What is a Good Communication?

The word Communication is defined when a message is passed from one source to another. You
can pass on a message through different methods such as talking, listening, writing, reading,
miming, singing and typing. There are also different sources you can use to pass on information.
This includes mediums like T.V, radio, Internet, newspapers, magazines, films, text messages,
telephones and billboards.

There are many different types of communication a person may use to communicate with
someone, these include:
Written- written communication can be used by anyone. Braille, e-mails, letters and policies are
examples of these communications. Braille is usually used by people who are visually impaired as a
way of reading information. Sign language is usually used by someone who is hearing impaired. Emails are used usually by younger people, I believe this because e-mails and technology has only
come into use recently and younger people are brought up using the internet and also tend to use emails as a quick way of communication.. This is a way of talking to someone anywhere in the world.
A message can be sent instantly to the person and a reply can be sent straight back. It is a cheaper
way of talking to someone than actually picking up the phone. Letters were used more before
technology advanced, there arent really used as often anymore because a letter would be written
and sent and wouldnt get to the receiver till a few days later and we expect more instantaneous
responses in this day and age.
Verbal Communication- verbal communications would involve a person speaking and listening to a
person. This type of communication is used in everyday life. It is also the best type of
communication to get a message to someone because if you dont fully understand what they have
said or asked you then you have to opportunity to ask them again.
All verbal communication uses the mouth and projects sound. Verbal communication is put into
practice when a person speaks to one or more other people and they listen and respond to what has
been said. This communication is used more in the health profession because they need to be able
to talk to and pass on messages and information to patients. This is important because it is more
personal to the patient; it also involves using the care values. When passing on important
information to the patient this should be made personal to the patient and not comparing them to
other patients in the service.
Non-Verbal Communication- non-verbal communication involves things like art, body language and
drama. Body language is classed as a non-verbal communication depending on how you act can
project a message. A person can get a message from how you act. If you act disruptive in front of
them they will automatically get the message that you dont want to be there resulting in your poor
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behaviour. Art and Drama can also pass on a message, depending on what you choose to draw or
make can pass a message to someone about who you feel or what you are thinking about. This is a
good way of passing on a message if you dont feel comfortable talking to people.
Graphical Communication- graphical communication involves things like posters, signs and
symbols. This type of information is a quick and easy way in getting information across to the
public. You will mainly see things like posters, leaflets and billboards around. Posters include mainly
pictures and small sections of information. Whereas leaflets contain more in depth information
about the situation. Billboards are good ways of passing on important information. This is good
because people driving by can see the boards and will take time to look at them to see what
information is been presented.
Communication is important in a health and social setting so that the service can be carried out in a
professional way. Communication is a way of passing on a message. It is important for care
practitioners to communicate so the service is run correctly and no patients are put in any danger.
Also communication must be maintained between care practitioners and patients so the patients
are aware of any change in their labour and are aware of any complications.
If communication wasnt used in my service I feel that it wouldnt be run as well as it should. As my
service is based in a care setting of a hospital the midwifes need to use different methods of
communication to pass on information from one source to the next. If my service was to have no
form of communication at all, service users wouldnt feel comfortable using the service and staff
wouldnt really know what was going on. Usually appointments are made by my service and the
patient is either phoned about it or a letter is sent to their house. For there to be no communication
the patients wouldnt know when they have appointments. Also in my service they offer a lot of
different leaflets. These offer parents information and guidance through a pregnancy and after the
pregnancy. Without these, especially for first time parents, they may feel that they have no idea
what they have to do and may feel like they arent been assisted. The main form of communication
used in my service is verbal communication. This involved patients and staff communicating with
each other. It is important for this method of communication to be put into practice so the patients
know exactly what is going on and they dont have to panic about anything. If a midwife was to hold
back important information and not share with the patients, this may leave them worried that
something is wrong. By communicating all the time with the patients can make them feel more at
ease and more relaxed throughout the pregnancy.

Communication Skills/ How They Can Be Applied In My Service

During a communication there are many skills you need to have maintain to ensure that your
communication runs correctly, these include things like.
Making Eye Contact- it is important to make eye contact when communicating with someone to
make them feel comfortable when listening to you and also make them feel like you are interested
in what they are saying to you. Shy people find it very hard in making eye contact with people; this
can be very uncomfortable for the person who is talking to them. Eye contact plays a big part in
keeping a conversation flowing, using eye contact makes you seem interested and shows that you
are listening. By using this skill in my service the patient will feel more comfortable and will feel like
they can talk more because the care practitioner will look like they are interested in the
conversation.
Use Good Body Language- for you to project good body language is important in my service, this
involves using eye contact, smiling and making sure you look interested, also making sure that you
are able to answer any questions so make sure that you are listening to the whole conversation, also
avoid butting in to the conversation as this can affect the conversation and may drift off, also avoid
shifting eyes and head quickly during conversation when someone asks you a question. Do not look
down or to the side. Look directly at the person with a sense of keeping the conversation persistent.
Using this skill in my service will make the service user feel more at ease if the carer is using good
body language, this makes the carer look more professional and look like they are doing their job
correctly.
Be bold and different in what you ask- by doing this skill you will make the person listening want to
continue listening to you. If you ask the same questions the receiver may get bored and may lose
concentration in the conversation causing there to be an awkward atmosphere. By changing the
topic of the conversation makes people more interested and they will feel more involved because
they will know what to say back to you. Using this skill in my service can make the patient feel more
comfortable and they will feel like they can talk to you if you ask different questions making them
feel accepted and like you can be bothered talking to them.
Use good listening skills- it is important for a person to use good listening skills so the person knows
that you are listening and are interested in the conversation. Your facial expressions also tell the
person how interested you are in the conversation. If you use good listening skills you will always
know what they are talking about but if you dont hear what they have said you have the
opportunity to ask again so you can carry the conversation flowing. Using this skill in my service will
ensure that the patient knows that you are interested in what you have to say and will feel more
comfortable in talking to you.

