Writing Feedback / Benefit from response to emergency needs [3]

Do you mind proof reading and let me know: how can i structure this? what dou you think would be a good title? Cheers

The aim of this essay is to express a reflection done on a significant event that took place during my placement. This will focus on the benefit from holistic response to emergency needs. A Gibb's (1988) model of reflection will be applied and in order to comply with the confidentiality as required by the Nursing and Midwifery (NMC) Code of Conduct only the titles of involved people will be used with a pseudonym name of Mrs BEDE for a woman we were caring for. A summary of how this enhanced my learning development will be given before concluding.

At the start of my shift we were introduced to the care of Mrs... who was admitted in one of the maternity unit as she had a spontaneous rupture of.... six hours before the estimated due date and was not yet in established labour. Also, we were informed of other past health conditions such as multiple surgeries, depression, and anxiety. ... put it clear that early ... may lead to increased incidence of variable deceleration on which can lead to increase in caesarean section case. In fact, Mrs BEDE was induced and according to her birth plan choice (REF), epidural was given however she did not manage to remain mobile as the epidural affected in numbness of her legs (REF). She also had to be on a Continuous monitor in order to continually monitor and record the foetal heart rate. It is recommended for women with problems in their pregnancy or other risk factors including the use of epidural analgesia and other drugs such as those used for induction, to have a close foetal monitoring known such as ... (REF,). Despite her wishes, Doctors with other professional were faced with a challenging situation thinking whether she will be able to labour and deliver normally or not.

We then proceeded in the room where Mrs ... was and introduced ourselves. The midwife started making a new entry in the medical note and interest of how would be Mrs ... plan for her care; I was reading what the midwife was recording. After we did the normal emergency equipment check she then asked me what I wanted to learn and she gave me a brief explanation and told me that along the care we will be giving to Mrs ... I will manage to build up many skills which I did. Moreover, as I was keen to learn how to interpret and record the findings, was regularly checking the observations of Mrs ..., and I had to keep an eye on the print out form from the machine, the time, as well as the woman's reactions in order to respond efficiently to any change and be more proactive.

Later the foetal heart rate dramatically dropped and I stood up just when I wanted to alert the midwife about those changes, herself was asking Mrs ... to change her position quickly and she asked me to raise the emergency alarm. The available staff responded rapidly and some of them stayed for a while. However, after just four minutes everything returned to normal until the woman delivered.

It was very good to see how this promoted more the care of Mrs ... It was only after ten minutes when the Doctors came back to do a full review and one senior kept coming every fifteen minute until delivery. It is asserted REF) that knowledge on its own is not sufficient for making decisions. Healthcare professionals need good and clear reasoning (....) in order to give effective and evidence based care. The Doctors had to balance .... wishes, all her past medical history, other midwives views, as well as the care given on the day and related response. Therefore, this information brought up another picture which contributed to the whole care given. Mrs BEDE care was holistically attended to, and this benefited not only her but also her baby, and her family.

I was really pleased to see the way I with the midwife we spotted at the same time the changes and how the knowledge we had on NURSING CARE contributed to the care given to .... When she was fully dilated and had a pushing urge the doctor offered an examination and was happy for the woman to start pushing. Forty minutes after the doctor was informed and come back. While observing the pushing stage, she/he then approached the woman and spoke with her informing that she was not pushing effectively and as she had previous surgeries including caesarean that there was other risks that could be associated such as risk of uterine rupture. Consequently, options of ventouse or forceps were introduced and the woman was happy for the doctor to go ahead with any option they believed to be efficient. It is clear that pushing with epidural is often frustrating and ineffective (REF).

Nursing knowledge is fundamental and integral part of women care. This contributed to my learning and I hope that it will remain for my future practice. I understood that most of the time the epidural analgesia may increase both the length of the second stage of labour and the need for instrumental delivery. Following the care plan only would not fully benefit women in the maternity field but also we need always to use our critical thinking