‘No one can prepare you for the transition from student to qualified practitioner.’ These are the wise words of my mum, former intensive treatment unit nurse and current matron. She's absolutely right. At university, we had talks about the process of qualification: what to do and what to expect. I'd studied and trained for three years for this moment. ‘So why,’ I thought, as I stood in front of the mirror in my brand new uniform on my first day on shift, ‘do I feel like I have absolutely no idea what I'm doing?’
I swung from nausea to excitement to dread all within the first hour, and by the end of the day, I was exhausted. Everyone had said how exciting it was to finally have your PIN and start working your way, with no one looking over your shoulder the whole time; how come I felt so out of my depth? The job was the same that I had been doing for three years, but the responsibility had increased tenfold.
My medication rounds in the first week took twice as long as they should have done, as I painstakingly checked allergies, doses and the hours between two, three and four times. Each time I discharged a woman home I would panic, going over and over in my head everything I had done, absolutely sure I had forgotten something—although I never had. I documented everything and stayed late to make sure that my actions for the whole shift were accounted for on every woman and baby's notes in meticulous detail. I honestly felt that my PIN was dangling by a thread and that the slightest mistake or omission would send it crashing to the ground. My imposter syndrome came out in full force; I couldn't have worked harder or better, but I still waited for the hand on my shoulder that would cart me into an office to tell me someone somewhere had made a mistake, and I never should have been allowed to qualify.
I hasten to add that it was not all doom and gloom. I was lucky enough to get my supernumerary time. So, while I was having intermittent internal meltdowns, I was also able to throw myself into tasks that I had not been able to do as a student, and take time to update myself on guidelines and recent changes to practice. I countersigned for intravenous and controlled drugs, gleefully signing my name without having to leave the room for a countersignature.
‘I documented everything and stayed late to make sure that my actions for the whole shift were accounted for’
The first time I signed into a computer with the access role of ‘midwife’, I had a flutter of alarm but a simultaneous moment of pride seeing it next to my name, knowing that I'd earned it. Without a mentor over my shoulder, when women asked me questions, my answers simply rolled off my tongue. Not only did I know my stuff but I wasn't reflexively looking at my mentor for confirmation or guidance. I started to feel confident in my own abilities, that I was actually a midwife. The work felt overwhelming and, at times, it was to the point that I would drive home in tears. Other times, the sheer enormity of the responsibility I had taken upon myself was enough to send me spiralling. But I started to see each day as a learning opportunity; how can I prioritise better next time? How can I streamline a discharge so the family can get home as soon and as safely possible?
My first week wasn't easy. It was emotional and demanding. Starting on the postnatal ward felt like a baptism of fire. I put enormous pressure on myself to get everything done, and handing over unfinished postnatal checks and referrals made me feel horribly guilty. However, a piece of advice drummed into me by several of my colleagues started to lift some of that guilt; we run a 24-hour service and even with the best will in the world, no one will achieve everything they set out to at the beginning of a shift.
I can't count the number of times I have heard that said to me and it's a mantra that I now repeat to myself when I'm feeling overwhelmed. It's also the most important piece of advice I will pass on to others. The support I have had has been fantastic, from the practice development midwives who are always available with a box of tissues (or a napkin in a pinch) to the cohort of current preceptors now a year into their careers. They listen, they share and, most importantly, they validate. To hear from a fellow midwife that they felt exactly as you did is the most uplifting thing. They say it takes at least six months to feel settled into the role and while that seems far away, at least I know that I'm not alone.
A wise midwife once said that ‘the fear’ is what will make you good. While I have sometimes felt paralysed by fear, I have learnt to embrace and channel it into my work because I know that it is what makes me a safe practitioner. The day that I lose it is the day that I know I should leave the profession. Becoming a midwife is the hardest, scariest and most irrational thing I have ever done, and was it worth it? Absolutely.