‘I had never thought of it like that before…’
6 September 2016 | Jane Robinson
Have you ever had an experience that completely changed your clinical practice?
Jane Robinson, Clinical Improvement Project Lead for NHS Improvement writes for the QNI blog.
As a midwife, the first time this happened to me was when reading Sheila Kitzinger’s ‘Episiotomy and the Second Stage of Labour’ (1984). It completely changed my management of delivery.
I had been taught to shout, ‘PUSH!’ but Kitzinger highlighted that this depersonalises women and I immediately had an, ‘oh my goodness, I had never thought of it like that before…’ moment. From then on, I talked more softly to the women in my care and actually found this more powerful. Other professionals noticed and commented on my approach. I hope that it also has an impact on the students that I mentored.
I recently had another ‘I had never thought of it like that before…’moment.
I have been working with Dr Crystal Oldman, Chief Executive of the Queen’s Nursing Institute. Most of my clinical experience to date has been in hospitals. However since working with Crystal, I no longer call hospital care ‘acute care’. Community nurses provide acute care to patients too and in doing so often help them avoid unnecessary admissions to hospital.
Patients are being discharged from hospital much earlier, but still need some of the care at home that they would previously have received in hospital.
The second realisation for me was that the national aim to reduce length of stay in hospital has a huge impact on our community colleagues. I have been in practice long enough to remember when a woman having a hysterectomy was in hospital for a week.
Patients are being discharged from hospital much earlier, but still need some of the care at home that they would previously have received in hospital. This means patients are now engaging in self-care more frequently, with the support of community nurses and their teams. I am embarrassed to say that I had never thought of it like that before.
This experience will change my clinical practice. Understanding differences and communicating between my mental and physical silos will lead to better patient care. If I truly put the patient at the heart of my practice, then these barriers seem less important and less restrictive.
For all of us: exposure to new experiences, reflection, talking with and listening to others’ points of view can improve our practice. This is all within our gift.
If you would like to share your ‘I’d never thought of it like that before…’ moment, please do so at [email protected]