This booklet is a learning resource provided at the National Educational Conference on female genital mutilation (FGM) organised in Exeter in February 2011 and is relevant to the learning of a wide range of healthcare professionals, including medical students, doctors and midwives. It aims to provide key summary points, both from the lectures on the day and guidelines published to date, in order to aid recognition and management of cases of female genital mutilation.
almost 9 years ago
I'm not sure why I like to quote lines from films on this blog. I mean, I really haven't seen enough of them to make myself out to be some sort of hotshot film geek. I'm hoping this is the last (probably inappropriate) quote I use for a while, so here goes... 'Give me a word, any word, and I show you that the root of that word is Greek.' Courtesy of Gus Portokalos, the funniest character in the My Big Fat Greek Wedding. Sometimes I feel like medics tend to do that, we have a habit of making absolutely any conversation about Medicine. It seems to give us a bit of a bad rep, but surely it's understandable? I mean, it's what we do. It's what we've 'always wanted to do' i.e. since leaving the womb*. It's what we're always going to do. Right? Even so, it's surely human nature to relate everyday conversation to something you think that you know a lot about. Let's take a look at real-life example, cue the Blue Peter quip 'here's one I made earlier': I know nothing about football. Well, I know a bit more than some and a lot less than your average football fan so I guess I know VERY little about football. I do, however, know a thing or two about Hillsborough Stadium in Sheffield. Why, you ask? Well, the Hillsborough Disaster in 1985 saw the deaths of 96 Liverpool fans during an FA cup semi-final. A pivotal case emerged from this disaster which affected medical decision-making at the end of life, that of Anthony Bland. Bland was left brain damaged and in a 'persistent vegetative state' (a disorder of consciousness) after the disaster. In 1993, he finally won his battle to have the treatment that was keeping him alive withdrawn. This was a landmark case in both medical ethics and law. Don't say you heard it hear first, look it up: it's relevant. It would be dishonest to say, 'Give me a word, any word, and I'll show you that it's somehow linked to Medicine. But just ask me what I know about football, just once and I might just surprise you. *After writing this entry, I realised that it might be unfair to presume that there isn't at least one person who knew that they wanted to be a doctor just seconds after taking their first gasp of air and crying their eyes out in the midwife's arms. My sincere apologies if this applies to you. (To have a look at more of my entries, visit: http://contemplationsofamedic.blogspot.co.uk/)
almost 7 years ago
Maternal Care addresses all the common and important problems that occur during pregnancy, labour, delivery and the puerperium. It covers: the antenatal and po…
over 4 years ago
Healthcare regulation in the UK is “incoherent”, “expensive” and requires a “radical overhaul” according to a review by the body which oversees the work of organisations including the Nursing and Midwifery Council.
over 4 years ago
The clock is ticking for occupational health (OH) practitioners to make their voice heard on the Nursing and Midwifery Council’s (NMC) plans for three-yearly checks, or “revalidation”, of practitioners’ fitness to continue to practise and its proposals to revise the NMC Code of Conduct. Nic Paton reports.
over 4 years ago
I am setting up this blog to chronicle my adventures of babycatching in Africa. This site is for all of you who have loved, encouraged, and supported me over the past 29 years. This is my evolving story of stepping out into the unknown and meeting life as it first makes its way into the world.
