Was there an opportunity to discuss with the midwife- what did you learn from that?

Student Midwife’s Written Reflective Report- Shoulder Dystocia. 2000 words
(UK Practice)
Event that I witnessed- Tania, a 28 year old para 1, had a BMI of 40. She had a previous forceps delivery a year ago at 39+4 weeks gestation. She was on high risk antenatal care pathway due to her BMI, but her pregnancy was uncomplicated. She was admitted to the labour ward at 38+6 weeks gestation when her membrane raptured at home with strong contractions with her partner present. She made good progress in labour and received epidural at 6cm, which worked well. She was contracting strongly 4 in 10 and was fully dilated after 6 hours. Due to the epidural, she commenced active pushing after an hour, as per the trust guidelines. 45 minutes into pushing, vertex was visible but advancing slowly. Maternal observations were normal, as with the CTG. An hour into pushing, indicators of turtle neck were present, however the midwife failed to interpret the signs presenting and continued assisting Tania with pushing. The midwife in charge had come in the room for routine check, after assessing the situation, she observed shoulder dystocia and immediately urged Tania to stop pushing and pulled the emergency buzzer for obstetric intervention. An emergency call (2222) was placed for obstetric emergency shoulder dystocia as well as neonatal emergency. A female infant was delivered with respiratory distress and was transferred to NICU for respiratory support. Tania suffered PPH of 1L shortly after delivery, which was well managed by the obstetric team.
Introduction- 250 words
Use Gibbs’ reflective cycle – briefly state the rationale for the chosen model rather than another and state why it is found useful in the context of reflecting on clinical incidents. Also discuss the significance of reflecting on incidents.
Main Report- 1550 words
This is not a reflection on incident itself, but rather the legal, professional and ethical aspects and the learning that takes place!
• Demonstrate knowledge and understanding of professionalism, legal and ethical dimensions to practice, professional regulation and related development in practice.
• Examine clinical governance and clinical risk, providing an analysis of how these components affect an individual midwife’s practice
•Incident reporting- why is this important. What legal re-dress do clients have if harm has been caused. How does this affect the midwife’s duty of care? What is Datix?
• The importance of culture, communication and documentation.
• Duty of care, accountability and duty of candour.
• Human factors
• Why is working as a team important?
• Description of the incident- be succinct
• Can be human failure
• Systems failure
• Mitigating circumstances
How the incident was managed and how was it escalated/reported? Datix
• Why report incidents & barriers to reporting: blame culture/fair culture
• Reporting through Risk management discuss and analyse in the context of incidents
• Were statements requested/the significance of statement writing. Link to your professional/student responsibility?
• Was there round table-and root cause analysis: discuss its significance
• What were the outcomes of the incident: for the client?
• Client involvement
• How did you learn from it?
• Was there an opportunity to discuss with the midwife- what did you learn from that?
Analysis:
· The analysis section is important to argue your points using words such as however, nevertheless on the other hand and whereas. Decide what particular points of the incident you will analyse, tell the marker why you have chosen those aspects-might be because it had the greatest impact on clients care and your learning. Support with appropriate references: citing research papers where possible is essential.
Action plan as part of your reflective report
· What you intend to do in future and how it will be achieved. Also, how it will be evaluated.
Conclusion- 200 words
· Please ensure you have a conclusion that brings all the points of your reflective account together- relating it to learning and to your practice. Include references in your conclusion. Relate your points to theory and to the reality of practice and always to the client involved in the incident.
Harvard style reference ONLY!
Always support statements with relevant research and credible citations.
· References should demonstrate a depth and breadth of reading.
· Be clear why you have included a reference in your text – use it to make your point more clearly by giving additional information.
· Use up to date literature evidence
· Relevant to UK practice.
· Minimum 25 references- Journals and books relevant to UK practice.
· Journal DOI must be included with references.
· Support arguments with references from research texts – make a P=point, support with a reference, provide an E=example, counter that point with a different reference – this then becomes an argument and then L=link to the next paragraph (PEL). Do not just state one point and move to the next point.

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