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Resilience: Showing strength in the face of adversity #usmsconf17

Here are a few pictures and thoughts shared from the @ussumidwifery ‏ conference ‘Resilience: Showing strength in the face of adversity ‘… Thank you to everyone who came to see the great speakers at this conference. It was a great honour to present my work alongside some of the wonderful researchers listed on this programme…Having spoken at many conferences, I can also say that these student midwives really know how to look after their guests….Thank you  and ..❤🎓😍

Taken from The knitted midwife’s blog: ‘The Royal College of Midwives has highlighted that the UK is still short of 3500 midwives.  This is an update to the published report here.  The update to the report can be seen here. Whilst this is an improvement on the 5000 midwives needed three years ago, this chronic shortage adds to the pressures that midwives are facing every day in their working environment.  Additionally there is a ‘retirement time bomb’ as over a third of the current midwifery workforce is aged 50 or over.’…these knitted midwives represent the midwives missing from the workforce.

All of the speakers at this conference were indeed inspiring, but one message seemed to remain strong throughout…

”BUILD a tribe – don’t wait to find one’ – Prof Mavis Kirkham

Reminds me of the #Findyourflock story last year

We also had  from tell us to “find our tribe”

😊💛

One of the most inspiring parts of the day was seeing student midwife Hannah Cook get a standing ovation at … the future of midwifery is bright…..She will be re presenting her talk at this year’s  awards conference….If you can….get there!

✨

I too feel as if being a midwife is what I am…I also feel that it is written through me like a piece of rock. It is my professional identity. But having resilience as a midwife is not about ‘toughening up’ as  puts it…..

I am not even sure if resilience is the right word for what we are talking about here… Resilience is not a magic pill!

💊💉🌡

The most interesting conversations of the day in my opinion were around the ethics of caring for midwives, and bullying. There is still so much more to do….and I still see uncaring behaviors taking place. Are we an insecure profession?…trying that much harder to prove ourselves?…or are we embittered by another pill too difficult to swallow?…one this is for sure…

Image result for wrong is wrong quotes

This day gave me the chance to meet with and listen to some of my research heroes…Thank you to everyone who engaged in my presentation and to those who continue to engage as my work as it continues…

#usmsconf17

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤

 

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‘Making & Breaking the Maternity Experience’#Uclhmw2016 – A midwifery conference

Attending and presenting work on midwife wellbeing at , I was thrilled to see so much of one conference dedicated to supporting the midwife, as well as the mother. I was also keen to hear  Jacqui Dunkley-Bent update us all on the new plans for maternity services in 2017! – Bring it on!

-Improvement in Perinatal mental health in maternity services was highest on the agenda as we can see here – midwives were really responsive to making these a commitments a reality.

Yet we can see that NHS England is also looking to transform the workforce as part of this plan. There are so many ideas buzzing around my head at the moment that I am feeling dizzy… “so much to do and so little time” – As Willy Wonka would say.

We also saw how mothers are experiencing poor support in decision making…

Both  and  really must be heard by all midwives, everywhere, more often! Read more about these experiences here. …and here.

Women are roaring for change!

Christine Armstrong

There are so many great resources available from dignity in childbirth … We really need to challenge the way that women experience respect in maternity care.

And the #CaringForYou campaign?

Sadly, bullying still a real issue in midwifery, as  confirmed … punity, public shaming & undermining must stop.. We must be kinder to one another…remember why we became midwives in the first place and love each other for the critical safety of mothers and their babies.

…..more ❤️ is needed!

We must ‘Create a positive culture’ –   says at 

What can we do?

There is indeed much to be done. I wanted to personally thank , and @MaureenMcCabe15 (and their teams) for looking after me so well as a speaker at this conference myself. I have never been so well looked after at a conference 😘😍

And thank you to all of those who appreciated my presentation and engaged in this very important work. I love this particular image that people have been sending me (see below)…I believe it was created at the#BirthTrauma2016 conference & shares a powerful message 💜💙💚

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There really is so much to do and so little time!

Image result for so much to do and so little time willy wonka

As a last thought introduced to us by Sheena Byrom ‘Midwives are humming birds never too small to make a difference’

Until next time – Take care of yourselves & each other ❤💚💙💛

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💚💜❤Preventing Birth Trauma at #artofbirth16💚💜❤

Recently, I was asked by Dr. Gloria Esegbona from the @art_of_birth to share some of my thoughts on birth trauma at the latest  summit at Kings College London. My first thought, as always was…. do you mean physical? or psychological?… I was assured that her latest event would be addressing both. Time to learn & grow 💚💜❤

art-of-birth-event-with-sally-pezaro-2016

And so how can we as midwives prevent physical birth trauma?

