Wray, J

English

University of Salford Institutional Repository

4 April 2008 THE PRACTISING MIDWIFE ■ VOLUME 11 NUMBER 4Comment Julie WrayI visited a local NHS Trust recently and Iwas immediately struck by thefriendliness of  the staff  on arrival andthroughout my stay. Without exception, thestaff  I met wore smiles, were courteous,helpful and looked happy to be at work. Thewarm atmosphere was refreshing andpowerful; for too long now I have dreadedvisiting hospitals but on this day it was apleasure. I discovered later that the Trust ran ascheme called ‘Being a patient’ – a kind of  training programme that emphasises the need to consider the patient at the heart of  their work. In other words, thescheme enforces the explicit message that everyone is a potential patient andservice user. The scheme involves every member ofstaff, from porters to managers, andembraces a patient-centred philosophy. Onthe one hand this programme could beinterpreted as a PR strategy and has all thehallmarks of  a Disney or McDonald’sapproach to business acumen. Yet on the other hand it could be viewed as apositive and humanistic move. By treating all staff  equally, the message is that they are cared for, valued and,moreover, that they genuinely care about patients and their experience. This ethos reminded me of  those all-important early lessons during mytraining days, way back in the 1970s. The notion of  being a patient and caring for a loved one was engrained from day one. These values were consolidated during my midwifery training wherewoman-centredness was promoted and practised.  I recognise that in large organisationssuch as the NHS it is challenging to achieve a culture that values the patient and creates an ambience of  caring andrespect for one another, irrespective of  who you are. Putting the patient at thecentre should be a reality and not rhetoric. Iknow that in theory most midwives aim to do this, with the grounded mantra of‘woman-centeredness’ philosophy. But this is not happening consistently on a day-to-day basis and I wonder why. Time to listenTime – or the lack of  it – and busyness due tothe sheer weight and volume of  work are themost frequently quoted factors thatmidwives claim deters them from being withwomen and practising woman-centeredness. A recent comment made tome by a busy and tired midwife illustrates agood point:It is luxury these days to be able to sit with awoman and simply chat and talk to her in arelaxed way… I miss this aspect of  my work butit [talking] is not valued as real work anymore.Have we really lost those opportunities tointeract with women by talking andlistening?Feelings towards babiesA further dimension in this debate is thevalue and emphasis on the baby and, morebroadly, the family. I wonder whether themidwives consider the baby as a patient orservice user? The answer to this question israther complex and I imagine variousresponses would emerge. People sometimes ask me: “Do midwivesneed to like babies?” I was once asked bysomeone who was considering midwiferytraining whether it was an imperative to likebabies. This made me think about how oftenI heard midwives say that they preferred tocare for women rather than the babies. Ofcourse this anecdotal view may not be a truereflection for the majority of  midwives. Butthinking about the value that is placed uponthe baby as a person and individual I am notsure how, and if, the ethos of  ‘being apatient’ translates across. Is it the case thatthe midwifery profession relies on themother to interact with the baby and engage with the baby as a person? Certainly,for  babies who are sick and cared for on aneonatal intensive care and special careunit, different issues apply. But how do weview the well baby in our care andinteractions? I think this debate could befascinating and your views and commentsabout this are very welcome. A private matterAnother issue that intrigues me is how weaddress the baby’s privacy and dignity.During a period of  fieldwork on postnatalwards (Wray 2006) I noted that somemothers screen the bed to ensure privacy fortheir baby, especially during nappychanging and feeding. However, onneonatal intensive care and special careunits, privacy and dignity are managed (ornot) in different ways. Babies are oftennursed in the nude and on public display. Isthis right?To return to my original discussion on ‘being a patient’ in midwifery with all its complexities and skills, are wegenuinely baby friendly (and I’m not talking about breastfeeding)? Is it time to re-evaluate our values and beliefs inrelation to the baby? TPMJulie Wray is Lecturer/Research Fellow,School of Nursing, University of Salford Valuing mothers – and babies, tooBy treating all staffequally, the messageis that they are caredfor, valued and,moreover, that theygenuinely care aboutpatients and theirexperienceREFERENCESWray J (2006). ‘Seeking to explore whatmatters to women about postnatal care’.British Journal of Midwifery, 17 (5): 204-208.TPM april 08 v3_TPM feb 08   20/05/2011  08:50  Page 4

Valuing mothers - and babies too

Seeking to explore what matters to women about postnatal care’.

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Valuing mothers - and babies too

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