The Pandemic - As experienced by a Midwife
I'll be honest, I genuinely thought covid would get me...
These are the words I said to my GP on the December 2020 when I finally went to see her.
I am writing this to, explain my prolonged absence from work, my lived experience as a member of staff working through this pandemic, because I feel guilty, but I also feel my mixed emotions are valid and should be heard.
I had been battling silently with bladder and bowel dysfunction for nearly a year. Something I began to notice when I, as a rural community midwife, began consciously dehydrating myself at the start of the 1st lockdown. My "usual" places when out on visits were either closed or queued out the door, I also didn't feel as comfortable going into these places. With my job, I am going to see newborns, mother's immediately postnatal and at that point we really didn't know what was happening with Covid... I began to plan my visits with returning to unit or my GP practice in between each of them, which meant my days were getting longer, I was feeling more fraught and more stressed. I started being plagued with headaches, so was taking regular paracetamol, ibruprofen and had a rehydration sachet on my way home every night, this was becoming my "new normal".
I then decided that as the additional stops were just part of "my new normal" I could start drinking fluids again, because I was rarely 60-90 minutes without a toilet stop and my kidneys were sore... Then the urgency began, I was, for want of a better phrase, "hitting the door running"... Time passed and then, I decided I should buy waterproof seat covers for my car, telling myself and others that it would protect the car from the dogs dirty paws, or should I spill anything whilst eating and drinking when driving... When I secretly knew my body was struggling with this "new normal". My lowest point came when I got lost when driving to a visit, so my time between stops was considerably longer than I expected. I knew as soon as I reached my car I wasn't going to make it anywhere. I had to relief myself in the car in my lunchbox. Please let that sink in.
Alongside the unpredictable nature of the pandemic, the constantly changing information from the government and managers, the stifling PPE, massive changes in working patterns/routines, being told to spend as little time as possible in the unit (I live 45 minutes away) was quite unsettling, having to wear a uniform again, managing the emotions of my frightened and understandably worried caseload, supporting the women I work with and who had essentially become "my bubble/family", my own growing homesickness, being the only regularly present Royal College of Midwives trade union rep, helping our staff through issues within the trust, pregnant members of staff being unsupported by their managers, covering additional homebirth on calls due to sickness, not only in our area, but the whole county, having to deal with investigations into a homebirth I had attended, which was passed about the management structure, like a hot potato for a plethora of reasons and repeatedly being asked for a statement which I had already written and provided at the very start, over the course of several months. Which I'm sure you will agree was not ideal and quite a lot to deal with. It felt like psychological torture.
I "attempted" to keep up to date with my masters leadership module, I had undertaken shadow shifts with managers on days off to help keep the peace within my team and personally, I came away feeling really downhearted at what I had heard and seen.
I have been asked many times by friends/colleagues why I was doing this module because they felt "I was not a yes woman" which is true, I'm not. I do ask the awkward questions, I do point out the somewhat obvious flaws in systems which are not always fit for purpose, or ask why knee jerk blanket policies are introduced without holistic consideration.
I was a manager before I joined the NHS family, so I understand management from a private sector point of view. With that in mind, I have been witness to and been on the receiving end of incredibly unprofessional and cruel management styles since training to be a midwife and following as an employed member of staff. My answer to these questions were always the same, I want to do this masters because, should I ever wish to progress to this collective, I want to be the best I can be for my team. I also wanted to know why decisions were being made by those above me, were they being made with an understanding of what I and my team mates do day to day, because a lot of doesn't ever feel that way...? I wanted to understand where my managers were coming from.
I sat in on a meeting at the height of covid and heard a member of management say that she "didn't care what the midwives were doing, they needed to be 'sat on' in order to do their e-learning, there was no excuse"... Whilst I'm not in the acute trust anymore, my friends are, I know how they feel when leaving chronically short staffed tough shifts, this is part of the reason I went to work in community, the feeling of self worth and esteem is better there, but yet we (community midwives) are still asked to do more, provide more evidence, more paperwork and all in less time with no more staffing. Our time owing is rarely a true reflection of the work we do. I only ever claim for time spent past 17.00, I never claim for the daily missed lunch breaks or the early starts. So that work is always done for free.