over 4 years ago
Shattered. Third consecutive day of on-calls at the birth centre. I’m afraid I have little to show for it. The logbook hangs limply at my side, the pages where my name is printed await signatures; surrogate markers of new found skills. Half asleep I slump against the wall and cast my mind back to the peripheral attachment from which I have not long returned. The old-school consultant’s mutterings are still fresh: “Medical education was different back then you see....you are dealt a tough hand nowadays.” I quite agree, it is Saturday. Might it be said the clinical apprenticeship we know today is a shadow of its former self? Medical school was more a way of life, students lived in the hospital, they even had their laundry done for them. Incredulous, I could scarcely restrain a chuckle at the consultant’s stories of delivering babies while merely a student and how the dishing out of “character building” grillings by their seniors was de rigeur. Seldom am I plied with any such questions. Teaching is a rare commodity at times. Hours on a busy ward can bear little return. Frequently do I hear students barely a rotation into their clinical years, bemoan a woeful lack of attention. All recollection of the starry-eyed second year, romanced by anything remotely clinical, has evaporated like the morning dew. “Make way, make way!...” cries a thin voice from the far reaches of the centre. A squeal of bed wheels. The newly crowned obs & gynae reg drives past the midwife station executing an impressive Tokyo drift into the corridor where I stand. Through the theatre doors opposite me he vanishes. I follow. Major postpartum haemorrhage. A bevy of scrubs flit across the room in a live performance of the RCOG guidelines for obstetric haemorrhage. They resuscitate the women on the table, her clammy body flat across the carmine blotched sheets. ABC, intravenous access and a rapid two litres of Hartmann’s later, the bleeding can not be arrested by rubbing up contraction. Pharmacological measures: syntocinon and ergometrine preparations do not staunch the flow. Blood pressure still falling, I watch the consciousness slowly ebb from the woman’s eyes. Then in a tone of voice, seemingly beyond his years, the reversely gowned anaesthetist clocks my badge and says, “Fetch me the carboprost.” I could feel an exercise in futility sprout as I gave an empty but ingratiating nod. “It’s hemabate....in the fridge” he continues. In the anaesthetic room I find the fridge and rummage blindly through. Thirty seconds later having discovered nothing but my general inadequacy, I crawl back into theatre. I was as good as useless though to my surprise the anaesthetist disappeared and returned with a vial. Handing me both it and a prepped syringe, he instructs me to inject intramuscularly into the woman’s thigh. The most common cause of postpartum haemorrhage is uterine atony. Prostaglandin analogues like carboprost promote coordinated contractions of the body of the pregnant uterus. Constriction of the vessels by myometrial fibres within the uterine walls achieves postpartum haemostasis. This textbook definition does not quite echo my thoughts as I gingerly approach the operating table. Alarmingly I am unaware that aside from the usual side effects of the drug in my syringe; the nausea and vomiting, should the needle stray into a nearby vessel and its contents escape into the circulation, cardiovascular collapse might be the unfortunate result. Suddenly the anaesthetist’s dour expression as I inject now assumes some meaning. What a relief to see the woman’s vitals begin to stabilise. As we wheel her into the recovery bay, the anaesthetist unleashes an onslaught of questions. Keen to redeem some lost pride, I can to varying degrees, resurrect long buried preclinical knowledge: basic pharmacology, transfusion-related complications, the importance of fresh frozen plasma. Although, the final threat of drawing the clotting cascade from memory is a challenge too far. Before long I am already being demonstrated the techniques of regional analgesia, why you should always aspirate before injecting lidocaine and thrust headlong into managing the most common adverse effects of epidurals. To have thought I had been ready to retire home early on this Saturday morning had serendipity not played its part. A little persistence would have been just as effective. It’s the quality so easily overlooked in these apparently austere times of medical education. And not a single logbook signature gained. Oh the shame! This blog post is a reproduction of an article published in the Medical Student Newspaper, February 2014 issue.
almost 6 years ago
Terri Coates explains why it’s difficult to show the reality of birth of screen, and why she gets a hard time from admissions tutors on midwifery courses
almost 5 years ago
The RCM website is published by The Royal College of Midwives. Midwives magazine, Evidence Based Midwifery and Midwives Jobs are published by Redactive Publishing Ltd on behalf of The Royal College of Midwives.
over 4 years ago
The Nursing and Midwifery Council urges patients to have their say as it drafts a new version of its code for nurses and midwives.
over 5 years ago
Thousands of NHS workers, including nurses, midwives and ambulance staff, are taking part in a four-hour strike in a row over pay.
over 5 years ago
Nurses, pharmacists, dentists and midwives could face language skills checks to make sure they are fluent in English, under plans being put out to consultation.
about 5 years ago