Dont send mixed messages- it is important that a person doesnt send out mixed messages when
involved in a conversation. This can cause the conversation to become awkward and you may forget
what you were talking about. We say one thing yet our body language reveals something different.
This non-verbal language will affect how we act and react to others, and how they react to us, this
could be in a positive or negative way. Using this skill in my service will make the patient feel more
comfortable with you been around them and wont be afraid to ask you any questions. Mixed
messages can happen when a persons spoken words dont match a persons actions they are
showing.
Use correct vocabulary- for a conversation to run smoothly you should make sure you use the
correct vocabulary. When speaking to a patient you should make sure you use correct terminology
when speaking. No slang or swearing should be used. Using this skill in my service is important
because you will want your patient to know that you fully understand what they are talking about
and will feel that they can ask you anything if you show to them that you know what everything you
say to them means. Also this demonstrates professionalism.
Slow speech down- it is important that a person talks smoothly and fluently when speaking to a
patient. Talking at a constant speed will help your patient when listening, talking too fast can mean
that your patient hasnt fully understood what you have said and this may lead them to accepting
something when they havent fully understood what you have asked. It is important to use this skill
in my chosen service so patients have time to listen to the whole conversation and respond with an
answer. Especially when a woman is in labour, as she may not be fully concentrated; this then will
result in the carer asking the patient again so they have defiantly understood what is happening,

My service and what I plan to do

For my assignment I am going to find out about how a
midwife uses good communication when dealing with
vulnerable women during their pregnancy. I have chosen the
role of a midwife as it is a future occupation I am very
interested in. For me to find this out I am going to carry out a
1-2-1 conversation with a midwife. I intend carry out a short
interview and ask her about her job and what skills they use to
enable a good communication between them and their
patients. I will also carry out a group conversation with new parents to ask them different questions
about how they feel about the service they are been offered by the hospital and asking general
questions about what they want from the birth and how their life will change with a baby in their
life.
A midwifes job is to care for a women and her baby throughout the antenatal period, during labour
and birth, and for up to 28 days after the baby has been born. It is important for a mother to build a
good relationship up with the midwife because you need to work together and she needs to support
you in all your choices. In order to help you give birth, your midwife needs to be respectful,
responsive, unintrusive, and accepting. This will help to make you feel safe and enable you to relax
throughout this process.
There are different types of midwifes who are based in different
departments of a hospital, midwifes whoa are based in a hospital are the
ones who care for you when you are in labour and help with the delivery. A
community midwife is someone who will come out to you at home to do
checks before the labour process; a community midwife can be called for
home births. They will also visit you between 10-28 days after giving birth
just to check that you and baby are coping and adapting well.
A person will go through a lot of training to be able to become a midwife, 3
years at university must be done for you to be able to qualify the midwife role. During your time at
university you will be sent out on placement, getting experience of births and what happens during
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the process. This is also a good way to get to know already qualified midwifes in the case of you
working in that hospital in the future. Your course will include both theory and practice. They are
designed to prepare a student for the responsibilities of being a midwife. Once qualified, a midwife
must be able to care for women throughout pregnancy, birth, and during the postnatal period too,
as well as care for new-born babies. She must be able to detect problems and summon medical help
if needed, and be trained in emergency procedures herself.
The hospital where I will be carrying out my investigation will be the labour ward at Calderdale
Royal Hospital, Halifax. The hospital had a great team of midwives, doctors, nurses, healthcare
assistants and support workers staff the suite and their aim is to provide women who have
additional needs during their pregnancy or birth with the highest quality care. There are 16 rooms
with en-suite facilities. Ideally a woman can stay in the same room for her labour, delivery, recovery
and post-natal care before going home with her baby. There is also access to a birthing pool room.
To help patients in labour there are TENS machines, aromatherapy, birth
balls, birth stools and a pool. The centre also has gas and air (Entonox),
pethidine and meptid for women who request extra pain relief. If patients
need an epidural they will be transferred to the labour, delivery, recovery
and postnatal (LDRP) suite at the hospital. The centre helps around 750
women a year to achieve a straightforward normal birth.
They also offer a special unit which provides specialist care for babies who
are born too early or who have developed complications that need
additional support. The unit is run by specialist doctors and nurses and healthcare assistants.
As it stands, training to be a midwife at university is free. The NHS and government fund this
course, which it why universities only accept up to 50 students a year. This is a good way of getting
people to become interested in being a midwife, as there is a shortage of them around. I feel that
there is a shortage of midwifes because the job doesnt appeal to everyone plus placements at
universities are very slim. Huddersfield University only offers 40-50 places on the midwifery course.
I will expect the standards of communication quite high. Being a midwife is a very intense job and
the level of communication has to be projected in my service. Midwifes have to know what they are
talking about and be able to act fast in answering any questions from service users. Being able to
answer questions immediately gives the patients a clear idea that you know what you are talking
about and will put their full trust in you at a time when a woman is most vulnerable.

Types of communication I am going to use

In order for me to carry out my assignment I am going to have to use different types of
communication for me to be able to get a sufficient amount of information I need.

Internet- I am going to have to use the internet for a lot of my assignment. This is an
easy way to get information about things. For example I will use the internet to get
information about my service, as I am doing a health service I will use the NHS
website a lot for my information. All of the websites I will use I will include the
address in the bibliography so my work can be referred to, I will try not to use the
internet a lot and try to use more primary sources in my work to make the
information more reliable.
Verbal Communication- This will involve me doing my 1-2-1 conversation and group conversation.
For this I am going to go to the maternity ward at Calderdale Royal Hospital any interview a midwife
for my 1-2-1 conversation, then if I am able I will have a group
conversation with a mother and her birthing partners, This will
involve me asking the midwife different questions about her job
and what skills they need to have to carry out their job in a
professional way. The interview will only be short; this will give me
the chance to write a transcript of what was said. In the group
conversation I will talk to some of the patients in the hospital, this
will also give me chance to write a transcript of the conversation we had. The conversations can be
about anything, I will be looking more about how fluent the conversations are and the types of body
language which is used by the person I am interviewing.
Leaflets- using leaflets in my work will help me to get information about my
service and also learn different procedures and policies they have to follow to
ensure a patient is safe within the service. Leaflets offer a lot of information
and it summarises the key information so it is easily read. Leaflets can include
a lot of information so making titles bold or inserting a contents page can
make it easier for a reader to find out where the information is that they need
to find. Also when designing a leaflet it is important not to write pages and
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pages of information, breaking information down into bullet points and small paragraphs can make
reading it easier.
Technology- I will need to use a range of different pieces of technology to
help me with my assignment, I will use things like T.V ads, telephones and
computers to help me do this. I will use the telephone to make it easier for
me to ask for an appointment to speak to a midwife. I will need to carry this
out as part of my 1-2-1 communication. I will also use the computers to type
up all of my information I have found out about my service, the internet will
also come in handy when researching information about my service and how
it is run.