“we can reduce ventouse to and with left lateral & slow head delivery

“Preventable physical to & caused by poor positions and outdated pushing practices

Quiz – Which methods of pushing during vaginal delivery and pelvic floor relate to which perineal outcomes?

(No peeking at the link to get the answers first!)

#Discuss #GetYourGeekOn

Methods:
-open-glottis technique?
-Valsalva pushing?
———————-
Outcomes:
-incidence of instrumental and cesarean delivery?
-incidence of postpartum hemorrhage?
-urinary incontinence
-Episiotomy rates?
-maternal satisfaction?
-fetal heart rate (FHR) abnormalities?
-Apgar score?

No peeking at the answers link before you comment/answer below!

(We are still awaiting more evidence in any case)!

The Art of Birth is promoting art in the science of to prevent #birthtrauma 

And so what about the psychological trauma and the 2nd victim…the midwife?

Can we begin to understand women’s experiences in relation to psychological birth trauma? How do we revisit the language we use during birth? Can we all be more compassionate in our practice?

I was quoted on this day when talking about “superhero midwives” – healthy, well-supported lead to healthy, well-supported mums. …It is true…so many people wanting to do good….some burning out. Some traumatised.

I thank you all for hearing about my work on the wellbeing of midwives in the workplace.

I had some really great panel questions too…What I loved most about this conference was that I managed to receive lots of  and create  with so many inspiring midwives, doulas, students and others wanting to support each other, share and learn  💚💜❤.. I can’t wait to see some of you in the near future and learn more about how you have turned these lessons into practice. 💚💜❤

Until next time – look after yourselves and each other #GetYourGeekOn 💚💜❤

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Following #Expo16NHS..I could be replaced… ‘technically’

And so another NHS Expo conference comes to an end. It was a lively 2 days with lots of amazing people coming together to share new ideas about the future of health and social care.

The conference was largely dominated by the digital and technical innovations that may help to create the NHS of the future (and make it better presumably)… I have always been interested in how technology may make a variety of health care improvements…I have written about one of my ideas here.

Sir @DrBruceKeogh providing a broad outline on recent ground breaking digital innovations

The digital news as reported by @keithgrimes was as follows:

  • Patients will be able to book appointments, order medications, and download records, US ‘Blue Button’ style, on a revamped http://www.nhs.uk to be launched at Expo 2017.
  • Anyone will be able to access detailed stats on performance in key areas such as dementia, diabetes, and learning disabilities
  • There will be online access to 111, which can lead to direct appointment, signposting, or callbacks.
  • By March 2017 there will be a directory of approved apps from March 2017, with subsequent support for wearables
  • 12 hospitals to become “Digital Exemplars” – each receiving £10m funding, matched by trust, and partnering with world leader organisations.
  • The creation of a second round of ‘national’ excellence centres, with more detail to follow.
  • The creation of an NHS Digital Academy to teach Informatics skills to NHS staff and create the next generation of Clinical Chief Information Officers and Digital Health Leaders.

And for more digital ideas….

MY DIGITAL FOOD FOR THOUGHT…

Often, whilst working clinically as a midwife, I also find myself behaving like a robot… (Don’t worry… I obviously use my gut and intuition too)!…but really, as midwives we are calculating risk at all times….like a computer. Also…we follow certain pathways as midwives…if a blood pressure becomes out of range…we take the next prescribed step in making a referral or delivering a new treatment to fix it. A computer could do this.

Imagine a woman coming into a clinic to see a robot (of sorts). She is scanned, measured and given the full M.O.T that she would normally receive from a midwife, but it is the robot who calculates the risks and the next steps to take. At the end of the exam.. the robot gives the woman a print out report, which outlines what should be done next in light of any new findings. The robot can answer questions too…

…(hopefully better than google can)

…or it can tap into a Skype call with a registered health professional. Imagine a future like this..better or worse? In a pressured maternity service, this could indeed be the new way of things. Could I be replaced as a midwife?…’technically’?

I think not. But a digital future like this could certainly support midwives in practice. Would it be safer? are human errors more common than digital ones?… Certainly worth exploring I think.

