Placement handbook

2013/4

Draft UWE Sept13 1

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INTRODUCTION AND BACKGROUND TO DEVELOPMENT OF THE MIDWIFERY PROGAMMES

Midwifery is a practice based profession. The essential values and beliefs on which the programme is founded are inextricably linked to the philosophy of midwifery care. This is recognised as the provision of a safe environment in which the woman’s individual physical, psychological, social and spiritual needs can be explained and expressed and wherever possible met. The midwife should be committed to take a leading role in providing this care in a sensitive and comprehensive service, which should be easily accessible and acceptable to the population.

The appropriate care and preparation prior to, throughout and following childbirth has positive effects on the health and well-being of women and their families. To this end the education and preparation of competent midwife practitioners is seen as essential to the provision of this philosophy of high quality care.

The office of midwife has been recognised in all societies and her/his role has evolved though centuries to the independent accountable practitioner of today

The overarching philosophy of the programme is to enable those entering and progressing though the programme as expressed in the definition above to develop from a lay-person or novice into a professional who can competently comply with the activities of a midwife as required by the European Directives (80/155/EEC Article 4)

The concept of development from novice to expert is based on the work of Benner (1984). In particular, it is focused on the acquisition and use of clinical knowledge related to experience in the clinical area supported by the theoretical content of the modules in the programme provided by personal study and timetabled sessions. The term lay person/novice on entry to the programme is used as the majority of course members have a diverse range of prior life skills and experiences with very few coming from a healthcare background. They do, however, all share a strong enthusiasm for learning about midwifery and participating in practice. It is a statutory requirement for the midwife to be competent at the point of qualification in order to undertake the expected role. The philosophy of the programme is to therefore ensure that not only is competency achieved but that following qualification the midwife is enabled to progress through to become an expert practitioner and appropriate role model. The appreciation by the student of the need for lifelong learning is also a priority to enable the midwife to adapt to the demands changing care provision exerts.

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Member States shall ensure that midwives are at least entitled to take up and pursue the following activities:-

to provide sound family planning information and advice to diagnose pregnancies and monitor normal pregnancies; to carry out

examinations necessary for the monitoring of the development of normal pregnancies

to prescribe or advise on the examinations necessary for the earliest possible diagnosis of pregnancies at risk

to provide a programme of parenthood preparation and a complete preparation for childbirth including advice on hygiene and nutrition

to care for and assist the mother during labour and to monitor the condition of the foetus in utero by the appropriate clinical and technical means

to conduct spontaneous deliveries including where required, an episiotomy and in urgent cases a breech delivery

to recognise the warning signs of abnormality in the mother or infant which necessitate referral to a doctor and to assist the latter where appropriate; to take the necessary emergency measures in the doctor’s absence, in particular the manual removal of the placenta, possibly followed by a manual examination of the uterus

to examine and care for the new-born infant; to take all initiatives which are necessary in case of need and to carry out where necessary immediate resuscitation

to care for and monitor the progress of the mother in the post-natal period and to give all necessary advice to the mother on infant care to enable her to ensure the optimum progress of the new-born infant

to carry out the treatment prescribed by a doctor to maintain all necessary records.

Changes in the profession itself along with the level of responsibility and autonomy required by the midwife warrant the development and provision of a pre-qualifying degree programme (SNMAC1998). The role of midwife covers a number of facets: clinician, educator, manager and researcher. In order to fulfil the multifaceted role a midwife, like other comparable professionals, should bring to bear the broad range of key skills and attitudes normally developed in a graduate. In addition, specialised knowledge of a range of biological science, social science and management disciplines is necessary for those working in a field where scientific, technological, managerial interpersonal skills are required in day to day practice.

