Midwifery: Values of Professional Practice - Research Paper Example

MIDWIFERY: VALUES FOR PROFESSIONAL PRACTICE Introduction In midwifery placement most expect to deal with happy parents and bouncing babies in a fulfilling and loving environment. However, experience shows that this dream normally remains only a dream. As much as there are positive and memorable experiences, it can become a little demanding for a nurse. However, the most challenging and hard situations in placement become most fulfilling in midwifery career. It grants a nurse the opportunity to test skills acquired so far and examine oneself (MacMillan, Snowley & Gilling 2007). In some emergencies the nurse is immediately made to learn new skills. Sometimes it presents an opportunity to reflect on related episodes in practice. The most important however, is the fact that a nurse learns more about oneself, develops courage and skills to deal with complicated situations (Chesney, 1996 p. 9). The essay is a reflection of one similar experience during placement. It brings out the importance of personal and interpersonal relationships in handling patients with postpartum depression. This occurs soon after delivery whereby a mother experiences depression, tearfulness, loss of appetite, anxiety, suicidal thoughts and a sense of worthlessness as a parent (Poobalan et al 2007 p. 380). A nurse must feel a strong psychological and sociological connection with the mother and family (Takase, Maude, & Manias, 2006 p. 335). Most women are not aware of having this problem and therefore try to battle it out on their own. They continue to suppress these feelings and fail to open up to those around them. The process can be challenging. It is important the mother understands her situation. After she has come to terms with the condition, corrective measures can be applied. It is ideal that she is given enough support from close family members more so husband, sisters or even friends. Developing a therapeutic relationship with both parents, friends and family, makes it easier for the mother to cope with her situation. Considering the nurse precisely understands a mother’s experience, it becomes natural to mirror own behaviour in relation to the situation (Huynh, Alderson & Thompson, 2008 p. 198). The reflection process presented in the essay is guided by Gibbs model of reflection. The choice of this model is strategic since it gives clear and step by step guidelines on how to conduct the process. I chose King’s theory because it aids to clearly bring out personal values and beliefs. The theory involves three interacting systems apparent during the episode in placement. The success of therapeutic relationship was as a result of the nurse showing empathy, care and support (Delaune & Ladner 2007, p.324). Episode of Care during Practice Placement It is normal for most nursing students to try and anticipate what placement would be like or how they are going to conduct themselves once there. In my case I was not expecting any big surprises. In my last placement I only knew that I was going to deal with parents and babies who are not so unique. They might be first time mothers or have had other births before but it matters little once one has the necessary knowledge and skills (Frith & Draper, 2004). As a nurse I was to help by giving support, care and attention throughout the process. In this case a woman experienced some problems during delivery. Earlier on, about five months in her pregnancy the doctor had noted feelings of anxiety, depression and irritability. However, at the time it was thought to be as a result of death of her mother-in-law. The deliver was not normal. The umbilical cord was wrapped around the baby’s neck and his heart rate had dropped rapidly. There was no question about having an emergency caesarean section. The doctor was called in and without waste of time she was lying on the operation table. I noted that as the process was about to be completed, she asked for her husband. He was allowed in as the team vacated the birthing room leaving them alone. She needed his support and reassurance that indeed everything was going to be fine. Almost a half an hour later I returned with the baby and delivered it to the mother for breastfeeding. As much as the couple were overjoyed with their son, trouble started once they reached home. She began feeling irritable, anxious, fearful and guilty. She could not produce enough milk for the baby. This further augmented feelings of inadequacy. It was as though she was ill qualified to take care of him. Moreover, she constantly had recollections of the happenings in the hospital. This intensified her depression. She would sob continuously for hours and feelings of worthlessness would not abate. At this point she decided to seek medical attention. The symptoms correlated with postpartum depression but she was obstinate to admit it. In fact she kept aloof from her husband who had been supportive all along. On meeting the women she was still reluctant to admit her problem. She had not shared it with anyone, not even her husband. According to her it would be betrayal to have any negative feelings about their only child. Again, everyone seemed to love him and she could not afford to be the one harbouring such feelings towards him. At first it appeared as her personal problem but I begun to talk to her regarding the prevalence of the condition. Also I pointed out some of the well known effects if untreated. I encouraged her to open up. It was shocking to learn all along she harboured the intention to murder her son. Every time the child cried it appeared to her as though he was in pain and therefore unwilling to live. Killing him would help her overcome the feelings of inadequacy and restore everything back to normal. She simply did not feel as though he was her child. She talked to her husband as well. He proved to be very understanding but a little disturbed. We talked over it and indeed he admitted having been worried about her behaviour in general. Sometimes he would see her pull a face whenever the child cried. She always implored him to take a long walk with the child away from her. On occasions when he returned after an hour or so she complained that he had came so fast. She really wanted the child off her site. She talked to her friends too. Interestingly, one had a similar experience only that in her case no medical intervention was sought. It was constantly stressful for the family who had no idea of the ailment. In this instance no one was judgmental and a plan was devised to try therapy before any medications was used. She made plans with her husband for weekend dates away from home and the usual responsibilities. This also was arranged with a couple of her closet friends. They made an arrangement to go out on regular basis and enjoy together. These activities transformed her life like she never imagined. The moment she chose to open up to other people slowly the depression started to abate. She did not sink as deep into depression as before. At the end of it all she appreciated the support, love and care to those close to her. Once again she was able to love, cherish and adore her baby just like a mother needs to do. I came to understand the way patients feel about themselves helps in the healing process. Sometimes it is important for patients to move away from the home environment. The