Reflecting on emergencies
Reflective practice can be a helpful way of understanding clinical events, particularly if they are distressing. Mary Kellett describes a situation and uses a reflective model to evaluate what she learnt
I have chosen Gibb's (1988) model of reflective practice to make sense of an emergency I experienced while on my first clinical placement in maternity care. For the purposes of this article and to maintain patient confidentiality, I will use the pseudonym Ann for the woman and the pseudonym Bill for her partner.
Early in my first clinical placement as a student midwife, Ann presented to the labour ward for removal of a cervical cerclage. She was at 37 weeks' gestation and healthy. Bill did not accompany her. I introduced myself as a student midwife and we chatted. I also obtained her consent to observe the procedure. Ann had a relaxed demeanour and did not appear anxious.
Ann's vital signs were within the normal ranges, and she was therefore prepared for the procedure. After the procedure, Ann said that she felt weak and began to experience pains. Although she was unsure what was happening, Ann contacted Bill, as she felt that he should be present if she was in labour. Following an assessment by my preceptor midwife, assistance was summoned as it appeared that Ann's condition was deteriorating. When the clinical midwife manager, obstetrician and anaesthetist arrived, it was concluded that Ann required an emergency caesarean section.
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