Transmission of Values
Every service has a set of values that they must follow to enable a patient to have the best quality of
care possible. It is the staff of the service who are responsible for portraying and communicating
these values within the service and setting a good example. This is especially important for people
working within the health sector as they are caring for vulnerable people. It is important that these
values are followed within my service as a midwife is responsible to care for pregnant women
throughout their pregnancy.
I will now explain examples from the transmission of values and explain how they are applied into
my health service.
Getting to know the service user in a sensitive manner and sharing experiences- within my service it
is important for this to be carried out as much as possible to ensure that all patients feel
comfortable. As a midwife, it is important to make a woman feel as comfortable as possible, asking
questions and sharing past experiences with a client can keep their mind off things and also you will
learn a lot more about your patient this way. By starting off by introducing yourself to them you can
start off a conversation, where automatically a service user will feel at ease when talking to you.
This value would be expected to be shown from a midwife so the patient feels comfortable talking
to them, sharing experiences can take the patients mind off the pain, also sharing experiences
about the birthing process can prepare.
On the visit to my service I expect to see very caring and understanding members of staff. I expect
them to be very talkative and always wanting the best for their patients. I expect to see the staff
with a big welcoming smile on their face, which will make the patients feel more comfortable with
speaking to them. I feel most people will be very relaxed and will really enjoy what they do in their
job as it is a very rewarding job, by sharing the experience of bringing a new life into the world.
Promotion of a persons identity in a positive manner- in any situation whether it be at home or out
in a health setting a person will feel more comfortable if they know that their personal identity is
been accepted by others. An example of this would be calling the person by the name they wish to
be called. For example Jessica can be shortened down to Jess if a patient tells you what they want
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to be known as this should be accepted and you should always refer to them this way. This value is
important for a midwife to follow so the patient feels like they are been respected and treated in a
fair way. Respecting the person and their identity can build friendships between the carer and the
patient.
On the visit to my service I expect to see the staff taking extreme care in promoting a persons
identity. I feel that the staff will be very caring and will come very attached to their patients so it is
important that they continue to promote identity. I feel that they will show this by making sure that
they have the name of the patient right before calling it them. For the staff to do this, it will make
their job a whole lot easier and will feel that they are doing their job properly by asking the patient
questions just to make sure that names are pronounced correctly.
Respect for individual differences- in my service, it is important that you accept a person for who
they are everyone is different, live different lifestyles and come from different backgrounds, by
accepting a persons identity can lower the chances of discrimination being projected within the
health service. Whenever communicating with someone, it is important to maintain eye contact,
sharing experiences and speaking to them individually can make a patient more comfortable. This
value is important for a midwife so the patient feels at ease when talking to you. Respecting them
for their individual differences can build friendships and for a patient to be able to trust the midwife
is important so the patient feels comfortable when sharing information with you.
On the visit to my service I expect to see the staff respecting everyone for who they are. Whether
they are from a different ethnicity or have a disability. The staff need to accept people for who they
are and make sure that they do not discriminate anyone whilst doing their job as this could get
them into big trouble and may find that they lose their job.
Consideration of choice and preference- it is important within my service to use this value, it is vital
that a patient is able to make choices for themselves, in my service patients usually have to make a
birthing plan of how they want the birth of the baby to be and what things they want to include in
the birth, this may be things like the type of birth they wish to have e.g. natural/water birth also
they decide how many birthing partners they want and who they are. A care practitioner should
respect a person for what they choose and not judged by someone for their choices. This value is
important for a midwife because they need to respect whatever they choose, if a patient chooses
they want an epidural this should be respected and dealt with straight away.
On the visit to my service I expect to see the staff accepting the patients choices and supporting
them in any way possible. A woman may decide that she doesnt want an epidural or doesnt was to
use any form of pain relief. This should be respected by the staff and they should then be there all
the time to help the woman get through her labour. It is important for staff in my service to do this
as it will give them a good reputation and people will be more likely to come back and use the
service.
Encouragement of independence and support- in my service it is important for a care practitioner to
promote independence in the service. An example of this in my service would be to encourage a
woman to be independent in her labour and not to require too much help. A midwife is always there
to support a woman through the labour; a patient does most of the work herself with hopefully little
help. Help may be needed with complications in labour, a caesarean section or forceps are then
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used to help the baby on its way. This value is important for a midwife to follow so they can
encourage the patients to be independent, this will help the patient throughout the birth.
On the visit to my service I expect to see the midwifes playing quite a big role in the birth of a baby
but trying not to interfere too much. If the woman has had a healthy pregnancy and is in a healthy
labour with no complications the midwifes should step back a bit and let the baby come without
much assistance.
Praise- it is important for a care practitioner in my health service to praise a woman during her
labour. This will make the woman feel positive and feel like she is doing something right. A woman
will be praised when she has given birth usually using the words congratulations, the womans
family will then come and visit the parent(s) and the baby. During the labour a midwife will reassure
the woman and tell her direct instructions of what to do. This will also make the woman feel more
comfortable because she will be aware that she is doing things right. This is important for the
midwife to follow this value so the patient feels good when they have given birth, if a midwife
praises the patient for their efforts this will make the patient feel good. Also throughout the birth a
midwife should praise the patient so they dont feel hopeless.
On the visit to my service I expect to see a lot of praise been transmitted from the midwife to the
patient. By telling a patient that she is doing very well can encourage her to be more relaxed and
the pregnancy then shouldnt be too stressful. The midwifes are taught a lot about praise and how
to reassure a woman during pregnancy at university and on training courses. This gives the staff
more experience and a better understanding of how to praise a woman in pregnancy.
Positively establishing and maintaining relationships- this is important within my service so the care
practitioner and the patient feel comfortable when speaking to them. Building up a caring
relationship will make the patient more trusting towards the carer if they show that they care about
them. Starting off a conversation introducing yourself can get a conversation flowing and over time
a relationship will grow between the two. This value is important for a midwife to follow so trust can
be built between patient and midwife, these relationships are important so conversation between
the two are easy.
On the visit to my service I expect to see a very close bond between a midwife and a patient, this is
important because a woman is putting her full trust in the midwife for a un complicated birth. I
expect to see the patient and midwife talking a lot to each other and sharing different experiences
with each other.
Showing awareness of needs- it is important in my service to use this so the patients know that you
fully understand them and the needs in which they may need. In my service a person with dietary
requirements or disability requirements may need more assistance. It is important that you tell the
person that you are aware of the needs so they know that you are able to help them and give any
added assistance to them. This value is important for a midwife to follow so the patient is aware
that you know what you are doing in your job and you show that you are doing the correct thing to
meet their needs.
On the visit to my service I expect to see the midwife constantly letting the patient know just how
well her pregnancy and labour is progressing. This will make the patient feel more relaxed in their
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care and will make them aware that they know exactly what they are doing. Showing you know
what you are talking about will put the patient at ease and make the labour a better experience for
them.

