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Connecting, learning and reflecting through COVID-19 – Laura Smith

“Seeing a new life come into this world will never cease to be absolutely magic to me.”

Laura Smith is a Midwife at Causeway Hospital, Coleraine. She is passionate about her job – caring, empathetic and compassionate – qualities which lie at the heart of midwifery.

In the ninth of a series of Nightingale Blogs, Laura describes her path into midwifery, being part of a wonderful, supportive team, developing her leadership skills through the global Nightingale Challenge – and the privilege of being with women and their families at one of the most special moments of their life.

My name is Laura Smith and I am a midwife based in Causeway Hospital Maternity Unit in Coleraine. As a teenager I had always been interested in midwifery, but I never saw it as an option for me given as I had a flair for languages and set my sights on a degree in French and Spanish in the hope of going into teaching. However, six weeks into my degree I knew that my heart wasn’t in it. At a crossroads, I then took a post as a ward clerk in Maternity and Gynaecology in Antrim. Being in the maternity environment and seeing the role of the midwife lit a fire within me to go for it and apply to do midwifery. I started my training in September 2013 and took a post in Causeway in October 2016. I was extremely fortunate to do my placements in Causeway, and to take a post there was the icing on the cake for me. Within Causeway Maternity I feel that I’ve gained far more than midwifery experience – I feel so lucky to be a part of the most wonderful team who have always supported me in my doubtful days as a junior midwife, shared in the many laughs along the way and have become more like family to me. The highlight so far of my midwifery career always has been (and I’m sure always will be) being fortunate to share in the privilege bestowed upon midwives in being with women and families in one of the most special moments of their life; to see a new life come into this world will never cease to be absolutely magic to me.

I was approached by Barbara Strawbridge, Lead Midwife at Causeway Hospital, to apply for the Northern Nightingale Challenge Programme. My first reaction was one of shock – when I read the brief looking for individuals ‘recognised as rising stars’ – I couldn’t see how I would fit into that description! After a time of reflection and encouragement from Barbara, I began to see that this was an opportunity I couldn’t possibly pass up – To be mentored by the senior management team, attend conferences, learning events and leadership walk-arounds, and to learn more about effective leadership and team working along with the Trust’s other rising stars. This gave me the encouragement and empowerment to see myself with the potential of being a young leader; to see in myself what everyone else seemed to see.

New challenges as a result of the pandemic

There have been so many fantastic learning opportunities as a Northern Nightingale. I really enjoyed the Collective Leadership Workshop study day that was facilitated by the Northern Nightingale Challenge Programme Leads and the Trust’s Organisation Development Team on leadership qualities, and I also felt empowered to put myself out there to try new things which I wouldn’t normally feel comfortable doing, for example, the field hospital day. The Collective Leadership Workshop study day made me reflect on the different leadership styles I see around me, and to think about the kind of leader that I would hope to be some day. It demonstrated the importance of compassionate leadership and communication skills in facilitating effective team working. Prior to the Covid pandemic I had started organising a charity fundraising programme to aid the development of a bereavement suite in Causeway Hospital in Coleraine, to improve women and families’ experience in having a dedicated personal space when receiving bereavement care; additionally I felt that this would also benefit my leadership and organisational skills. Sadly this has had to be postponed – both Covid and I soon learnt that there would be many new challenges coming my way as a result of the pandemic.

Empathy for women

During Covid-19 there was a reshuffle of services to meet the needs of the pandemic resulting in the provision of inpatient maternity services in Causeway being relocated to Antrim Area Hospital, and the redeployment of Causeway staff along with it. Although I had known of nursing staff being redeployed to other areas, the relocation of maternity services wasn’t necessarily something I considered as a possibility and came as a huge shock to many of us. While the professional within me understood that this was a necessary move to ensure provision of anaesthetic and paediatric care to maternity patients, the emotional reaction was overwhelming and I became very anxious. How would I adjust to travelling an 80 mile round trip every shift? How would I feel without the team that I know around me? How would we cope in a larger unit? So many questions and anxieties, both rational and irrational filled my head.

In a way, I feel like my redeployment enabled me to have more empathy for the women who were also being relocated for their care – they had only ever considered being in Causeway Hospital to have their baby, they had a comfortable and easy rapport with the team; the fear of the unknown was definitely a shared experience for all. I worried that being in a different environment would affect my confidence and hold me back from being the midwife I knew I could be. Thankfully, my fears were short lived, I was warmly welcomed by the Antrim team and felt my confidence growing with every shift, and it was so lovely to be recognised by women who had been booked for Causeway Maternity Services as a familiar face even while wearing a mask!

