so much the birth partner can do, but sometimes it's not written about or talked about or clear, you know.

Caroline 9:45

I think we often don't pay enough attention, do we, to loved ones that are supporting people experiencing, in your case, uh having a baby or illness or disability. It can be as hard, maybe in a different way, but as hard for those supporters. It's important to to involve them. That's lovely to hear.

Anne-Marie 10:07

Yeah, and to to empower everyone and it's doing it in a way that I don't know what she was just magic. I don't know. She's doing it in a way that uh it's not like passing the buck, it's like empowering people and you know, showing how we can all help together, not trying to just sort of pass things over as well if that makes sense.

Caroline 10:28

Was there anything about her body language do you think that made her stand out?

Anne-Marie 10:32

Yeah, I mean she was she was quite relaxed. I remember her sort of sitting on the bed, which you're not really meant to do, but I just remember her sitting there. And then I was quite active during that birth, and she just sort of got the mat got the mats down, and I remember like holding on to her trousers at one point, like quite tightly. You know, she must have been in and out of the room a little bit and she must have been documenting and stuff like that. But I just I remember being quite present.

Caroline 11:00

That's the art of nursing, isn't it? Being present, fully present, or sympathetic presence, as McCormick and McCance would talk about with your whole self, but equally juggling the practicalities that need to be attended to in order for you to have the experience that you have. So being person centred is not about not doing the practicalities, but it's about being efficient with them and knowing what's right in the moment.

Anne-Marie 11:31

Yeah, and I mean that can be very difficult, and you know, sometimes it all comes together and you know, my birth fitted in with her shift and stuff like that. You know, there's lots of elements that come together that mean was a good experience for me. But she, I mean, actually, I saw I bumped into her at a conference a few years later, and she didn't remember me at all, but she wouldn't, but she was she was like still really. I said, Oh, it's the best. Um, it was just you know, you really inspired me to come and do this. And she her boss was there and she was like, You listening?

Sheila 12:06

Lovely.

Anne-Marie 12:07

So she was chuffed, but yeah, you know, she I don't know, you know, if I'm gonna talk about my experience as a midwife. There might be moments that other people would remember that I as a practitioner, you it's it's hard to gauge sometimes, you know, especially with birth, people are in a really vulnerable and painful and they're not their normal selves really. So it can be difficult to judge in the moment whether they have felt that connection or not.

Caroline 12:36

I think what you're saying is that in these relationships that we have with others, we leave something of ourselves with the other, don't we? As we go and that can be a really positive thing, as in your case. But it also can be less positive. You know, it's that old adage, people remember not what you do, but actually how you make them feel.

Anne-Marie 12:59

Yeah, and you know, it I think what I was getting at as well is you know, the same person on a different day or in a different situation, it can be, you know, very difficult. And I've had friends, well, it's an it's you know, if you're talking about your doctor even or something, and you say, Oh, I really love that doctor, and your friend says, Oh, but she said this, or I didn't like that, or you know, it's like it just and you just wonder, is it that they've just not gelled it as in their personalities, or is it that caught them on a bad day, or we're people as well, you know, and we all have bad days as well.

Caroline 13:36

You also said that um the midwife was there, it's it coincided with her shift, so you you know, in a sense, you everybody was lucky that that happened, and the context matters, doesn't it? Because if you had had a change of shift and then maybe somebody was pulled away and what have you, then that would really impact on your experience as well. Yeah, wouldn't it? So in order to be person -centred, the context needs to help you to to be person -centred. It's it's quite difficult. It's difficult in uh in a context where it either doesn't privilege that or shortages that we hear about impact so much that uh it has a negative impact on care.

Anne-Marie 14:24

Yeah, absolutely. Yeah, time and like you're talking about the practicalities. I mean, especially during co I mean I qualified during COVID and it was oh it was very, very difficult because you had all the extra practicalities on top of being newly qualified and trying to learn everything from scratch. Well, not from scratch because you've trained, but actually I went to a new unit when I qualified. So you know, it was a lot of different things all happening at once, and and it can be hard to build those connections when you've got all so many barriers in the way, as in time, masks, new rules that nobody's happy with.

Anne-Marie 15:11

In my case, not being familiar with my colleagues really, because it was a new area. So a lot of person-centred care, I think, is built on trust, and trust takes time, and it was a very difficult time to be able to try and build that. And you've got fresh energy, I suppose, when you're newly qualified, so you've got that on your side.

Sheila 15:32

Yeah.

Anne-Marie 15:34

So I definitely, you know, had experiences of connections, but wasn't easy. It wasn't easy.