What do women want from their midwife? A human face? compassion? Human touch?…None of these could be delivered by a robot (probably)… and so perhaps a digital future like this would afford midwives more time to be compassionate and ‘human’..

MOVING ON…

Also at Expo.. there was @roylilley….with @JaneMCummings

Singing ‘Always look on the bright side of life…’

🌅🌻⭐️👀🙊👍

Obviously they were doing this to celebrate and introduce 

..not far away now (19th October 2016)

And we also heard more singing as we enjoyed a very moving rendition of “I will try to fix you”…

💉💐💊🏥🚑

By the @NHSChoir for the  at

from with bonus live sessions from

My colleagues and I also presented our #ShowsWorkplaceCompassion research for the first time and some of the other work we have been doing in partnership with @NHSEngland to commission for a positive staff experience. Thank you to everyone who came along and shared thoughts and ideas to help us shape this project.

I was also invited to join sessions on the

Maternity Transformation programme: Delivering the 2020 Vision at #Expo16NHS #MatImp #MatExp #BetterBirths #BUMP

and the …

@empathymuseum at #Expo16NHS #WalkAMileInMyShoes via @HealthFdn.

Click the links to read more….

Next year, I hope to be sharing more research and ideas. No doubt I will still be on my quest to improve the staff experience within health and social care..after all… patient experience and staff experience are both sides of the same coin..

2-sides-of-the-same-coin

See the Twitter activity from#Expo16NHS here

Until next time…be kind to yourselves, and eachother 💛💙💜💚❤

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Reflections from a session in the @empathymuseum at #Expo16NHS #WalkAMileInMyShoes via @HealthFdn

One of the best things I experienced at this years NHS Expo 2016 was the @empathymuseum …where I was invited to #WalkAMileInMyShoes via the @HealthFdn. It was rather strange to be invited into a giant shoe box, but nevertheless… Just like Alice in Wonderland I found myself uttering….’curiouser and curiouser’..

As I wondered in to the cozy shoe box to sit on the sofa, I was asked to put on a pair of shoes.. Theatre shoes…(See below)…

I walked around and listened via headphones to the man who had kindly donated his shoes and his story to this project. He was a specialist nurse working in A & E. He spoke about how he had to face the reality of death at work every day. Not only did he have to do this, he then also had to engage loved ones and relatives in incredibly difficult conversations and help them to make the best decisions in the darkest hours.

This nurse was able to celebrate the incredible gifts people were able to give as organ doners, and see joy in how a family was able to see a part of their departed loved ones go on… All of this was very uplifting…and there was no doubt in my mind that this nurse was indeed a superb example of the profession. However…as I walked on…I found my self wondering whether anyone asked the nurse how he was? How long could he maintain this uplifting approach whilst dealing with death and emotional pain on a daily basis? Would cracks start to appear?

I often see examples of how we celebrate this service and self sacrifice…and to nearly quote Paul Simon… every generation throws healthcare hero up the award charts!.. and so we celebrate this eternal culture of giving. I certainly empathize with this nurse, and greatly admired his approach to his work… He is a hero..but he is also very vulnerable, both psychologically and physically as he continues to give all of himself to provide the best service possible.

My worry is that the more we place service and sacrifice upon a pedestal…the further our heroes have to fall…

 

As you can see from the film above…this really is an amazing and thought provoking project, as those who visit are asked to write messages to those they now share a new found empathy with.

I would have liked to have walked a mile in all of these shoes…and perhaps some day I will have time to…as you can soon also experience this project online here. So as a lasting thought on this amazing project…I would like to repeat my mantra…which is…always be kind to yourselves… and each other….

Until next time 💛💙💜💚❤

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Round up summary blog of the Digital Health and Care Congress at @TheKingsFund #kfdigital16

#KFdigital16 Sally Pezaro

What does digital future look like?  I have spent this last week at @TheKingsFund enjoying the Digital health and Care Congress or

Presentations from (5/6 July) at available here

Twitter transcript here

Presentations available here

This was a detailed and busy conference, and probably the one I have enjoyed most so far! Everyone was really friendly and engaging…I also enjoyed the best audience I have seen in a while…It was too detailed and complex to outline everything within this blog post, so I will just highlight a few of my favourite moments below.