I also took this as a learning opportunity as a Northern Nightingale. Redeployment has facilitated an opportunity to work alongside a brand new team – bringing a number of opportunities for learning and sharing on practice and expertise. For example, redeployment to Antrim Area Hospital facilitated a shared learning experience for all midwives, particularly surrounding the care of women with diabetes in pregnancy as they would not routinely be cared for in Causeway Maternity. The combination of the two maternity teams was such a refreshing and enlightening experience; each team was able to share different ideas on practice and care provision and come together as a collective in providing excellent quality care to women and families. I feel I have learned so many new things in Antrim that I will bring back to Causeway with me.

‘Please know that I am smiling’

During Covid I have been fortunate to experience the positive influence of social media and technology. I created a team WhatsApp group for ever-changing Covid updates and also as a means of promoting a feeling of togetherness and familiarity, while our team was redeployed to different areas.

In May, I was approached and asked if I would participate in an interview for BBC Newsline, looking at the changes in maternity care provision during Covid, and our experience. Initially I was unbelievably nervous! To be a spokesperson and represent midwifery, and the Trust, felt like a daunting responsibility; I worried in case I might not say the right thing, or come across as unprofessional – but with encouragement and reassurance from my team (and an absolutely delightful reporter who put me completely at ease), I spoke about the changes surrounding the presence of birth partners during induction of labour/early labour, and the wearing of PPE. I also shared the message that although things might look a little different, the word midwife means ‘with woman’ and that always was and always would be our priority – and how I hoped that by saying although you cannot see my whole face, please know that I was smiling – to offer some small reassurance.

As nervous as I was, seeing the reporter get choked up and say “you must be the loveliest midwife” made what initially was a daunting responsibility evolve into such an empowering experience and something I am so proud of doing.

Compassionate leadership

During Covid, I have seen that it is true that you do not have to be a senior nurse or a nurse manager to be seen as a leader, but that there is potential within all of us to be leaders irrespective of your Health and Social Care pay band or role. When faced with redeployment, each individual member of our team displayed their own leadership abilities; whether this was relating to practical organisational tasks or simply the provision of kind and compassionate leadership to others during a stressful time. I feel that compassion lies at the heart of midwifery and the care we provide to women and families, therefore I feel I can strongly identify with compassionate leadership, seeking to bring out the best in those around you, understanding that a positive shared outcome will come as a result of using a combination of everyone’s strengths and ability and practising excellent communication skills when interacting with team members and service users.

I feel that I have had to work a lot to maintain resilience during this experience, the stress and worry caused by Covid alone was then amplified by the stress of redeployment to a new area. Although it was worrisome, I feel that by acknowledging my own fears and concerns, helped me to have empathy for the women in the Causeway locality who were also having their care transferred to Antrim Area Hospital. During this time it was so lovely to be working in Antrim Area Hospital and be a familiar face for women coming through a new unit and without their birth partners. I benefited from the practice of reflection and examining what my stressors were, how they made me feel, and trying to determine why they made me feel that way by using mindfulness to work through them. A simple ten minute break to practice some mindfulness really was so beneficial, in addition to staying connected with my family, friends and team.

As a team, we all recognised the importance of self-care and looking after each other. Amongst the moments of shared anxieties and the unknown, it was really important for us to take opportunities to celebrate the joy in work! So we jumped on board the ‘Tik-Tok’ train as a team! My fellow midwife Alana Divito (a fellow Northern Nightingale on the Regional Global Leadership Development Programme) and I made a video demonstrating effective hand washing to lyrics of a Dolly Parton song, which was picked up and shared on social media by other healthcare organisations across the world.

Additionally a group of us participated in the ‘Blinding Lights’ challenge which was shared by a local news group and received over 45,000 views and hundreds of comments from the general public and service users, complimenting individuals who they recognised in the video and Causeway Maternity Unit as a whole. In this influential era of social media, it is easy to publicise when things are not up to standard, particularly surrounding healthcare provision. This is an important tool for the public to raise concerns and share experiences that can inform change. But it is also important to use this virtual space to celebrate the amazing, professional care that is delivered every day by midwives around the world. This experience of networking and seeing the positive power of social media was an encouraging and uplifting experience for our whole team, and particularly for myself as a young professional.

Most importantly, I am constantly reminded to be kind to myself! Remembering my accountability that I am only one person, and in order to provide excellent, efficient, high standard and quality care to women and families, I must first and foremost remember to care for me.

*Inpatient maternity services in Causeway Hospital are set to resume on 24 August 2020.

Laura Smith, Midwife, Maternity, Causeway Hospital, Coleraine

The Nightingale Challenge has been 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.

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