Sheila 15:41

Do you do you want to tell us because you've told us beautifully, really, about person-centred moments, you know, we were going to have a chat about that, but do you want to share with us any person-centred moments that you've had as as a midwife with the people you care for?

Anne-Marie 15:56

Yeah, I've done I have worked in a in a few rural areas.

Sheila 16:02

Yeah.

Anne-Marie 16:03

And I have found that in those areas, because obviously there's less people, the midwives and you know, all the healthcare professionals really are a bit more integrated in the community. So there's more connections sort of out with the hospital. Whereas in the cities where I've worked, you're a bit more anonymous.

Anne-Marie 16:23

I've found working in rural areas that continuity is a little bit easier and happens a bit more naturally and is a bit more achievable. So during my when I was a student, I did a continuity block and looked after someone throughout their pregnancy who's having twins. And she was amazing. It was just lovely to see her through the journey. And she needed to go to a city hospital to have the babies, and I was living close to this city, so I was able to meet her there and be a familiar face, yeah, and see her afterwards as well. And you know, my experience of of labour care up until that point had been you're just there for the labour, and then you pass someone over to you know, the ward or whatever. But I was able to, it was really nice.

Anne-Marie 17:18

I struggled with that as a student, not knowing what happened to them. And you know, as a student, it's great because you are a bit more free because you're not counted in the numbers or whatever. You can you can have that time and freedom to build those connections. So that felt really good. I never I'll never forget that.

Sheila 17:35

I can hear it actually in your voice, the way that you had that connection when you're talking about her. How do you see these person-centred moments? How how have and do they shape you as a midwife?

Anne-Marie 17:50

Well, they keep you going.

Sheila 17:52

Yeah.

Anne-Marie 17:53

I mean they it feels really good when you've feel like you've, it's like when you meet someone and you kind of hit it off. And you know that feeling you get of when you feel like you get each other, yeah. And you come away feeling like, oh, I had such a good, you know, I'm just talking about a normal life now, you know, you feel like, oh, I just had such a good conversation with that person, or I really got them, or I understood them, and you know, maybe you've made each other feel better or brightened each other day, and it's it's the same feeling of you just feel like you've made a difference and you feel like you've helped someone be understood.

Anne-Marie 18:37

That you've been able to either deliver on that, so it's when you've got time, you like some people need all different things, and sometimes people, you know, there's been times when you know, if people are having a preterm birth, they their babies might be going to neonatal or something like that. And when you get, you know, when they've been shown round the hospital or or you've just said something or done something that's put their mind at ease, or you know, they've been saying something for ages and and maybe no one's quite got what they what they want, and actually they needed you to read the whole guideline out to them so that they can make a decision about something, or something like that.

Anne-Marie 19:19

You can you can sort of feel it, you know, you can see it in their face when they're it's resolved. You've helped them resolve something. So or you or you or sometimes you know you've helped them understand something from your point of view, you know, they just can't understand why why they can't have something or do something, or you know, why something isn't gonna work.

Sheila 19:42

Yeah.

Anne-Marie 19:42

Um, and you've kind of been able to really sit and have a chat and explain and come up with a solution with them that is realistic.

Caroline 19:52

Yeah, it sounds very satisfying.

Anne-Marie 19:54

It's satisfying, yeah. Yeah.

Caroline 19:57

How's that that you get a sense of satisfaction from that connection and seeing the other? I was um thinking about when you were talking about you observing in others, what you experience when you said, you know, your nervous system will uh settle down, uh, that it sounds like you're witnessing that during this.

Anne-Marie 20:19

Well when I do, great, yeah. I think a lot of it is communication as well. You can have the most horrific scenario, but uh it's that whole thing is from your side, it looks like you know, someone might have had the most smooth, what you think is the most smooth experience, and they've had a really, you know, may found it really traumatic or something. And then you have one where you've thought, God, that was touch and go, that was really, you know, what an awful thing to go through. And then because you've managed to build that connection or communicate, or you know, everyone's worked together really efficiently, the teams work together really well, the person just is able to process it better and sometimes even doesn't even realise the enormity of what's what's happened, even though they know exactly what's happened, you've told them, but you've communicated that people like they do like to know what's what's happening, don't they?

Anne-Marie 21:17

They you know you have to really they have to have some element of well, it's trust and connection and and some people like more control over things than others, but yeah, some people just want you to not talk and get on with it.

Sheila 21:31

Yeah .

Anne-Marie 21:31

But again, it's trying to tailor it to them. And again, it's continuity does help with that isn't if you you know it's not always possible, it's not always realistic to have continuity models, but having some form of continuity, and for us, we try and keep that within a shift. Yeah. And most places I've worked as a midwife, we've we try, it's not always possible because of the skill mix and everything, but try and keep. At least the same with the same person throughout a shift. So I think that helps.