Care Value Base

The care value base is very important in a health service. This is because a satisfactory amount of
care has to be given to all clients and patients. It is a way of describing a set of values and principles
that are relevant to all health and social care practitioners. The care value base covers the 5 main
areas of care practice:
-

Promoting anti-discriminatory practise

Maintaining confidentiality
Promoting and supporting individuals rights
Acknowledging individuals personal beliefs and identities
Promoting effective communication

These are recognised and supported by health, social care and early years practitioners. These are
put into practise in their everyday work with service users and may not actually realise that they are
applying them in their work. Registered care practitioners who have undertaken professional care
training are more likely to see these values as been a part of their professionals code of practise and
are more likely to apply them in their work.

Why Are The Care Values Important?

Health and Social Care Practitioners come into contact with a wide range of people who experience
different care need problems. No one single person has the same care needs as someone else so
everyone care has to be dealt with in a specific way.

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Care practitioners have to find a way of ensuring that everyone receives a high standard of care. The
care values provide guidance for care practitioners on how to achieve the more successful practise
they can. The values protect service users from being mistreated, neglected and not given the
sufficient amount of care they require. They also set out a positive principle for care workers to
follow.
The NHS has a duty to every patient it serves and must respect their human rights. At the same time, it
has a wider social duty to promote equality through the services it provides and to pay particular
attention to groups or sections of society where improvements in health and life expectancy are not
keeping pace with the rest of the population.
http://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhscoreprinciples.aspx

The Values In Care

The two main values are to respect the worth and dignity of every individual and according social
justice and promoting the health and social welfare of every individual.
The respect for the worth of every individual involves accepting and treating everyone equally and
treating them individually so they dont feel like they are been treated any differently from other
service users. For anyone who has a specific need they must realise and be shown that they are
been treated fairly and arent been put at any risk of been neglected or discriminated against while
in the care of others.
The value of according social justice and promoting the social welfare of every individual is there to
ensure people receive fair and correct treatment in society. The care values can be put into practice
through the care principles of
-

Promoting equality
Respecting difference
Promoting individuals rights
Promoting choice and empowerment
Maintaining confidentiality and privacy
Promoting anti- discriminatory practice

When I do my 1-2-1 conversation with the midwife, I expect to witness a lot of things. As a midwifes
job is very hectic I might not have much time to ask all of my questions I have prepared. I will expect
to see the midwife having very good body language and being able to answer any of my questions
with ease. I will expect the environment to be quite quiet, maybe a few of the midwifes who are on
duty to be rushing a round in the case of an emergency. When I enter the labour ward I will have to
be supervised at all times because of security. On my last visit to the ward there was a lock on the
door and you had to speak to one of the midwifes on the desk through the microphone before I was
allowed to go in. As I was actually visiting someone I was let in straight away. This time I think I will
have to ring up before I go so they know to expect me.
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The same goes for when I do my group conversation, I will have to have permission from the
midwife and the patient before I am able to carry this out, I will also have to be supervised when
doing this, if I am able to. I will expect to see a very calm environment when doing this. The patient
may be in the early stages of labour or might have already had the baby but this shouldnt affect me
carrying this out.
It is important that I am prepared and ready when I visit my service as a midwifes roll is very intense
and I may not have much time to ask all of the questions. The midwife may need to leave my
interaction early if she is needed. I will need to make my interaction quite short but also have time
to look out for the body language which is been portrayed.

Putting the Care Principles into Practice

There are 2 legislations that can be put into practice to ensure that the care values are protected
against, these areSex Discrimination Act 1975- This protects a service uses from been discriminated against in a care
service. If a service users feels like they have been discriminated against, this can be reported and
will be dealt with in a sufficient way. The act is there to protect all service users and care
practitioners from the risk of this happening. If this act isnt followed it may end in a care
practitioner losing their job as it is against the law to break this.
The Data Protection Act 1984- this protects service users from getting their private information
leaked out to others around. All private information must be locked safely away where only care
practitioners can get hold of it. No private information should be passed around a care service. By
promoting this act a person can feel like they can trust the service and will feel comfortable knowing
that all their private data is stored away correctly away from other people getting hold of it. In my
service all of the client notes are locked safely away in filing cabinets and are locked securely.
Midwifes have to have special permission to be able to get out a patients file.
The transmission of Values and Care Values are both very similar. The word value means having an
importance. Therefore these need to be used throughout my service. They need to be used so
patients know they are safe while using the service and know what sort of care they are entitled to
get from the service. The transmissions of values are important in my service to ensure patients get
the best amount of care possible. Care values are important in my service as like the transmission of
values they need to be able to show high standards of care in the service.
Throughout my work I will continue to link in the care values and the transmission of values. This
will make it clear that my service believe highly in using these values and use them in everything
they do to ensure the care of the patients is right.

