Today it was my turn to be an intern at “Ö” and I signed up for the evening shift. I arrived to the Normal delivery ward with Sana at 13.30 We had planned to see some parts of the hospital that we missed during our last visit.  At 14.00 Sana had to leave and my shift started.

When Marianne gave me the characteristic blue clothes and a pager, I felt like I was a part of the team. I was very moved and enthusiastic about by my role. By following Marianne and other midwives closely I was tracking their work. The staff knew why I was there and was very helpful and welcoming. I even got permission to assist in a couple of deliveries. On my shift I was present during three deliveries;
all of them were different and unique.

At 15.00 Marianne got a new patient so we went to introduce ourselves. The Mother to be was in a lot of pain quite far in her delivery, so the whole thing proceeded pretty fast. I was amazed by Marianne
and how she in a small amount of time was able to make real connection with the patient. Her voice was calm and warm and the women easily put their trust in her and feel that they were in a good hand. After checking the condition of the patient we went to prepare some drinks for our new gests and also to bring all important equipment needed during delivery. Up until that time I hadn’t realized that the midwifes (due to poor planning) have to do a crazy amount walking/ running around the ward. Sometimes just for picking up equipment/ medicines or towels for the baby. One could compare it with a hard working out
session at the gym. I asked Marianne if the staff felt exhausted but she answered me with a smile “I know that it is pretty extensive but sometimes it is good to be able to stretch your body and have the possibility to take walk” Another delivery started and even this was a quick one. This time I even got to help the care givers by supporting the patient, holding her leg through contractions. It is hard to describe what I felt. It wasn’t as scary as I though, I was more exited and surprised. I was carefully observing the whole process, watching people in the room movie around and registering their reactions. The patients belonging like clothes etc. lying on the floor was from time to time disturbing Marianne and other midwives to work. There was no planned space for them. After exhausting time and “fight” finaly the baby was present on this world. This was like a magic moment that I will never forget. When mother saw her lovely baby girl the whole pain did not exist anymore. It looks like from now on was only those two and surrounding situation was gone.

Before going home I ask Marianne what she is thought about her job. The answer was ”I love my job and I would never change it for other one. Where else you could be able to see each every day those miracle when such a lovely small babies are coming on this world. For me it is a best job and I
couldn’t imagine me somewhere else”. I hope that me and Sana find a better solutions for the building and facilities. We should really think about the midwives, there body and create opportunity for them to take a walk in a nicer environment then a dark, institutional corridor.

At 20.30 I left the door of hospital, I went home with a lot of positive thoughts in my mind, ready to work!

        Today I was an intern at “Ö”. I worked the day shift with the midwives, following them and mapping their actions and needs. It was an experience I will carry with me for the rest of my life.

Delivery of beautiful baby boy “Al”

At 15.30 my beeper went off and the room I was assigned to for some hours of my shift room 9 flashed and vibrated through my blue outfit. My heartbeat rose when I saw Marianne running. She waved me in from a distance, smiling.

I walked in thinking I don’t know what to do with my hands. I was sure that mother and father would reject me if I looked unprofessional, but they didn’t even notice me as I walked in. I stuck my hands in the pockets of my shirt.

The mother’s contraction became more intense within five minutes and she was given nitrous oxide.  

There were two screens showing the mothers and the baby’s heartbeat, one was placed close to her head and one by her feet. I hadn’t had the chance to meet the head midwife in forehand so when Marianne walked out people in the room assumed I belonged there. The head midwife thought I was a medical student so she asked me for assistants and wanted me to stand very close to her and the mother to be so that I could better understand the situation. I couldn’t find the courage to speak, the room was filled with hope and strength and life. I did as she said. I looked at the mother as I stroke the mother’s leg in an attempt to give her some telepathic insurance that she was in good hands and that everything was going to be ok (because I still couldn’t speak). I saw her looking up and noticed that she was she was staring at her reflection in the ceiling boards. I wondered why the boards exactly above her body had a glossy surface. I got my answer when the baby “Al” came out with a splash. Obviously they had been changed because for hygienic reasons and they glossy surface allowed the staff to clean them instead of having them replaced after every other delivery. They also had a unexpected positive effect on the patient, when she saw her reflection in them she was distracted by the image and this also gave her a since of control of the situation which calmed her down. 