I was enamored by the work being done at Guy’s and St Thomas’ (@GSTTnhs) with the DrDoctor app…Guy’s and St Thomas’ had a challenge around DNA rates and patient engagement. They worked with DrDoctor to deliver improved clinic efficiency and better patient experience in outpatients, dropping DNA rates by 40% and saving hundreds of thousands of pounds in a matter of months. This really is exciting when you think of the implications for other acute areas.

DrDoctor (@DrDoctorApp)

DrDoctor helps patients talk to the NHS. Manage care online. Better outcomes and productivity for hospitals, better experience for patients. See the video below to see how they do this…

Thinking of my own project in developing an online intervention, I was also really interested to see the work of  The online mindfulness course. These guys really did have some impressive outcomes to share, which was great learning for me as I look to harness the best components of online support.

Stats below:

Also, thinking about my own midwifery work, it was great to see new online connections being made in the world of safeguarding and child protection with CP-IS services  allow multiple alerts to come up in acute areas of hospital trusts when a child enters the services who is deemed to be ‘at risk’. This means that clinicians over a wide geographical area can work together and save every child before they fall through the net.

#kfdigital16 2

Also in relation to my midwifery work, it was wonderful to see that one of the top 10 priorities of the Kings Fund is to provide integrated support for perinatal health. Doing this digitally will make this process so much more effective I’m sure…

#kfdigital16 7

I also very much enjoyed speaking to the iaptus team, who have created a patient management and reporting solution for psychological therapists providing cognitive behavioural therapy (CBT) and other related treatments. Great that this service can now move towards the digital age…

#kfdigital16 1

I also wanted to introduce you all to ClinTouch: A mobile support technology for people with psychosis

@clin_touch

ClinTouch: Is a mobile support technology for people with psychosis

University of Manchester • clintouch.com

#kfdigital16 6

As we introduce new technology to patients, clinical staff often have preconceived ideas of how new interventions will impact upon the patient. This is what found in practice..This really highlights the what we perceive to be true as health professionals often is not the reality of the situations. Our patients can surprise us everyday, and we must always remain open to finding new ways to support them to use technology in health care as it emerges.

Lastly, we were introduced to the Caldicott review, and the national data guardian’s data security standards by Dame Fiona Caldicott ( National Data Guardian) …

Following this review.. an Independent patient data task force was announced The new task force will build on the work of the Caldicott review. It will be really interesting to see how this work develops…

Research into public attitudes towards commercial organisations accessing health data showed that people tended to accept others accessing their health data when it was clear that there was a public benefit. It also mattered who the organisation was, what kind of data was used and how it was being protected from misuse.

As the ‘NHS to scrap single database of patients’ medical details’ – We need to look at new ways to keep data secure and use it wisely and ethically…But what resources will be provided to help clinicians and staff have the difficult conversion with patients about the opt-out/opt-in options?? – A challenge awaits…

Fiona Caldicott kfdigital16

You can hear Dame Fiona Caldicott ( National Data Guardian) in the video below speaking about the Caldicott review….

Chris Ham

I also wanted to thank Chris Ham (@profchrisham) for announcing me as the winner of this fabuolus Fortnum and Masons hamper (devoured over this weekend). Apparently I was the most engaged with the conference app. This is what you get for being a social media geek ☺

hamper

The most poignant phrase put forward at this conference for me was that “People often have a warmer relationship with their smartphone than their psychiatrist” – This was said by Prof Shone Lewis at 

And lastly, for anyone who is too busy, or reluctant to change and embrace new technology in health care…remember….You may be standing in the way of vital improvements to make your working lives easier and your patients experience of care much better….

Let’s make sure we are all life long learners who are never too busy to improve..

Until next time – Take care of yourselves and each other…

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The #WoundedHealer a reflection on #resilience #empathy #Support & #compassion in the #NHS workforce

Last week I attended the Wounded Healer – Helping Each Other to Care in the Modern Health Service conference on Tuesday 15th September 2015. I have a certificate to prove it and everything 🙂

I have spent the whole week reflecting on this conference, which brought together many experts who are passionate about exploring the plights of the wounded healer, and supporting those in need to care compassionately in challenging healthcare workplaces. There were also many who shared their own experiences of being a wounded healer (Including me)! Many had left the profession, moved to another part of the profession, or were still struggling to cope in challenging times. These stories were powerful, moving and also uplifting, as we also heard many stories of recovery. The main challenge of the day was of course focused upon finding new ways to help each other in practice to care compassionately in the way we all want to when we enter the health profession as ‘eager & excited puppies’ wanting to change the world.