All undergraduate programmes are carefully structured to provide an integrated balance of theory and practice. Placements are arranged in variety of health and social care settings, enabling students to gain insight and confidence in the practical aspects of their chosen profession

Zones

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Zone Placement Provider Includes

A GloucestershireGloucestershire Hospitals NHS Trust includes Gloucester Royal Hospital ,Cheltenham General Hospital and Stroud maternity unit

BNorth Bristol North Bristol NHS Trust includes Southmead

and Frenchay Hospitals. Cossham Birth unit

CBristol and North Somerset United Bristol Healthcare Trust (UBHT) and

Weston Area Health Trust includes Bristol Royal Infirmary and Weston General Hospital

DBath and North East Somerset

Royal United Healthcare NHS Trust includes Royal United Hospital Bath

ESwindon Swindon and Marlborough NHS Trust includes

Great Western Hospital

A zone is a geographical grouping of placements based on the counties and unitary authorities of the West of England. Midwifery has its own identified zones, providing the student with a full and comprehensive range of practice experience within the Trusts and community..

Brief description of practice allocations.

Throughout the three years, you will be provided with practice placements that facilitate your development of midwifery core skills and the achievement of the learning outcomes as outlined in each year of the Student assessment document

Whilst recognising that health care is increasing being delivered in Community settings. You will have the opportunity to deliver midwifery care in the home, birth units and in hospital. A varied number of learning opportunities will therefore be possible during these allocations to meet the required learning outcomes within different care settings.

In order to provide you with this variation, midwifery students at UWE, are expected to travel to placements areas across the region. We will try to keep you in your zone but due to the nature of the programme and in order for you to achieve the practice experiences required for registration, it is not possible to guarantee all placements

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will be geographically close to where you live. You may be allocated to at least one out of zone placement.

Students allocated a placement for which travel or accommodation may be necessary are advised to make an appointment with a student advisor to discuss their eligibility for claiming travel and accommodation costs.

Student Responsibilities for Practice Learning

Before Practice Learning Starts

When you have obtained details of your practice learning setting, contact the placement manager / equivalent. This should be at least two weeks before the starting date

When you make the initial contact introduce yourself, confirm starting date and time and clarify any issues of concern relating to your practice learning

Ensure you understand the specific expectations of your allocated practice placement/practice learning setting by accessing and reading appropriate documents.

Clarify the dress code of your practice placement/practice learning setting and where applicable conform to the UWE uniform policy.

During Practice Learning

Act at all times in accordance with the relevant codes of professional practice.

Act at all times, in accordance with Health and Safety regulations

Maintain confidentiality with regard to patients/clients/service users and documentation.

Be punctual, reliable, courteous and honest

Take reasonable steps to keep self and others safe.

Develop skills in working effectively as a member of the interprofessional team to support safe patient/client service user care

As a Student

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Identify your learning needs using the approved documents (eg learning contracts, portfolios, learning packages )

With the guidance of your Mentor / Assessor, seek out experiences for your level of practice and competence to support you in achieving your learning outcomes.

Should the practice teaching and/or supervision arrangements become ineffective, contact your mentor/assessor/supervisor/practice teacher to make them aware as soon as possible, and discuss the situation.

If the issue(s) remain unresolved, refer to and follow the appropriate guidance available in the programme handbook..

Ensure that skills required at each stage in the programme are attempted under the supervision of a skilled practitioner.

Where appropriate negotiate with Mentor/Assessor, relevant learning opportunities external to the practice placement / practice learning setting.

Adopt a questioning and reflective approach to your learning to increase self-awareness, confidence and competence. Where appropriate give and receive constructive feedback.

Prepare yourself for classroom or agreed meetings with UWE academic staff.

Ensure that practice assessment documentation ( where applicable) is accurately completed and submitted on time

Seek help from the faculty student advisers, if issues such as finance, accommodation or personal issues are impinging on your practice learning

Comply with the UWE sickness and absence policy, and the Trust/Organisations reporting arrangements.

Constructively evaluate the placement itself, using the UWE approved online evaluation

Student attendance

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Attendance for Pre-Registration Midwifery Students is compulsory and it is vital that students report any periods of sickness or absence to their allocated practice placement and the Faculty.

When on placement students may be asked to provide their contact telephone numbers because managers are concerned about their safety as lone workers. Students are advised that it is at their own discretion to do so but that they should be guided by the placement’s protocols

Any student who is absent from clinical practice or study days/block will be required to work the number of days lost, at the end of the course. Please see the programme handbook for information on this and further information below.

