After 2 ½ years of negotiations with the Bradford Foundation Trust, more than 45 members of the Royal College of Midwives, UNISON, and the Royal College of Nursing vowed to continue to lobby NHS managers after a collective grievance regarding the shortage of midwives was rejected on Thursday (Dec. 6). The grievance was a response to understaffing, lack of equipment for midwives and the chronic shortage of midwives serving a diverse and hard-to-reach community. In response to the grievance, NHS managers proposed a plan for £150,000 for maternity care assistants or support workers rather than hiring more midwives, which was requested by the three unions.

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Im not sure I like the sound of where this is going.....

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Josie
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It's the way it's been looking for a while, JosieJo.

Where I work, our MCAs run in theatre, some are trained to assist (ie surgeons assistant, the job usually done in theatre by junior doctors), they are fully breastfeeding trained, they take out catheters and venflons, do mum obs and the four hourly baby obs where required for babies at risk, they perform venepuncture, and a million and one other things - their role is expanding (the baby obs and venepuncture are relatively new) and they're being encouraged to study for higher NVQs and progress up the pay scale. On the face of it I have no objection to this - we have a core of experienced, knowledgable and skilled MCAs, they are fab, they should be developed and should be paid for what they do. But to look a bit wider, where will the expansion of their skills stop - it's not difficult to visualise a time where the wards will be staffed by MCAs doing the clinical stuff, with a midwife sitting at the desk doing the paperwork and - importantly - being the only registered practitioner and therefore the only one actually accountable. I wouldn't want to be that midwife.... that's not what I spent three years at uni for, and while most of our MCAs are great, there are a couple that I wouldn't want to be effectively practising on my registration whilst being unsupervised because I was tied to a desk. But look at it from the Trust's point of view, how many MCAs could they employ for the price of a midwife - the ward could be better staffed (in terms of bums on seats) and they would save money. There was also talk a while ago about having community based MCAs who would do routine postnatal visits for straightforward women... what about the training we have to recognise deviations from the norm? Again - who would be accountable?

Food for thought, eh.....

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When I worked as a trainee clinical support worker before starting uni I worked on a mixed ante/post natal ward.

I was there for a total of 10 weeks, and I had been shown how to remove a catheter, and a venflon, and was in the process of being taught how to do pulse (still not got the hang of that) and blood pressure, I also provided support for newly breastfeeding mums and babies.

I really enjoyed learning these skills, and having more responsibility, and I felt like I was being 'useful' as it gave the midiwves time to provide more care to the women who needed it.

But I can understand the points that have been made, and I do agree that someone with very little training or experience can't and shouldn't take the place of qualified midwives.

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[quote] There was also talk a while ago about having community based MCAs who would do routine postnatal visits for straightforward women... what about the training we have to recognise deviations from the norm? Again - who would be accountable?[quote]

Have talked alot about this with the girls on my course as its happening in one of our trusts atm. The concern from colleagues at the Trust is exactly as you say, what is a run of the mill visit last time doesnt mean a run of the mill visit this time, what if the woman had a red itchy patch on her leg and it was seen as a normal rash and they missed a PE? It concerns me that in a bid to save money - mums, babies, the profession and the MCA's who are expected to go out and be midwives on some level (lets be honest thats whats going to be expected of them even if its said its not) are going to suffer.

Yes it will be said to call in if you are not sure etc etc etc but what if you feel you are sure because you havent had sufficient training to recognise the abnormal?

It really does concern me. Im not saying that MCA's arent great because they are, but Im concerned that in a bid to improve staffing numbers MCAs will be put in vulnerable positions, 'why didnt you phone in?' 'why didnt you report X' etc etc when even experienced midwives miss things.

Am i wrong? or is this really the only way to protect 'real' Community Midwifery that takes place in the family home rather than the 'new' c/m which seems to be clinics in childrens centres?

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Josie
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what a bout the research presented at the RCM conference regarding MCA's performing ab palps, and canulation and ....VE's!!!!
OMG!

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+I thought that I would reply to this but from the MCA side. I have just started as a MCA whilst loving every minuite of it the job role is getting more and more complex as the years are going and although i have a lot of experience as a NA on general wards it is a lot for some one untrained to sometimes take on. but on the other hand being able to do the obs catherters (we can put them in as well once trained) venepuncture breast feeding etc it does mean that the devoted midwives have the time to spend on the high risk paitents as it it now said that we are the eyes and ears of the wards and can quite often spot porblems before they even start. After speakin to my dear Mum (RGN) she says that an NA MCA position is starting to be more like the old SEN(think thats right enrolled Nurse), but i will finish this with i might be just a MCA but some of us do have a lot of experience and we are not taking your jobs we are just an extra set of hands for you all to use!
And we always inform a RM of any change as its better to be safe but we also go through a lot of training as well.