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Part B
Questions I will Use in my 1-2-1 and group conversation
For this part of my assignment I am going to have a 1-2-1 discussion with a midwife. Here I will be
asking different questions where I will be looking to see how she reacts to my questions. I will be
looking at how she is stood/ sat and if there is any change in her body language when I am asking
her the questions. This will give me a clear idea if she is listening or if she is interested in what I am
saying/ I will keep questions short, giving her time to answer my questions. This will prevent
boredom. I will also keep the conversation flowing, not going off subject or changing subject. I will
then complete a transcript of the conversation I had, containing information about how she
answered the questions, e.g. her tone of voice or her body language.
I will then complete a group conversation with a group of people; this will be a pregnant woman, her
birthing partners and a midwife. A midwife will need to be present due to the situation of me not
knowing the people. This is for the safety and well-being of the patient. Also will make her more
comfortable that there is someone in the room who she knows and can trust. I will have to get
consent from the head midwife and the patient before actually having this conversation with the
14

patient; this is also down to confidentiality and safe guarding because I dont know the people and is
more for the safety and reassurance of the patient. As I dont know the people I will be speaking to I
will have to be careful in what I say to them so they dont feel threatened in the questions I ask
them.
1.
2.
3.
4.
5.
6.
7.
8.
9.

Do you enjoy your job?

What qualifications do you need to become a midwife?
What skills do you need to be a midwife?
How long have you been a qualified midwife?
What hours do you work in a typical week?
Do you have much free time on duty?
Is the ward always full?
Are there many complications which occur at birth?
What is the best experience you have had while been a midwife?

A 1-2-1 interaction involves 2 people, usually one person asking the questions and one person
answering them, although sometimes can involve a bit of both. In this case I will take part in a 1-2-1
interaction with a former midwife. This will enable me to ask questions about her job while looking
at her body language to see how she reacts to answering my questions.
A group interaction involves at least 3 people. In this case I will carry out a group interaction with a
couple in the ward. The questions will be random as I do not know at the moment who exactly I will
be carrying out this interaction with.

1-2-1 Transcript
For my 1-2-1 conversation I went to Calderdale Royal Hospital where I spoke to a midwife. My aim
was to have a conversation with a midwife and write a transcript, I had to make a note of the
conversation and look for how they present their body language when talking to them. This is how
it went.
I arrived at the Calderdale Royal Hospital at 10.40am, I was greeted at the desk by a midwife called
Lucy. At a first glance I recognised her.
Lucy: Sarah isnt it, Im sure I recognise you
Me: Yes I was here in April with my cousin
Lucy: Ahh yes I remember now (she smiled) so how is everything with baby
15

Me: Yes she is doing great, she is 10 month old now, weighs 17ib
Lucy: Wow she has grown then, she was only tiny when she was born
Me: I know, I have a picture if you want to see (shows her a picture on my phone)
Lucy: Aww isnt she beautiful, do you fancy a drink
Me: Yes please I will just have a glass of water if its alright
Lucy: Yes thats fine, come with me
(We walked up the ward and into the staff room)
Lucy: So how are you today?
Me: I am fine thank you, how are you?
Lucy: Yes Im great, just tired
Me: Am I alright to ask you a few questions from my health and social coursework then?
(Lucy was sat in the chair with a straight back and looked interested)
Lucy: Yes thats fine, what collage do you go to?
Me: I go to Hipperholme and Lightcliffe 6th Form
Lucy: Ohh lovely, its a good school that
Me: So do you enjoy your job then?
Lucy: If Im honest with you I couldnt actually ask for a better job, every day is a challenge but it is
defiantly worth it in the end, the patients and staff are also lovely.
Me: As I want to be a midwife in the future what skills would you say I need to become a successful
midwife.
Lucy: The first and most important skill you need to be a good midwife is to be able to use good
communication. As the patients are going through a major life event they need as much support as
they can. You also have to be able to answer any questions you are asked by patients and be able to
use proper medical terms. Also you have to be able to work as part of a team.
Me: Wow, a lot then, what qualifications do you think I would need to become a qualified midwife?
Lucy: Universities look for people doing relevant subjects, the ones they usually look for is
Psychology, Sciences, and Health and Social.
Me: That sounds ok then as I am doing those subjects at school.
Lucy: Yes you should be fine with those then, you just have to get the grades and o on to university
to do a midwifery course which is usually 3 years.

16

(At this point in the conversation Lucy was called into one of the rooms, as a patient was having
difficulty with the baby and was rushed for an emergency caesarean, Lucy was ok to leave and
came back into the room, I was sat there for about 25 minutes)
Lucy: You defiantly have to be on your feet at all times in this job (smiled, sounded out of breath)
Me: So do you have many complications in births here then?
Lucy: To be honest its very rare we do, we lose a few heartbeats of babies inside the womb when a
woman is strapped to the machines but thats due to the baby moving.
Me: Must be quite scary
Lucy: It is sometimes but you have to act professionally about it.
Me: Is the ward usually full on a regular basis then?
Lucy: Yes it usually is, this last week has been very quiet though
Me: How many hours do you work a week?
Lucy: Depends on the midwife and her role in the department, I am contracted for 37 hours that
includes me doing nights as well.
(She stopped to take a drink)
Me; Do you have much free time on duty?
Lucy: We are allowed breaks but when the ward is busy its very rare we have chance for a break.
Me: How long have you been a qualified midwife?
Lucy: (Counts on fingers) 9 years this August. Wouldnt change this job for anything in the world.
(One of the other midwifes called Karen came in holding a new born baby boy, the mother had a
caesarean and wanted to rest)
Karen: He is a big one isnt he, hes beautiful though, would you like a hold?
Me: Ohh yes please if youre sure its okay.
Karen: Yes its fine (She handed him over gently)
Me: Aww he is beautiful, I bet its a great feeling to know you have helped bring a new life into the
world.
(Karen and Lucy smiled at each other)
Lucy: Yes it most definatly is.
Me: What would you say that your best experience has been while been a midwife?

