Call the Midwife and the Role of the Nurse Essay

Introduction

The episodes in call the midwife are a clear indication of what midwifery was as back in the 1950s with the challenges and obstacles the nurses faced. The social and medical norms revolving around pregnancy and giving birth have significantly changed over time. Unlike today the challenges nurses faced where many with limited resources and equipment with under development in the field being the major contributor (Tharpe, Farley, & Jordan, 2016).

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The role of the nurse

The midwives in the past performed almost similar roles as today with their focus being the health and well- being of both the unborn child and the mother. The major difference in the service provider is in the current development in the field with both technologies playing a significant role. During these years, pregnant women gave birth at home until the mid1950s with the help of nurse midwives and the nurse had the discussion with the patient during the first visits where their child would be born (Tharpe, Farley, & Jordan, 2016).

On the contrary, all children are born in the hospital under the help of an obstetrician and midwife. The risk involved with this woman given birth at home especially in cases where there was an emergency that required advance equipment and expertise led to the change.

Traveling to patient's houses in the 1950s was a frequent practice for nurses. They had to carry the tools necessary for the treatment including determining the fetal heartbeat. Today, most pregnant women visit the clinic with a specified doctor's appointment on regular basis to ensure the well- being of the unborn child. Determining the fetal heartbeat, sex and pregnancy age today is more accurate and easier with the use of Doppler and ultrasound.

Part of the role nurses played in the 1950s according to call the midwife was to shave the patient. Today this has ceased to be a concern and women actually do not need to have their pubic hair shaved before giving birth. Changing the linen as well as keeping the patient comfortable during delivery remains the midwives role to date.

Family-centered care and health care barriers

Family-centered care has marked significant changes over time with the focus being directed to the parent's decisions about the pregnancy as well as the care offered to the newly born child. Doctors give advice about birth, labor and postpartum that today is viewed as a normal everyday event (Hunter, 2001). There are available materials for reference for the parents especially through developed technology. Prenatal care is personalized in terms of physical, emotional, spiritual, educational and psychosocial needs of women depending on their decisions and their particular needs.

Nurses were allowed to conduct laboratory tests to monitor the conditions of the mother and detect any risk by use of urine at home, as part of the family-centered care. Today tests are run by lab technicians in the hospital in most cases as a recommendation by the doctor. Regular midwives visits happen in some countries to monitor the growth and development of the fetors while an obstetrician does the same. Nutritional advice is offered during this visits that were prior done at home.

In the early 1950 and before fathers were not allowed in the delivery room. Today in most countries in the world, the father of the baby has the pleasure to experience birth together with the mother, which creates a stronger family bond. Keleher, (2001) suggests that materials used for delivery in the hospital have improved over time enhancing hygiene and safety. Technology advancement has contributed to machines that help improve and reduce the risks during delivery. An example is instead of using the fireplace in delivery rooms the heaters can be used that are safer and convenient.

The mortality rate in this field has significantly reduced over the past decades with the improvement in the field and other developments having a hand. However, these cases are still there though rare. When an infant dies due to undetected causes, according to Keleher, (2001) the family may time end up blaming the health practitioner as in the past seen with Nurse Miller leaving with a feeling of demoralization. Other aspects like lack of support from fellow and superior workers can be a healthy barrier in some places. When there is a shortage of personnel, equipment, and facilities there is always a barrier to deliver services.

Community resources

Communities grow with the development of the entire world so do the community resources. During the 1950s, the major source of transport for the midwives was bicycle as reflected in call the midwife. The available means of transport then caused delay and could most likely lead to the death of both the mother and the child during delivery.

On the other hand, transport today in most cases is not a cause of infant death. There are reliable means of transport in the world today reducing the risk (Sheila & Symonds, 1995). However, some places in the developing countries this is still a challenge but people often find solutions to transport issues including moving to places they can readily access medical care (Keleher, 2001).

Means by which tests and patient extermination is done in the 1950s is limited in terms of resources. Today the doctors are able to determine the condition of the unborn baby through ultrasound that ensures safety during delivery. Technology has increased awareness of the information about health education during pregnancy and how to take care of the newborn baby as well as the mother after delivery. Most of this information was passed through makeshift clinics that are still important to help mothers take care of themselves and their babies.

Legal and ethical issues

When the nurse taking care of the veteran agrees to have a drink with the patient, it seems so acceptable and nothing sticks the nurse to have an informal relationship with the patient. On another occasion in one of the episodes, there are pregnant women spotted to smoke in the hospital. There was no harm in smoking while pregnant according to doctors in the 1950s. They advocated for moderate smoking of up to four cigarettes a day and discouraged quitting because it could cause stress to the body. This posed a health risk to both the mothers and the unborn child. Smoking is not only a health concern today but also unethical depending on where it is done. Doctors have concluded through thorough research that smoking while pregnant has severe complications to the unborn baby including death.

Similarly having an informal relationship with patients is unacceptable today unlike before. When doctors and other health practitioners are involved in such relationships, it could affect the process of treatment as well as the relationship between workers (Sheila & Symonds, 1995). There is a distance maintained between the patients and doctors as well as midwives is important because doctors stand a position to know so much personal information about their clients and confidentiality is key to the relationship. It is also unethical for health practitioners to get information that is not relevant to treatment or take advantage of their position to sap unrealistic information from patients.

Bias/ Judgment

In the 1950s, parents preferred having their children treated at home instead of having to be hospitalized, as there seemed to be the judgment on the care provided in the hospital as opposed to caring for children at home. With time, people have understood the dangers of keeping at home children who are unwell without the doctor's advice. Advancement in the medical field has helped people gain confidence in doctors unlike in the past. It has also helped patients understand various conditions and what to expect in such cases.

Currently, in the world, pregnant women with disability face a constant challenge with some people treating them indifferently including nurses (Hunter, 2001). There still stands a gap in communication with such people feeling that the staff have little knowledge about their needs. A survey conducted in the United Kingdom indicated that the small number of women with disabilities received unequal treatment and care with less control over most things including their experiences and information.

Sometimes though rare patients find that most care providers expect them to know more than they do with the currently available information about pregnancy and childcare (Keleher, 2001). While pregnant, the small number of uneducated people in the face a challenge of access to information and in some countries, this has contributed to most unhealthy and under cared for children. These kinds of people due to their situation may be treated indifferently.

References

Hunter, B. (2001). Emotion Work in Midwifery: A review of current knowledge journal of Advanced Nursing, 34(4), 436- 444.

Keleher, K. C. (2001). Collaborative practice; characteristics barriers, benefits and implications for Midwifery. Journal of Nursing Midwifery, 43; (1) 8-11.

Sheila, H., & Symonds, a. A. (1995). The Social Meaning of Midwifery. Swansea: Red Globe Press.

Tharpe, N., Farley, C. L., & Jordan, a. R. (2016). clinical practice guideline for midwifery & women's health 5th edition. Burlington: Jones and Barlett learning.