Practice hours

Shift patterns

You will need to work shifts whilst on clinical placement. You will be expected to work weekends (Saturday and Sunday), but no more than one weekend in three.

You will also be expected to work night shifts. You should not do more than 3 consecutive night shifts.

You should not be expected to work a night shift which ends on the morning of a scheduled university day, or starts in the evening of a university day.

You will be expected to work the shift pattern adhered to by the placement, however in some placement areas, you may be required to work a different shift length to the registered staff.

Long day Shift – for example 07.30-20.00

Traditional day shift – for example 06.30-14.30 or 12.00-20.00 or any variation of a 7.5 hour shift

Night shifts – for example 19.30-08.00

The working week is 37.5 hours and you should not work more than 150 hours in a 4 week period.

European working time directives mean that you should not work more than 42 hours in one week.

As is the expectation for registered staff and to meet the NMC requirements, you will be expected to manage your child caring responsibilities around your shift patterns.

Bank holidays / Annual leave

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Bank holidays /Annual leave is fixed according to your programme of study and year. This is non-negotiable and students cannot request additional annual leave to manage child care responsibilities.

Adverse weather (snow / Flooding)

Students should check the university website for advice on University closures. Students should also check local radio for travel information.

Although University sites may be closed during adverse weather conditions, your placement is unlikely to be closed.

As students you should make safe and reasonable efforts to attend your shift. However, there will be times when you will be unable to do so.

If this is the case:

1) Ring the placement and let them know. They may ask if you could make a different shift start time. If you think this is possible then you should.

2) Please note that a new Practice Absence Reporting Line is now available. If for any reason you are unable to attend your practice placement please call the number given to you in induction week and leave your name, student number and location of your practice placement. They will not return your call but your absence will be recorded.

3) Because the University is closed, your absence will be counted as “Authorised Absence” and recorded as such. It will be added to any time you have to may have to make up at the end of the programme

4) If a mentor suggests that you leave placement early as the weather looks like it could deteriorate you will be “credited “with the full shift.

Private study days

Students are not entitled to private study days during clinical placement without prior negotiation with practice module leader and mentor.

Duty Rosters

Shifts are rostered by your mentor or the key mentor for the clinical placement area. You may make requests for certain shift patterns with a minimum of one week’s notice. Your mentor is not obliged to grant your request. You should be mindful of the needs of other students on placement with you and ensure that requests for weekends or nights are fair.

Under European working time directives, you are entitled to 2 dyas off a week, but these may not be consecutive. You must also have an 11 hour rest period within a 24 hour period

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Can I go early?

Placement staff may choose to let you go home early. If they do, please be appreciative and don’t assume you will to do this every shift. Beware asking to leave early as it may appear to the staff that you are not interested in learning and are not committed to your course.

Supernumary status in clinical placement

Students have supernumary status and as such, you are not counted as part of the clinical staffing numbers in the first and second year.

Meal breaks

You are entitled to a 20 minute break for every 6 hours worked. You are also entitled to a lunch break which is usually 30 minutes.

Working with your mentor

You should work with your sign off mentor for a minimum of 40% of the placement

Timesheets

Timesheets must be completed on a weekly basis and signed by your mentor or a registered nurse/midwife.

Making up hours

In order to achieve NMC requirements for minimum hours, students are required to make up any hours lost through sickness or absence (authorised or unauthorised) must be made up at a later date. Five days can be made up during the year no more than one additional shift per week. Please do not try to make up hours at any other time, if you have any more hours outstanding you will need to liaise with your personal tutor in the third year how these can be made up.

All days lost through sickness or absence from practice MUST be made up by the end of the programme and BEFORE the student profile can be presented to the Award Board

Absence due to:

Sickness – contact the absence reporting line and your clinical placement

Other than absence for sickness, all other authorised absence need to be negotiated with the academic personal tutor.

Compassionate leave – arranged through negotiation with your academic personal tutor. You will need to collect a form from the Information point for your academic tutor to sign.

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Jury service – you will need to contact your programme manager to discuss this further and explore the impact on your programme to develop a plan of action.

