Connecting, learning and reflecting through COVID-19 – Stacey Barclay

“I struggled with a strong sense of professional guilt not working on the ward during a very busy time and worried about staff who were working directly with Covid positive patients.”

Stacey Barclay is a midwife who is also expecting a baby.  She is also one of the Northern Trust nurses and midwives taking part in the 2020 Nightingale Challenge.

Stacey’s job role changed dramatically during the Covid-19 pandemic.

The government had identified pregnant women as being within a vulnerable category and women felt very anxious about going to work, attending appointments and leaving the house – and maternity services were changing and had to be delivered differently in order to keep women, their babies and staff safe.

In her blog, Stacey describes how she, as a midwife, advised and supported other pregnant women whilst experiencing emotions as a mum-to-be herself.

When I was nominated for the Nightingale Challenge I felt really excited about the opportunity to learn from others and develop my career as a midwife. What I did not realise at the time was that due to the Covid-19 pandemic my job role would completely change and therefore present new challenges to providing a high standard of maternity care. I have been a midwife in the antenatal/postnatal ward of Antrim Area Hospital for a year now, and prior to this, worked in the delivery suite and the antenatal clinic at the Ulster Hospital. My job role dramatically changed as I assisted in the set up and running of the Covid-19 pregnancy advice telephone line.

During the Covid-19 pandemic all areas of maternity services were effected and had to be delivered differently in order to keep women, their babies and staff safe. Visitors are currently not permitted onto the antenatal/postnatal ward, birthing partners are only permitted into the labour ward room, women must attend antenatal appointments alone and postnatal clinics have been set up rather than all postnatal visits taking place in the women’s homes.

Due to these changes maternity services look very different for women and their families. As midwives, we aim to provide women-centred care and acknowledge the importance of a family approach when welcoming a new baby.  With the continuously changing environment, women were often left feeling anxious about their ability to access services, how services would be delivered, and felt overwhelmed at the thought of going into hospital without their families. Due to the increase in anxiety it was quickly identified that women needed additional support and guidance. The Northern Health and Social Care Trust was the first trust in Northern Ireland to set up and go live with a pregnancy advice telephone line.

The government also identified pregnant women as being within a vulnerable category, women therefore felt very anxious about going to work, attending appointments and leaving the house. I was one of three midwives who advised and supported pregnant women, managers and community midwives about how to access up-to-date recommendations and guidance from the government, the Royal College of Obstetricians and Gynaecologists and Trust policies. We also supported managers with completing risk assessments for pregnant employees. Our aim was to reassure women, encourage them to attend appointments, seek assistance if concerned, and to ensure they knew their employment rights and liaise with Human Resources and Occupational Health. It was strange being a midwife and not just experiencing these changes in my job role, but also experiencing the impact of Covid from a first-hand perspective.

‘Maelstrom of emotion’

At the start of 2020, I had the joyous news that I was pregnant and expecting a baby! However, I also experienced the maelstrom of emotion as a mum-to-be with the uncertainty of the impact coronavirus might have on my experience of pregnancy and the delivery of my baby. My family were also very anxious about me continuing my midwifery role and were really concerned about any risks associated. But my managers were really supportive and I was able to move to the midwifery service that provided virtual advice over the telephone. This meant that I could continue to support women and feel safer in my work.

As a midwife our ultimate aim is to keep mums and their babies safe, the title itself meaning ‘with woman’. I therefore found it very difficult not being able to see mothers, to be face-to-face doing clinical duties, and working in a non-patient facing role. Although I was providing support over the telephone, I missed being able to work directly with women and their families and provide the same non-verbal communication that we are used to. Other colleagues also found this difficult; when providing care while wearing personal protection equipment you have to prioritise safety over the type of care you want to provide. I often had to explain to women that changes were not intended to make their families feel excluded but to preserve safety. I struggled with a strong sense of professional guilt not working on the ward during a very busy time and worried about staff who were working directly with Covid positive patients. While I understand everyone is making a contribution to the successful running of our services, I often felt guilty about staff who were working in a higher risk environment.

Recognising effective leadership

Having attended the Collective Leadership workshop through the Nightingale programme I feel better equipped to recognise effective leadership and identify poor leadership and engage with people in order to help improve outcomes. I was fortunate to witness and learn from positive management styles within maternity services; the management team showed empathy and tried to accommodate their staff who had to adapt to challenging home circumstances with lack of childcare, home schooling and caring for elderly relatives. However, while working on the pregnancy advice line I also witnessed the stress, anxiety and negative moments some mums in the private sector experienced due to the impact of Covid, with managers not prioritising their staff and not keeping up to date with guidance. Fortunately, most engaged in discussions and were willing to adapt the working environment to protect their staff, and I felt that my learning and knowledge of leadership helped empower me to have informative discussions with managers who were willing to engage with their staff and help identify alternative duties and find new ways of working.

Everyone has a responsibility

2020 was identified as the year of the Nurse and Midwife and we as Northern Nightingales set out on the programme with scheduled events to learn about leadership and to improve and promote our professions. I find it ironic yet inspiring that although things did not go to plan, we have all seen and learnt from effective leadership in practice during these unprecedented times. What better way to celebrate the year of the Nurse and Midwife than the general public acknowledging and being grateful for the NHS and the jobs that are carried out every day.

Being a Northern Nightingale has provided me with an insight into how the pandemic affected other nurses and midwives’ roles and how effective leadership shaped their services. It has given me a great support network and provided links with other nurses and midwives that I would not usually be working alongside.

I’m 34 weeks pregnant now and shall be going on maternity leave. I’ve been really supported by my fellow Nightingales and the Trust Nightingale Leads. The changes to virtual learning mean that I’ll be able to continue the Nightingale Challenge programme and I’m glad that I will be able to link into learning events and stay in touch with everyone.

It is very apparent in the Northern Trust that leadership is everyone’s responsibility and has been a contributing factor in the Trust being proactive in providing a high standard of care. Leadership behaviours have been demonstrated with new initiatives being implemented, staff have been ready to adjust to their changing roles and have gone above and beyond to show compassion to their colleagues and services users in uncertain times.

Stacey Barclay, Midwife, C2, Antrim Area Hospital

Stacey is one of 27 nurses and midwives in the Northern Trust who are taking part in the Nightingale Challenge.  The Nightingale Challenge was launched by Nursing Now – a programme of the Burdett Trust for Nursing, to improve health globally in collaboration with the International Council of Nursing and the World Health Organisation.  The Nightingale Challenge asks for every health employer to provide leadership and development training for a group of young nurses and midwives during 2020, the International Year of the Nurse and the Midwife.

@nhsctrust #NorthernNightingales
@NursingNow2020 #NursingNowNI #NightingaleChallenge
#InternationalYearoftheNurseandMidwife

Other Northern Trust Nightingale Blogs

Gemma McClean, Hospital Diversion Nursing Sister
Judith Shevlin, Community Mental Health Nurse
Denise O’Donnell, Acting Ward Manager, Covid-19 assessment ward
Eleni McCrea, Community Midwife, Whiteabbey Hospital

16th July 2020