mind must be freed from the day to day routines and responsibilities. An atmosphere created around a patient that is free of stress, fear, anxiety and anger helps to quicken recovery (Khademian & Vizeshfar 2008, p. 458). At times those closest to the patient such as family members are responsible for the creation of such an atmosphere. In this instance the mother was worried about her safety when with the child. However, she was not able to confide to her husband instead went ahead to avoid contact with him. The decision to open up and share with those closest to her was rewarding. For the first time she felt self-worth and normal just like any other woman. The ability to show love and care for her son, made her whole again. She felt good seeing that her son was in safe hands. This feeling is vital in dealing with depression. Therefore family members or close friends must be allowed to visit and see a patient. They must be able to share freely and reveal their feelings and experiences to each other. In most cases a mother will be comfortable with people who are non-judgemental. It is important when dealing with a depressed patient to describe strategies in place for the healing process. No matter the weight of her feelings the situation must be handled like any other medical case. It must not be made to appear so unique or unmanageable (Fowler et al 2007, p. 222). Most patients want to know their condition to determine whether or not they are normal. For some mothers not being able to love their own children appears the vilest condition. It brings feelings of worthlessness, fear, guilt and anxiety. It is may seem no one would understand if they choose to let known their feelings and thoughts. On the other hand a nurse is very much aware of postpartum depression (Logsdon et al 2006, p. 67). It is not something to scare anyone but to be understood. A nurse understands it is not a mother’s mistake but changes in her own body. For this reason she is more than willing to listen to her and help her cope with the changes. She encourages her to open up to those closest to her. In so doing the mother develops courage, ably handles her feelings without fear, guilt or anxiety. On a similar note those living with the mother will be able to understand her actions and reactions. They will be made to understand her feelings and how to respond to her actions. This in a great way helps in the healing process. This scenario presented a good opportunity to understand the concept of self-healing. It became apparent to me that indeed with the right atmosphere a patient can heal oneself. This however is not to disregard medicine. In some cases medicine prescribed by a doctor works more effectively with the right attitude and frame of mind. As a nurse I have learned that it is my role to create an ideal environment to enable a patient find inner strength and direction. The patient must be free of external pressure, negative feelings, fear or anxiety. She must be made to understand her feelings are normal. Almost every woman experiences the same. Once a woman is not scared of her feelings, it becomes easy to open up and share experiences (Sohr-Preston, & Scaramella, 2006 p.67). This takes a therapeutic relationship to a whole new level. Theory, Value and Beliefs that Support Practice According to King’s theory the healing process is made possible by an interaction of three systems. There is the personal, interpersonal and the social systems of interaction (Parker, 2001 p. 197). The personal system is the smallest and it deals with individuals such as a nurse and patient. This is an important system since it sets a platform for the patient to open up to a nurse. It is the stage where a mother is willing to confide to another person. Though a stranger, the patient is convinced that a nurse is willing to help. There are questions to be asked, needs to be attended to and past experiences or preconceptions to be shared. A nurse is required to define the problem and establish the kind of assistance needed by a patient. The questions asked by a patient are responded to in a clear and straight forward manner. Good communication skills are a must if at all the patient will be made to feel at ease (Chitty 2005, p.178). The interests and needs of a patient dictate the type of service to be utilized. In case the nurse successfully creates a secure and enabling environment, it makes an individual feel wanted (McCathy & Rose 2010). As a result the patient will find techniques to get attention or alternatively minor requests are made. The underlying problem can only be presented to a nurse if excellent interview skills are put to use. As a nurse explores and tries to understand the problem a patient’s independence slowly diminishes (Ludwick & Silva 2000). By all means possible the nurse tries to seek help that would see to the recovery of a patient. At this point the two are much familiar with each other thus a patient feels better and helps in a great way to reduce feelings of worthlessness or helplessness. Interpersonal system introduces family and friends in the relationship. It is another step towards enhancing therapeutic rapport with a patient (McEwen & Willis 2006). A mother must feel comfortable and willing to open up to close family members and friends. It is a way of expanding the world of the patient which had narrowed down to a personal affair. From feelings of loneliness, hopelessness and worthlessness, the patient is ready to experience love, care and understanding. Just like the personal relationship with the nurse, a patient does not expect to be judged by loved ones (Adamski, Parsons & Hooper 2009, p. 359). The relationship gradually progresses to the social system whereby a patient interacts with a larger group. There are other healthcare workers, family members, clubs, religious groups, social networks, school etc. Through effective communication to a number people a patient feels wanted in a larger social setting. There are testimonies to be shared and needs to be met. Through sharing experiences a patient is able to help others in similar situation. Conclusion Conservatively it is estimated one is seven women suffers from postpartum depression. This is a huge number considering most cases go unreported. Women continue to suffer in silence while others are driven to suicide. If the appropriate medical attention is not given, the end results are damning to family and society. Normally, the women fail to develop a bond with their children. This bond is vital in growth and development of a child. On the other hand nurses offering care for mothers with postpartum depression must be non-judgmental. A therapeutic relationship with a nurse determines how the healing process will be carried out. The choices made by a nurse are unique since they are directed towards the well being of another person. In order to be able to help a patient, one must show willingness to explore their live. A nurse must be kind enough, seek to uplift living conditions of a patient, appreciate and understand a patient’s situation. This cannot be realized without good and effective communication skills. A nurse must open up, listen reflectively and empathize with the patient. Once the nurse and patient are able to interact freely and confine to each other, it helps enhance recovery process. 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