Military reserve personnel – you will need to contact your programme manager to discuss this further and explore the impact on your programme to develop a plan of action.

Authorised absence – this can be granted for hospital appointments and carer emergencies.

Interview days

You are entitled to attend all job interviews in year 3. Time missed should be made up and you must prepare for interviews in your own time

What counts as practice hours?

All clinical placement hours count. Simulation sessions focussing upon episiotomy, breech birth and emergency skills drill and work based learning days at the trust also count as practice hours..

Work based learning days

During practice placements the link between theory and practice will be enhanced by prescribed work based learning days in your zoned (practice) area on certain weeks of the academic year. These sessions will use your clinical experience as a trigger to review and consolidate your learning, and as a springboard for further exploration and discovery.

The philosophy that underpins the curriculum not only recognises the importance of a programme of preparation that is practice centred, but acknowledges the need to promote the integration of theory and practice for the achievement of professional competence.

The work based learning days aim at strengthening this theory practice integration in a number of ways:

1. expanding the opportunity for students to develop independence, autonomy, flexibility and reflective thinking;

2. using real life scenarios to facilitate student learning;

3. accessing sources of information to support midwifery practice as it is delivered;

The focus of the Work Based Learning Days will be on incidents emerging from practice. These could range from broad situations such as advocacy and

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empowerment to specific case studies. They will also include skills to enhance practice. What is important is they are deemed appropriate to the learning outcomes of the Professional Practice module the student is undertaking.

Since these Work Based Learning Days occur within each practice placement experience, more information about the dates and organisation of these days will be contained within the relevant practice module handbook.

Attendance is compulsory and absence requires you to contact your Academic Personal Tutor with an explanation?

Pregnancy, Maternity Leave and Maternity Support Award (Paternity Leave)

As soon as you know you are pregnant, contact your programme manager.

Pregnant students are entitled to a year’s maternity leave which will be arranged via your programme manager. In order to make stepping off and back on to the programme at an appropriate time, maternity leave may start earlier than anticipated.

Pregnant students are obliged to inform their clinical placement area. Your mentor or their manager will need carry out a risk assessment to ensure your safety.

If you are the partner of someone who is expecting a baby, you are entitled to up to 4 weeks maternity support leave. These 4 weeks can be taken at any point during the first year of the baby’s life and can be taken separately. Maternity support cannot commence before the birth. Please see your programme manager to negotiate this.

Placement allocation

Placements are allocated through the Professional Practice Office and each placement must meet the NMC requirements of the programme. Students are not able to request certain placement areas. If a student has a personal reason to not be allocated a particular placement area/ speciality (for example, family member is a service user in that area), then they can do so through negotiation with their programme manager.

Students must be prepared to travel to their placement allocation as agreed when the offer of a place at UWE was accepted.

Because of the complexity of placements and the need to ensure transparency, tracking and equity, students will not be allowed to contact and/or organise their own placements (unless undertaking an elective experience).

Accommodation whilst on Placement

If you are unable to travel to placement on a daily basis and require accommodation, please see the student advisors.

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Retrieval of practice

If you fail the final placement of each year, a retrieval placement will be considered at the award board. Retrieval needs to happen in the first 12 weeks of the subsequent year in order to meet NMC requirements. If this is not possible, the student needs to step off the programme and return at a later date if appropriate.

Please note, a retrieval placement is not an automatic right and the decision is made by the award board, not a member of your programme team.

Retrieval placements are arranged through the Professional Practice Office. Retrieval placements are usually for 5 weeks, to include one week orientation and 4 weeks assessment period. This maybe 8 weeks, depending on individual student extenuating circumstances.

Accidents in clinical practice

If you have an accident on clinical placement, regardless of how minor, you need to inform the university via the practice support line

The academic year dates are published on the University website, see:http://www1.uwe.ac.uk/aboutus/termdates/2012-13termdates.aspx

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DRESS CODE

Students are requested to check the uniform requirement when they first make contact with the practice placement. However, whether they are required to wear uniform or not, are made aware that they will be meeting patients, clients, and that therefore their dress should reflect their professional position.They are advised that dress should be safe and hygienic. The list below, gives some general points on maintaining the professional image.

