In this assignment, I will discuss the practical skill of facilitating a client with positioning and attachment and hand expression in which I have become competent in practicing. Using the clinical placement feedback form, I will be looking at the following aspects; positioning and attachment, communication and history taking. In accordance with the NMC (2002) Code of professional conduct, as in order to maintain confidentiality all names have been changed to protect identities. Aisha is a twenty-five year old, prima-gravida who had been on the postnatal ward for one day. Aisha had requested assistance with breastfeeding as she felt that Jake (baby) wasn’t getting enough milk. I proceeded to explore Aisha’s feelings on pregnancy, her birthing experience and details of what feeding had been like until now. History taking is the key to patient assessment, it enables the health professionals to deliver a high standard of care. History taking allows for a better understanding of patients’ problems. Care priorities can then be identified and the appropriate interventions used to optimise care, Fawcett (2012).Taking a history can offer a number of clues to help work out the underlying cause of the problem and resolve the solution. Exploring Aisha’s history allowed me to understand what issues if any Aisha was having which was leading to her difficulty in breastfeeding; it also allowed me to provide holistic woman-centred care based on Aisha’s needs. Taking a woman’s history can reduce the need for her to revisit any painful experiences she may have had, when having to transfer care to another health professional they already have the details allowing them to work towards a solution.
In order to obtain a correct and relevant history, it is vital that good interpersonal skills are used to enhance the rapport between the midwife, the woman and her family. Good interpersonal communication skills include, active listening, exploring, prompting, tact and information giving these components are vital to establish a good rapport and obtain information. The use of active listening skills, information giving and open questions allowed me to extract relevant information from Aisha in order for me to assist her in the best way possible. A study by Schmied, et al, 2010, examined the women’s perceptions and experiences of breastfeeding support, both professionally and or peer led, exploring to the components of support that they deemed to be “supportive.” The findings focused on the importance of person-centred communication skills and of relationships in supporting a woman to breastfeed. Therefore to ensure effective relationships between midwives and clients, good communication is vital, in order for midwives to achieve positive outcomes their clients need to feel that they are genuinely cared for; this can be facilitated by the use of a mixture of verbal, non-verbal communication and open questions this allows midwives to show their concern. Bacon (2012) states: ‘Communication skills are the lifeblood of any interaction whether personal, professional, social or otherwise (Murray et al, 2006). All of us practise skills in communication all the time. Communication is a complex process and involves a number of interacting factors as described by Scully and Dallas (2010). These factors can be physical (e.g. deafness or speech impairment), psychological (e.g. an anxious student), and social (e.g. a new mother at home with her baby). How midwives respond in each situation will require skilled thought. These skills need to be embedded within the midwife in order for her to respond compassionately and flexibly regardless of the circumstances with which she is faced.’ When communicating with a woman you have to be conscious of the language used, ensuring that it is positive regarding the woman’s ability to breastfeed effectively. Walker (2007) found that inadequate, insensitive or apathetic approaches to breastfeeding by health care...
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