This conference was facilitated by the practitioners health programme (PHP). The NHS Practitioner Health Programme is an award winning, free and confidential NHS service for doctors and dentists with issues relating to a mental or physical health concern or addiction problem, in particular where these might affect their work. The conference was also led by the Medical Director of the PHP, Dr Clare Gerada (). Clare is one of the advisors to my own research project, and I always draw so much strength from her knowledge, passion and wisdom. I am sure I will be consulting clare again once my Delphi Study has drawn its conclusions.

One of the highlights for me was meeting Professor Jill Maben, Director of the National Nursing Research Unit at Kings College London. Her work focuses upon the workforce issues facing today’s nursing populations (). Jill disclosed that she had left clinical practice as a result of unhealthy levels of stress in the workplace. She outlined to all of us her own work in discovering how new nursing students are indeed ‘eager & excited puppies’ wanting to change the world. These students quickly then realize that these dreams may never become a reality in the current working cultures of the NHS. As a result, they may choose to give preferential treatment to ‘favored’ patients or ‘poppets’ (Maben et al, 2007). I myself was privileged to finally make contact with such an inspiring research team.

We also heard from Professor Ivan Robertson, Mr Julian Lousada, Mr John Ballatt & Dr Penny Campling who all spoke about the importance of intelligent kindness, compassion for one another in the workplace and about how challenging workplace behavior may actually indicate a deeper pain. How do we cope? Do we deflect our pain on to others?

My thoughts were “Unkind people are unhappy people” and perhaps this is why we are seeing a lack of compassion between colleagues in the workplace. Those who display adverse behaviors need support too. There were certainly some stories of challenging workplace behaviors that suggest that this might be the case.

It was suggested that NHS staff enjoy hard work in their profession of choice. But this demanding work is only satisfying if it is matched by adequate support, resources and control.

This was followed by reflective sessions where professionals shared their own experiences, suggested advice for others and new forms of support. I think I was the only midwife there, and I am still concerned that there is little focus placed upon the well being of other nursing professions. I always find it cathartic to reflect among my own kind. I may have been the only midwife, but we are all one big professional family. This is my tribe. The people that understand and can empathize with the wounded healer. I hope that our insights can propagate among those who need it most.

The workshops that followed included:

Dr Derek Chase – Mindfulness and its Benefits

Dr Jane Marshall- The Addicted Professional

Dr Caroline Elton – Under the White Coat

Dr Peter Ilves and Mr Nigel Praities – GP’s, Resilience and Burnout

Mr Gary Marson, Dr Clare Gerada and Ms Pip Hardy – The Wounded Healer

Ms Debbie Sandford – Schwarz Rounds

Although these workshops largely focused upon the experiences of GP’s & Doctors, I could consistently relate the issues being raised with any other healthcare professional to a higher or lesser extent. The issues remain the same in any healthcare profession.

Along with the health practitioner programme, the  were referred to as a valid source of support for health care professionals. Schwartz Rounds are a multidisciplinary forum designed for staff to come together once a month to discuss and reflect on the emotional and social challenges associated with their jobs. The rounds are designed to offer emotional and social support for staff – not look for clinical outcomes.  Yet my concern is that these rounds require face to face talking and the time to attend a meeting at the planned time and location. I hope that the online intervention I intend to build in order to help midwives in distress can compliment these rounds in supporting all health care professionals in time.

For more information and reflection upon this conference, I would like to direct you to this blog post by Jonathon Tomlinson, as it holds some great references to other reflections and narratives in relation to the wounded healer.

I would particularly like to quote this from his reflective blog “There is a distinction between strength – to carry on regardless, and courage – to admit ones’ vulnerability – which is key to overcoming shame.”

It concerns me that the NHS may indeed be unwell. I reflect lastly upon the NMC Code of professional conduct which states that nurses and midwives must: 8.7 be supportive of colleagues who are encountering health or performance problems. However, this support must never compromise or be at the expense of patient or public safety.  We are in fact duty bound to look after one another for the safety of patients and the public.

So be excellent to each other.

Always.

Maben J, Latter S, Clark JM. The sustainability of ideals, values and the nursing mandate: evidence from a longitudinal qualitative study. Nurs Inq 2007;14:99–113. doi:10.1111/j.1440-1800.2007.00357.x