17

Lucy: There isnt really one which has stuck out to me but every day is different and you face a new
challenge every day.
(After 15 minutes I handed the baby back to Karen)
Me: Thank you ever so much for that Karen.
Karen: Ohh youre very welcome.
Me: Well thank you for your time Lucy, its been great to see you again Lucy.
Lucy: Ohh no problem love its been great, I hope you succeed in your exams and hopefully in a few
years time you will be a part of our team.
Me: That would be great
Lucy: Come back again if you want your always welcome.
Me: Ohh I will do, thank you ever so much, see you again
Lucy: See ya, have a safe journey back
(Both wave as I waked out of the ward)

Group Transcript
I did my group conversation with myself, a patient and her husband who were on the ward in the
Calderdale Royal Hospital. They were called Jess and Simon, They were both 19 years old. Jess had
been called in to be induced as she was a week overdue. Here is how the conversation went.

18

I entered the room with Lucy who was there all the time. Lucy told them I was there as a trainee
midwife. Lucy was aware of what I had to do. In this I was looking for the body language of both
Simon and Jess.
Lucy: Hi this is Sarah a trainee midwife.
Simon and Jess: Hi there
Me: Hi
(Jess was laid on the bed and Simon was sat on the chair besides her)
Me: Is this your first child then?
Jess: Yes our first, very excited
Me: Do you know what sex the baby is?
Jess: Yes its a girl
Me: Do you have a name for her then?
Jess: Kinda yeah, we cant decide between Ruby or Harriet.
Me: Aww there lovely names.
Jess: Yeah took a lot of thinking
Me: Do you live locally?
Jess: Yes from Shelf, not too far.
(Simon was sat with his feet up on the bed, Jess was still sat on the bed, Lucy was preparing the
equipment for Jess to be induced)
Jess: Lucy, my mum is on her way, would you be able to send her in when she gets here.
Lucy: Yes of course, nearly ready now.
(Jess looked worried)
At this point I had to leave the room; I went down to the canteen and got a drink, when I got back
to the ward I wasnt allowed back into the room. Jess had been induced.
Lucy: She has been induced now; hoping baby will be here later on today.
Me: Ohh lovely, well Im going to get off now
Lucy: Okay thank you and I hope it has helped with your coursework
Me: Yes it will have done thank you for letting me do it
Lucy: Its fine, See you later then.
19

Me: Yes see you later.

I walked out of the ward and went home

20

Comparing my interactions
On my visit to Calderdale Royal Hospital I went into the ward on was greeted by the midwifes. In my
1-2-1 interaction I was greeted by a midwife called Lucy. She was a midwife I had met before from
the birth of my cousin in April 2011. I knew her quite well because I spent a lot of time in the hospital
with my cousin. This was good because I didnt feel awkward talking to her or asking her questions
because I had met her before. The conversation started off by her recognising me, she asked
questions about my cousin and how she was getting on. I showed her a picture on my phone of my
cousin to show how much she had grown.
We went into the staff room where I began asking my questions I wanted to find out for my
coursework. Lucys body language was great throughout the conversation, she used good eye
contact, always listened to what I was asking her and was able to come out with a reply straight
away. In the middle of the conversation it was cut off due to an emergency for one of the women in
the ward. She was having complications and had to be taken for a caesarean. Lucy was called in to
the room just for support but when the woman was taken down to surgery Lucy came back to the
room and our conversation carried on. Her body language remained as it was at the start, she
smiled and looked interested all the time. The questions I was asking to Lucy were about her job. I
asked questions like: Do you enjoy your job? What has been your best experience while been a
midwife? Etc. The main care value used in this was that she was promoting effective
communication by listening at all times and being able to communicate in the same way back when
answering the questions.
Near to the end of the conversation a midwife called Karen came into the staff room holding a new
born baby. It was the one which had been born through caesarean and had only taken half an hour
from when Lucy was rushed out. I was allowed to have a hold of the baby. She was explaining that
midwifes usually take care of the baby after the birth if the mother is tired. The woman who had
given birth was on her own and needed to rest because of the caesarean she had just had. The baby
was lovely. The midwife take a lot of care of babies when they are born. The baby was dressed by
the midwife and then was fed and cared for by the midwife until the mother was alright. I ended the
conversation and handed back the baby. I had a really good time there and was glad I chose to carry
out my 1-2-1 interaction there. Also because my future career is to be a midwife I feel that the
answers to my questions were answered very well and will help me in my future career.
In the group conversation I was greeted by Lucy again. She took me through all the safety rules
before entering the room. The patient and her boyfriend were told before I went in that I was
coming in just for the experience. I walked in the room with Lucy. Lucy began getting the
equipment for the woman to have an induction and I began asking them questions. My aim of this
was to look again for the body language of them and how they reacted when asked them questions.
The questions I asked them were just about the baby and what their plans were, I asked questions
like Is it your first baby? Do you have any names yet?
The main care value that was applied in my group interaction was promoting confidentiality. As I
was only a visitor in the ward I was unable to access any of the patients notes and had to be very
careful in what I was asking. Obviously some of the conversation I could not include in my transcript.
This was just conversations Jess was having with the midwife which I was unable to include in my
transcript.
21