Caroline 22:06

So if others are experiencing that sense of satisfaction that you describe because you're trying to promote that that sense of continuity, that has to be a good thing, right? Because we're hearing now that the shortage of nurses and midwives, well, it's not really that at all. It's it's more or short of places that nurses and midwives want to work. So we need to be creating these environments that promote person-centred moments. And I was really wondering how do you do that?

Anne-Marie 22:40

You know, it's a hard job and it does, it's tiring with the shift work and night shifts, and you know, it really it's a whole lifestyle. So it does influence your your whole life.

Anne-Marie 22:55

Occasionally, you know, stepping back and just thinking about what it is you're doing and trying to sort of centre yourself. I think that helps. I was thinking it was International Day of the Midwife yesterday. So I did actually have a bit of a reflective day yesterday. I thought, and I found my I got one of my old laptops working as well, and I found my old dissertation from uni. So I was reading that recently as well.

Sheila 23:22

Lovely,

Anne-Marie 23:24

You know, I was feeling a bit like gosh, I haven't read anything properly for a long time. And I think I think that helps to, you know, when you when when you feel inspired again, that helps to inspire others. And when you look back and, you know, just doing this and being able to focus, focus on the good things, yeah, uh, and bring it back to what it's all about is is like massively helpful because then you think about why you're doing it, because because like I say, you know, in some hospitals you don't see anyone ever again, you don't actually know what kind of impact you've had on somebody unless they send you a card. And you know, whether someone sends you a card or not isn't, I mean, those moments are great.

Anne-Marie 24:10

They're really it's really wonderful when when somebody acknowledges that, but you totally understand why you wouldn't, you know, you're so busy when you have your baby, what you know, to take the time to do that is difficult, you know. Um I wouldn't expect it of anyone at all. Um I don't I don't know that I even I don't think I did. Just think next thing, so let's say it's it can be hard to it can be hard to know.

Sheila 24:38

You might not have got to send in a card, but you got to to meet that lovely midwife at the conference and tell her, which was lovely.

Anne-Marie 24:45

I know. Yeah, that was good. That was good.

Caroline 24:48

No, it's funny when that happens, isn't it?

Anne-Marie 24:50

You know, students, it's great working with students. I'm a practice assessor, so I work with students a little bit, and that I mean I find that really helpful because you're you're saying things out loud so as you're explaining to them and you want them to be inspired. So you look for the positives and you're talking through you know, conversations that you've had with with the woman and the family and person. So I think that helps.

Caroline 25:19

Do you think we um have enough spaces? We create enough spaces in the ward for the team to come around and think about what's going really well, you know, so that you maintain that sense of inspiration.

Anne-Marie 25:34

I think it depends where you work. I was a student in a lot of different places and saw how different places work and where I work now. There's a lot of midwives working extremely hard to create good cultures. And I mean, I can't think of anywhere I've worked where it's really bad.

Anne-Marie 25:56

Y ou know, I've on the whole, if not always found midwives to be very enthusiastic and caring. And I don't know if it's something about the fact that we're autonomous or something, you know, we're like we have to own it. We have to own what we're doing, and we can deliver a whole episode of care with with no medical input at all. I mean, it's getting rarer and rarer, and we work really well with our medical colleagues.

Anne-Marie 26:28

I think where I work, there's a strong sense of coming together and spaces where things are celebrated, which I think is is really good. Sometimes, you know, there might not be time for all the supervision that you want and stuff, but I think people are trying. I do think people are trying.

Caroline 26:49

Yeah. Thank you so much, Anne-Marie. That sounds like a really great place to stop.

Sheila 26:56

Amazing. It's been lovely hearing your your story, Anne-Marie, and lovely to have a midwife.

Caroline 27:03

Oh, that's fantastic. And you've through your stories, you you really have talked about how they they shaped you as a human being and that that sense that you know nursing is a kind of lifestyle choice and one not to be taken lightly.

Caroline 27:19

But you've made us really think about the importance of teamwork, working as a team with patients and and their loved ones and walking alongside them and building that kind of trusting relationship. So continuity for you is is really important as well as communication, but also thinking about the context and what can we do with the context in order to enable everybody to experience these person-centred moments. So there's loads there for us to take away and ponder. And once again, thank you so much, Anne-Marie.

Anne-Marie 27:57

Well, thank you for having me.

Sheila 27:59

Thank you, Anne-Marie. Take care.

Anne-Marie 28:01

Thank you. Thank you. Bye.

Caroline 28:04

What stories do you have that shape you? What learning can you take away and ponder before we meet next time? We look forward to seeing you then. Bye.

Sheila 28:16

Bye bye.