When baby “Al” came out the room changed, relief, peace and love dominated the room. There was more movement in the room and as people started to walk around I noticed the nurse’s aide stepping over something, the couples personal belonging were piled up in a corner of the room.  I then understood that the shelves in the rooms were used to store only medical equipment and they were no place for the family’s belongings. It isn’t my greatest discovery but it is still an important one, the delivery room lack personality and don’t match what’s going on in them.

I left my shift with a big smile and a sense of content.  

Today at 14.30 we re- visited “Ö” to meet Marianne and visit more wards.  We didn’t manage to see the entire clinic so we booked another study visit for Thursday 2 feb.

The first thing we noticed is that the staff is very flexible with their schedule and they always adjusted their time to patient’s needs and demands. This means that they can be booked for one ward in the building but then depending on the situation they have to be in another ward.  At “Ö” the different wards are located in various parts of the building unit so when we tried to map the staffs walk paths they showed very irregular patterns.

This time we had the opportunity to speak with the staff for the day shift and got lots of interesting information. Sana made an internship and worked a 8 hour shift as midwife helper, assisting a few deliveries.

Summary of today’s information:

• Staff rooms should be close to patient rooms so that the staff doesn’t have to a long way to run in case of emergency.
• Fika room can be combined with working/ computer stations. This provides the opportunity for the staff to have discussions in an unofficial and relaxed way, ETG screens need to be there.
• Some part of this room should be able to make separate for more heavy discussions .
• Staff should also have a resting room, not close to the patient’s area.

Art on walls:

• Today the “Ö” in general has very little art. Also the art has not been thought through as there is no art with nature themes.

Women are allowed to have maximum 2 people with them to the delivery ward.  Patient decide who they want to bring usually it’s their partner. The restrictions are to avid risk for infections.

• While in delivery the family is assisted by a team of three; one head midwife, one second midwife and one nurse’s aide.

Work teams:

• Staff works in three shifts.
• 9 staff members work each shift
• The coordinator for whole Göteborg city has her office at “Ö” normal delivery ward. Her job is to direct all women in delivery different hospitals, checking bed availabilities and staff.

In general:

• Staff expressed that they would prefer a solution in which one room could easily be reused for different functions. Patients could have one room dedicated to them from the beginning to the end (before delivery, during delivery and post-delivery).
• All different delivery wards should be at one floor level.
• Staff should have areas dedicated for them. The changing rooms are today in the culver in a banker.

Today we  went and met with Marianne,  a midwife at “Ö” hospital. We saw two different wards today; the “normal delivery ward” and BB. She said that her vision for the future delivery wards were those that put the woman and the child in the center. More so, she wished for a personal atmosphere in the ward and said that we should work according to 4 keywords; personal, power, joy and color.

For the outside environment she wished for close connection to planned green area, a park, in which the patient could take a walk, rest, breath and maybe sit on a bench and eat an ice-cream.
She wants the patients to be met by staff when they enter the building and requested calming waiting area in close connection to the entrance but outside the ward. She explained; one waiting area should be dedicated only to patient and their spouse. Relatives and/ friends should wait outside the ward as they could cause stress to the patients.

Marianne told us that the way from the delivery ward to the operation halls should be studied so that it is efficient and private. In case of emergency the ill women should not be seen by those just about to give birth.
She thinks that there are too many delivery rooms at the ward today. Instead of 12 room she would prefer 6 patient rooms per ward. Today each room is  around 21 sqm, most of them one patient rooms,  some 2 patient rooms and one 4 patient room.
In the normal delivery ward she showed us the patient rooms and  gave us a list of necessary things

• All patients should have their own private room with WC, shower and bath.
• Delivery bed for normal sized women/ for overweight women.
• A good sitting/ resting place for spouse/family.
• Adjustable seating for staff (should be able to adjust height)
• Computer/ working spot for the staff. Monitor screen etc.
• Music equipment
• A handle to hold on to/ lean against and hang in to take load of their back.
• A towel wormer machine for the newborns.
• Movable table to place doctors equipment.
• Storage for medical equipment inside the patient room.
• Adjustable light (patient should be able to control light in the room)