Both the masters module and trade union rep positions are not back-filled, which meant that my team were being detrimentally affected by my lack of presence and it understandably caused friction and displeasure. I continued to provide care for my caseload rarely handing work over, but it meant that I couldn't help my team when they needed it. I couldn't pick up extra visits/work, I feel this is wrong, both of these things should not impact on the wider working teams. We should have protected time, our hours should be backfilled. I was away from my team more and more, yet my caseload was that of a member staff with no extra commitments and then some.
The union rep work was an unfortunate clash of timings, pandemic, sickness, mat leave and HSIB reports, but it all really carries a humongous emotional load. The midwives I support and advise, the information I have sat and listened to, the Nursing & Midwifery Council panels who judge whether you are fit to practice, the unprofessional managers I deal with, the outcomes, this all weighs heavy on your heart and mind.
The pandemic weighs heavy, the fear that women have had weighed heavy, the fact that I didn't have the answers for women weighed heavy.
I had annual leave booked in March, the night before returning to work I had what I felt was normal return to work fear, I then subsequently didn't sleep well, to be expected (I thought), I told my husband I felt off when I woke and that I wanted to return to bed, he encouraged me to join him on a walk with the dog prior to work, this helped, made me feel better, I ate breakfast and left feeling brighter.
On the motorway I encouraged myself with positive thinking, turned the music up and sang, as I arrived at work and got out the car I realised I had forgotten my swipe card. I could see it hanging in the hall, my head and heart started racing. After trying to tell my colleagues what had happened, I returned to my car and started to drive back home. From leaving work until I got onto the motorway, I chastised myself heavily, feeling so angry that I made such a dumb mistake. Once on the motorway I made the decision to turn up the music to drown out the anger in my head. I then tried to focus on my breathing. The traffic was heavy and there were articulated lorries and vans on either side of me. I could not catch my breath, I couldn't feel my face or hands, my pulse was racing and I panicked. I then have no memory of this, but I managed to dial my husbands number and left a voicemail saying that I thought I was having a stroke whilst driving on the motorway....
I now know that I had a panic attack, I'm under the care of the GP waiting to discover what is causing my bladder and bowel issues, I am beginning to feel it is stress related. I am seeing the local mental health provider following a diagnosis of anxiety, post traumatic stress disorder, obsessive compulsive behaviours and intrusive thoughts.
This has been a tough time in my home.
I have yet to return to work, the time spent away has been incredibly difficult, the void midwifery had left has made me realise how much of a vacuum it had become. The more I gave; the more it took. The more I had heard from management, risk or the NMC about about "just another risk assessment...", "can you just complete this audit form", "the community midwife didn't do...", the more obsessive I had become about making sure I had checked things over and over again, doing 10-12 hour days 4 and 5 days a week, the lack of sleep or switch off time I had. I had no boundaries. I was over functioning in a system that is chronically disfunctional. I have lost myself and I can't quite establish when that happened. Not being there in the early days was horrid, I was on edge constantly, I was sweating, tachycardic, insomnia increased and was experiencing nightmares.
I am scared about what this means for me in my career choices. I love the good bits of my job, I loved the caseload I have, I worship the women I work with, my managers are mint and have always had an open door policy, I am extremely fortunate to have an excellent Professional Midwifery Advocate, but I am scared about if/how I can do this going forward. I know changes need to be made, I've learnt lessons the hard way, however in the last 18 months I know of 6 midwives who have left the profession (not only at our trust but others as well) but what makes me sadder, is I know of at least 10 more who are looking for a way out.
Something has to change, in addition to myself, because I know this is not an isolated feeling. I am telling you this as my managers, my leaders, my colleagues; I have profound mental health problems that primarily relate to my job and this pandemic, my career and my calling is in jeopardy. But know this, I am not the only one, but I might be the only one who speaks up.