Bank Work Do not wear UWE Uniform or Student badge when undertaking work for Bank or Agency. Student badge should be worn at all times in practice for identification.

Hair If you have long hair, please ensure it is securely tied back.

If you have short hair, it should be of a tidy appearance requiring a minimum of “maintenance”

Jewellery/Watches All jewellery should be discrete. If you have pierced ears stud earrings should be worn. Do not wear large or fashionable watches that may cause harm when handling patients.

General Appearance All clothes worn whilst on placement should be well laundered and maintained.

Shoes For both male and female students, black lace up shoes should be worn. Footwear should be kept clean and in good repair. Female students should wear black or natural coloured tights/stockings.

Coats You are not required to buy a coat but it is a good idea to purchase a dark coloured full-length coat or raincoat which will completely cover your uniform whilst travelling. This is particularly useful when undertaking community-based Health Visitor or Community Midwifery placements

Smoking You should observe all no smoking rules in operation whilst on practice placement

Travelling Whilst travelling it would be preferable to travel in your own clothes and change into your uniform when you arrive where there should be changing facilities. If this is not possible, uniform should be completely covered and worn for the minimum amount of time outside your placement. It is inadvisable to be seen in public in uniform as members of the public may mistake you for trained staff and seek assistance that is inappropriate to your status.

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ADMINISTRATION OF DRUGS POLICY for UWE 3 year Midwifery Students

The qualified midwife remains accountable for the correct administration of the drugs as prescribed on all occasions. At no stage during the programme is it expected that 3 year student midwives will be solo drug administrators.

The 3 year BSc (Hons) Midwifery students are not registered nurses and therefore they will need active involvement in drug administration from their first clinical placement. They will be expected to pass a numeracy test during the initial 20 weeks of the programme. They will also need to meet the assessment requirements in the clinical assessment .This will not be achievable unless they are actively participating in drug administration.

In order to achieve

The student should have substantial experience of drug administration in the midwifery practice environment.

The student should be fully aware of the implications of the drugs in relation to midwifery The student should also be aware of and comply with local policies and the patient group

directives.

It is an expectation that students will participate in the administration of all drugs including situations when one or two trained persons are required to check the drug prior to administration. In these circumstances students will be observers for the checking process. However, they should be encouraged to be the administrator of the drug under direct supervision (NMC 2009), provided they have received the appropriate training as to use, dosage and methods of administration (NMC 2009).

This will include:- Prescribed stock drugs e.g. Standing Orders, Protocols and Patient Group Directives IV Fluids. IV Additives. Blood and blood products. All injections. All drugs administered to neonates. Epidural top-up.

Two trained midwives/nurses are required to check the above list; however, one trained midwife/nurse may be substituted by a pre-registration student midwife who is in the final stage of the programme and has:-

Successfully passed the numeracy test. Attended all the pharmacology lectures. Achieved the NMC standard for the administration of drugs in the assessment document.At all times the student will remain under the supervision of a registered midwife, who remains accountable for the correct administration of the drug as prescribed on these occasions.

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Flow charts for Student involvement in investigations.

Process for investigation Student midwife i

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Investigation outcome feedback to student as approrpiate

Interviews Student support provided before, during and post interview (must involve a tutor/PALM)

Interview Requests - Supervision and Management Routes

Student advised to contact Practice Education Team and Personal Tutor for support

Statement requested all routes personl tutor or PALM must be present

Decison regarding investigative route. supervisory /management

Internal or reportable. Notification to Trust /Manager must include notiification to PALM/Supervisor

SIRI or Clinical Incident

Investigation outcome feedback to student as approrpiate

Interviews Student support provided before, during and post interview (must involve a tutor/PALM)

Interview Requests - Management Routes

Student advised to contact Practice Education Team and Academic Personal Tutor for support

Statement requested all routes Academic personal tutor or PALM must be present

Decison regarding investigative route. Reportable to Management

Internal or reportable. Notification to Palm /Supervisor

Practice issues/whistle blowing

Flow chart for Practice issues and Whistle blowing

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