I found that talking to the patient and her boyfriend was quite awkward because I didnt really know
them and I felt like I was invading their privacy by asking them questions. They responded very well
to my questions. Their body language was good but could have been better. Her boyfriend didnt
really speak throughout the conversation. Jess answered all the questions very well. She used good
eye contact and stayed on subject at all times. I found this conversation worked very well.
Towards the end of the conversation I was asked to leave the room as she was about to be induced.
I went down into the canteen for a drink and then went back up about half an hour later. I wasnt
able to go back into the room to see the patient so I decided to end the conversation and go home. I
said thank you for their time and left the ward. My service showed signs of using confidentiality
because of the fact I was unable to include certain things in my work. Confidential things which I
may have overheard I was unable to repeat outside of the service. This also showed that I was
promoting confidentiality.
When comparing both of the interactions together I found that I benefitted more from the 1-2-1
than the group conversation. In the 1-2-1 it was easier to have a proper conversation with Lucy
because there were only 2 of us and I knew her from a past experience so it was easier to talk to her.
Lucy used good body language, she always looked interested in what I was saying, and she
answered all questions immediately and offered me a lot of advice to help me in the future to be a
midwife. She sat up straight in the chair; her arms were rested on her lap. She wasnt slouched and
didnt have her arms folded. She also used good eye-contact and slowed her speech down when
answering my question so I could fully understand what she was saying. This demonstrated that she
was quite professional in her demenuer. I wouldn't have expected her to have been relaxed as this
was a formal situation and interview. She showed that she valued her role and responded promptly.
This showed me that her professional knowledge was good and that she was being sincere in her
response. This is an important skill as midwifes have to make clients feel at ease when dealing with
women who are fraught, anxious and nervous about giving birth.
The group conversation was good but I found it difficult in deciding what questions to ask. As I
didnt know what I was going to do for my group conversation until I got there I didnt have any
questions planned to ask so I had to think of them on the spot. I just asked basic questions about the
baby and how she had been throughout the pregnancy. The body language of Jess was very good;
she answered all of my questions. She was sat on the bed and used good communication skills.
Whereas Simons body language was very poor, he didnt really speak and was sat slouched in the
chair with his feet up on the bed. I found this was a major barrier in this interaction and didnt really
see any positive body language from him.

22

Care Values In My Service

On my visit to the Calderdale Royal Hospital I found that they used a lot of the care values. As my
service is a care environment it is vital for them to use them. Care values are important so they staff
as well as the patients feel safe when been in the hospital. Pregnant woman in the hospital will need
as much care and support as possible. The main care values which are used are things like
confidentiality, equality, rights and individuality. Here I will explain all of the care values which I saw
presented in my service.
Promoting Confidentiality- On my visit to my service I saw a lot of this been shown. When I first
arrived in my service and I was greeted at the main desk I could see a number of filing cabinets full
of patients notes. Also the computer data bases will have a lot of the patients details. Both of these
have positives and negatives, the positives of a filing cabinet is that it can be put into alphabetical
order making it easier for them to find. A negative would be that it is easy for one persons notes to
be lost and also if you lose the key for the filing cabinet then you wont be able to access any files.
Strengths of a computer data base is that files and notes can be found instantly. A negative would
be that if the computer system goes down they wont be able to access any files. They all have
positives and negatives so its a good idea for them to be stored in both. I saw they both been use in
my service which I thought was great and they had to have permission from another member of
staff before taking any patients notes.
Treating Everyone Equal- This care value is important in my service because all the women are there
for the same reason, therefore must be treated equal at all times. On my visit to my service I saw
this been put into practice. Midwifes switched from room to room checking on the patients. Not
one patient was left unattended for a long time which was good. They were all given the same
treatment from the midwifes and were all treated in the same way. This also occurred in the staff.
They all got along with each other and no one was left out. They all had a good working relationship
and the work was shared out equally between the midwifes. This is important so that people feel
respected when using the ward and dont feel like they are that people feel respected when using
the ward and dont feel like they are been discriminated against.
Treated As An Individual- When visiting my service I found that everyone was treated as an
individual and everyones differences were taken into consideration. In the ward there was an Asian
couple. By overhearing a conversation between the male and one of the midwifes he was explaining
that his wife was not allowed to eat pork and also had a nut allergy. The midwife had a very positive
attitude towards this and made it clear to the people in the kitchen who were then able to make
alternative meals for her. This is good because it showed how much my service cared about their
patients and took every little problem into consideration and was dealt with in the correct way.
Promoting Choice- This care value was presented throughout my service. The patients were offered
different choices, ranging from the food they wanted to eat to the birth they planned to have. As its
the mother who has the baby it is important that she gets all the say in what she wants in the birth.
Every woman is different and will want different births. Some women want a natural birth and some
would prefer a water birth. On very rare occasions a woman will ask for a caesarean but if there is a
problem with the baby she may be rushed to have an emergency caesarean. Giving someone
23

choices makes people feel like they are been treated like an individual and will respect this and
enjoy their time more if they feel they are been treated properly.
Transmission Of Values
During both of my interactions I saw a lot of the transmission of values been used. This showed me
that my service is a very professional service that respects the needs of patients and are very
understanding in the care of the patients.
Getting to know the service user in a sensitive manner and sharing experiences- during the visit to
my service I saw a lot of this been used. The midwifes showed a lot of this. As soon as a new patient
entered the ward they were automatically greeted by the staff. After giving their name and
information they were taken into a room where they were made to feel comfortable. The rooms
were all individual. People who were in labour had their own room for privacy reason; once the baby
was born some of the woman who may have had to stay in overnight were moved into a room with
four beds. Using some primary sources of information, when my cousin was in hospital I attended
the birth. She was put into a room with four beds in, as she wasnt in labour at the time. Later on
during the day she was induced. We left the hospital about 6pm. As her contractions got more
intense she was moved into a room by herself. We were called back about 1am, she gave birth at
3.33am and was moved back into a room with four beds about 10am the same day.
Respect for individual differences- during the visit to my service I saw this value been used a lot. The
staff respected everyone in their care and took into consideration of all the differences the service
users had. While I was at my service a man came up to the desk to speak to the staff about his
partners diet and the foods that she is unable to eat. This was accepted straight away and the staff
made sure that some action was taken in getting the woman some alternative food. This showed
me that my service is a very good care environment and they respect everyone using it and try their
best to make sure that everyone gets the right amount of care which they expect to get.
Promotion of a persons identity in a positive manner- during the visit to my service I saw this value
been used. The staff made sure that they made sure they were correct before saying a patients
name. They also made sure that the patient was happy with the name that they were referred as.
The person I did my group interaction with was called Jessica but she wanted to be known as Jess
the staff accepted this and put it into practise. This will have made Jess feel happier and will feel
that she had been accepted in the service.
Consideration of choice and preference- during the visit to my service I saw this been used quite a
lot. The staff were always there asking questions to the patients and always willing to answer any
queries they may have had. There was one man who came up to one of the members of staff and let
them know that his wife could not eat certain foods. The staff deal with this very quickly and
alternative food was prepared for the woman. This showed that my service had a good
understanding of their patients which showed that my service is a good care environment.
Encouragement of independence and support- during the visit to my service I saw this used a lot.
The patients were encouraged to be as independent as possible. The midwifes are there for
support, not to actually do everything for the woman. They encourage them to do as much as they
can themselves without any help. Pain relief is always there if needed but sometimes are advised if
24

possible not to use much pain relief as they like births to be as natural as possible. On the odd
occasion of an emergency forceps or a caesarean may be used.

