Fundamentals of Midwifery: A Textbook for Students (9 page)

Raising and escalating concerns
Raising and escalating concerns is a fundamental responsibility of all healthcare workers, and theNMC have published guidance on this (NMC 2013). If students or practitioners are worried gener- ally about an issue, wrongdoing or risk which may affect or is affecting others in the workplace or in their care, they should raise a point of concern. This is not an easy thing to do, which is why students are advised where to access support at the start of the programme. These include their personal supervisors, university lecturers, midwifery mentors and Supervisor of Midwives.
Quality assurance
The quality measure of midwife lecturer to student ratio at the university demonstrates theresource commitment from the university to that provision, where 1:10 is seen as best practice.Clinically, the birth rate to midwife ratio should also be considered, with the additional quality‌
14 measures of Care Quality Commission reports, Professional Standards for Health and Social Care, Maternity Liaison Committee, LSA audits, all of which are readily available to the public. Evi-dence suggests that if the team of teachers includes a Supervisor of Midwives, it can enhance communication between the universities and their clinical placement areas and provide an additional level of support to newly qualified midwives during their transition period from that of student midwife.Midwifery educationalists are often invited members of LSA working groups and receive routine communication, for example newsletters from the LSA, which are disseminated to student midwives. This ensures close links between education and supervision, with resultant benefits to education, supervision and to the LSA. Any forums that bring education, practice, Supervisors of Midwives and the LSA together are in line with Maternity Matters (Department of Health 2007) and research advocating closing the theory–practice gap.Universities value student evaluations and seek student representation on committees at programme, departmental, faculty and university levels. Student evaluations of modules, place- ments, programmes and the university are sought and acted upon. The National Student Survey is undertaken annually; all students are invited to complete this in their final year of study. The results are available to the public, and are valued as a serious quality measure of student satisfaction.
Student support
Personal supervision is an element found in all pre-registration midwifery education pro-grammes, and is generally undertaken by a member of the midwifery teaching team. University processes tend to determine the format this takes. The personal supervisor role can play a sig- nificant part in a student’s progress whilst on the midwifery programme. It allows a relationship to be developed between the personal supervisor and the student, with mutual respect, honesty and confidentiality being crucial components. Ideally the student and personal supervisor meet early after the programme commences agreeing the subsequent frequency and format for further contact. As with the mentor–student relationship, a rapport between the two parties must be established in order to maximize the benefit; therefore the option of changing should always be available. Changing mentors clinically, or personal supervisors in the university, is not a failure, but merely recognition of different learning styles and personality traits.Student support services are also a feature of Higher Education Institutions, but these vary. The student union is an example. Student midwives/nurses may find it more challenging to participate in student unions and campus life for various reasons (see Figure 1.1). They are still eligible to receive student union support and to participate in any student ballots. It is important to also access various study support services available to all students, including library services, study skills advice and information and communication technologies (ICT). These are all essen- tial to learning and continuing education post-registration. Additionally, most universities will have confidential counselling services, which can be accessed by students; at times these may help to cope with the conflicting demands and stresses which may accompany student life.
Health screening
Health screening has consistently been a feature of all healthcare programmes, with all studentmidwives requiring health clearance prior to the course commencement and to declare annu- ally their good health and good character (NMC 2009), whilst on the programme and prior to
Campus life 15Academic study Clubs and societies Social lifeStudent/campus politics
Conflicting commitmentsOlder age profile than non-vocational students
Family commitments Accommodation off campusPlacement working hours/ shift work
Figure 1.1
Conflicting commitments faced by midwifery students.their admittance to the NMC professional registers. Students with long-term health issues must be passed as fit to undertake the programme from the occupational health department. Stu- dents whilst on clinical placement can also access the Trust occupational health department should the need arise. Students and midwives must take responsibility for their own health, and are required to have all vaccinations recommended by the Department of Health to protect themselves and the people in their care. These include rubella, measles and seasonal influenza. All midwifery students prior to commencing the programme are tested for blood-borne viruses due to the risk of exposure prone procedures.
Criminal record
All students and midwives upon appointment have to undergo a Disclosure and Barring Service(DBS) investigation. Should this return with a positive record, a meeting would be convened between the applicant, an admissions representative and a Trust representative to discuss this in more depth. This meeting would be to determine the gravity of the record, and to determine whether this would preclude the applicant from being successful with this application. Gener- ally, decisions are dependent upon the nature of the offence, circumstances surrounding the offence and the time elapsed since it was committed. All applicants are routinely asked at inter- view if they have anything to declare; therefore the opportunity is afforded to discuss this frankly and honestly. Should any offence, subsequently disclosed on the DBS not be declared at this point, it is generally viewed unfavourably. It is worthy of note that all offences will be disclosed with an enhanced DBS enquiry, even speeding offences and offences committed as a juvenile. Any subsequent offence, warning, reprimand or caution received whilst on the pro- gramme, or as a midwife must be notified to the university (if applicable) or the NMC and may initiate a Fitness to Practise investigation (NMC 2011a).