Friday, 30 November 2012

Supervisors of Midwives

The life of an IM can be difficult sometimes due, not to the women we care for but to what should be simple things.........

At 0850 this morning I rang a local NHS trust to get some help in getting a woman in to see the phlebotomist in order for them to take antenatal booking bloods. This is something I usually do myself, I am very proficient in taking blood and have rarely failed but having had 2 attempts I thought the experts should do it in this case. Ok, so I have 2 contacts at this particular hospital, one is the community midwifery manager and the other the contact Supervisor of Midwives, (SOM). This SOM always writes me a very nice letter; in response to my booking courtesy letters, offering her help should I need it. Yesterday I rang the community midwifery manager but she could not speak to me due to being in a meeting, other than to say she would call me back. She did not call back, which is ok, she is a very busy lady and as we are friends too she may have though I just wanted a chat and so this morning I tried my other contact the, SOM. For the sake of anonymity let us call this SOM Mary

The Dialogue:
Operator: Can I help you?
Me: Can you put me through to Mary please
Midwife: Hello Triage midwife Anne speaking
Me: Oh sorry I thought I asked for Mary
Anne: No sorry she is off till Tuesday
Me: Oh ok well as you are a midwife maybe you can help me please. I am Virginia Howes IM and I have a client who needs some routine booking bloods done, she needs to see a phlebotomist really as I have tried twice and failed can you arrange that for me please?
Anne: Oh we send the difficult ones to day care they are really good at doing blood so I will put you through to them
Me: Thank you
Midwife: Hello day care, midwife Jane speaking.
Me: Hello Jane I am Virginia Howes IM and I have a client who is difficult to bleed and I have been told you are experts at it can I send her to you please?
Jane: Oh no we send them to the phlebotomists if they are difficult.
Me: Oh ok yes that’s what I originally thought /wanted so can you do some blood forms for me please? (This is a trust not local to me so I don’t carry their forms. Had I succeeded in my attempt at taking the woman’s blood I would have put them through my local trust as I DO have their forms, it’s the same PCT so I have it from the top that the funding is coming from the same place and it’s fine to do this).
Jane: The phlebotomists will do the forms just send her in with her notes.
Me: Well therein lays a problem because she is booked with me an Independent Midwife so the notes will not be NHS notes or familiar to the phlebotomist, it will cause all sorts of confusion so could you not just do the forms for me please?
Jane: It will be fine just speak just to them and explain…I will put you through
Me: Ok thank you
Phlebotomist: Hello can I help you
Me: Hello yes I am Virginia Howes IM and I need to send a woman in for routine booking bloods I have been told that you will do the forms at my request?
Phlebotomist: Oh no we don’t do forms you need to ring day care.
Me: oh no! I am going round in circles here…Can you transfer me back please
Phlebotomist: Ok

The line rang for about 5 minutes and then cut me off………..
I now want to bite my knuckles and have been on the phone for 25 minutes and need to go back to the starting point.  I rang the hospital main line and it rang and rang and rang. I gave up redialled and it was answered in a normal time. By now I am thinking “ok well lets resort to supervision after all a SOM is the person a midwife is meant to contact if she is having issues or problems”.

Operator: Hello can I help you?
Me:  Can I speak to the Supervisor of Midwives on call please.

Now, a Supervisor of Midwives is meant to be on call 24/7 in case of emergencies. Switchboard, all maternity managers and notice boards are meant to know who she is and she should be instantly contactable. The line rang for 3 minutes. I was now beginning to think “oh my goodness this is about a simple blood test but what if I was at in emergency situation, how much time this is wasting”. I gave up and redialled but started making notes of times and conversations.

Operator: Hello can I help you?
Me: Yes I would like to speak to the Supervisor of midwives on call please.
Operator: You mean midwifery liaison?
Me: No, I mean the Supervisor of Midwives on call and it is important she can be contacted as she is someone to contact in emergencies.
Operator: Ok  I will page her

By now I had put the phone on speaker and was recording the event….this was serious and that imaginary situation of me being involved in an emergency and the resulting questions during my investigation of “why didn’t you contact the SOM” was coursing through my mind.

Operator: Sorry but I have paged her twice and she is not answering her bleep I will ring her extension.


SOM on call: Hello can I help you…….phew!

Bloods sorted forms in post to woman so she can go to the phlebotomist when it was convenient for her…job done good result

Time taken?  48 minutes.  Issues raised, ?????





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