Praise- during the visit to my service I saw a lot of this been used. The staff were all very supportive
for the patients. The midwifes are always telling the woman how well they are doing. This is good
for the service because it shows that they have a full understanding about what is going on and also
shows that they care about the patients who come to use the service. I was very impressed with the
service they maintained and the staff were all very understanding and didnt force the patients into
anything. It was all about praising the woman.
Positively establishing and maintaining relationships- during the visit to my service I found this was
used quite a lot. The women and the staff had a very close relationship which showed just how well
the staff were doing their job. All of the patients seemed happy with the service they were been
given and it seemed like everyone got on with each other because they all knew each others name
and they werent afraid to talk to them or tell them anything.
Showing awareness of needs- during the visit to my service I saw this been used a lot. As I
mentioned before there was a man who came to speak to one of the staff to tell them that his wife
was unable to eat certain foods. The staff dealt with this very well and supplied alternative foods for
the woman. I can also tell this is used a lot in my service because all of the birthing rooms were
fitted with beds that could be hired and lowered and also the bathroom had bars so the patient
could pull themselves up. This shows that they take everyone as an individual and make sure the
rooms are okay for everyone to use.

25

Part C
Barriers in My Conversations
When carrying out both my 1-2-1 interaction and my group interaction I didnt really find many
barriers. This shows me that my service deals very well in improving the service and tries to prevent
many barriers. I feel that the 1-2-1 went better because I knew the person I think this prevented
many barriers from occurring. Whereas in the group interaction I was put into a room with 2 people I
didnt know while Lucy stepped back to obviously observe the conversation for safety reasons. This
did feel a little awkward and I found myself struggling what to ask but I feel that the conversation
went ok.
Barriers in my 1-2-1
In my 1-2-1 interaction I feel that they werent very many barriers in our conversation, I only picked
up on 2 which actually occurred in my interaction but there was an Asian couple on the ward and all
of the midwifes I saw in the ward were white British. Here are the barriers I picked up on in my 1-2-1
interaction.
Noise- When carrying out my conversation we did it in the staff room. The door was left open and
the ward was quite noisy. There were many people walking up and down the ward and there were a
couple of people in labour causing the noise to be quite bad. I could hear the screams of the women
and people walking past the staff room tended to pop their head around the door to say hello. This
did affect our interaction as it put us off track a bit. There was also a bit of traffic noise as some of
the windows were open in the hospital. This may have effected how well the staff performed their
job as traffic noise can be very off putting.
To overcome this barrier we tried not to let the noise put us off and tried the best we could. As the
interaction went on the noise quietened down and we were able to carry on without any
distractions. Towards the end of the conversation another midwife came into the staff room with a
new born baby. This was a distraction for the interaction because when I held onto the baby I had to
make sure I was holding him correctly, this distracted our conversation. Also the midwife Karen who
brought him in to the staff room stayed in the staff room and I found that she joined into our
conversation. To overcome the traffic noise the only thing which may have prevented this would be
to close the windows.
The benefit of overcoming this is that the staff would be more relaxed and would be able to
concentrate more on their job. Noise cannot always be helped, especially in my service, which is a
care environment. People who use my service are usually the women who are in labour. This can be
a very painful experience for a woman and may cause them to be a bit noisy. But this is the whole
point of my service, to guide them through the pain and get them their baby at the end of the day.
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Reference:
Exposure to noise from road traffic can increase the risk of stroke in the over 65s
Researchers followed 57,000 people between the ages of 50 and 64 for an average of 10 years. Over
this time, 1,881 people had their first stroke. People aged 65 or older who were exposed to louder
traffic noise had a greater risk of stroke. This was caused by the traffic noise. It was found that the
noise increase blood pressure and caused people not to get much sleep, all this resulting in a stroke.
This was a good study to link to social class as it was found that people who earn a lower income
tend to be the ones who lived by the busier roads and were submitted to louder traffic noise also
known as noise pollution.

Emergency- During our interaction Lucy was called into one of the rooms where a woman had been
in labour for a while and had to be rushed for an emergency caesarean. When she was taken to
surgery Lucy came back because they had everything under control and wasnt needed. This left me
sat in the staff room for about 25 minutes. When she came back the conversation carried on.
There wasnt really a way I could have overcome this barrier. The other midwifes needed assistance
from Lucy and it is Lucys job so I had to respect that and be patient and wait till she came back.
Lucy was on duty at the time and was able to take out time to answer my questions. I could not
really intervene in the situation as I am not trained to do anything there. The only thing which I
could have done and which I did do was to step back and let them do their job.

Language- This barrier didnt actually occur in my interaction but in a conversation I overheard
there was an Asian male speaking to one of the midwifes. The midwife had problems
understanding some of the things he was saying and she had to keep on asking him to repeat
himself. This must have been difficult for the midwife to keep on asking what he was saying but if
she didnt hear she will have had to so she didnt end up passing on false information or changing
the subject.
This didnt occur in my interaction but for this barrier to be overcome they need to make sure that
they have a midwife who can translate in case anyone comes in who doesnt speak English. They
also need to employ people from different backgrounds because everyone speaks different and can
be embarrassing if they dont know what they have said. If the hospital was to have people from
different cultures it will help the patient feel more accepted in the environment if there is someone
they know that they can talk to and will understand everything they have said.
The impact of them overcoming this would be that the service users would feel more comfortable in
using the service if they were able to speak their own language and know that they would be fully
understood by the care practitioners. The service users would feel more respected and more
included in the service and not feel like they are been discriminated against.
Reference:

27

break down language barriers and enable effective and safe communication between English and nonEnglish speakers across the UK
this is a reference from a company called Cintra, they are a voluntary organisation who train
people to become interpreters. This would be a good thing for the my service to look into as on my
visit I didnt come across any translators. Obviously there will be some based around the hospital
but when one of the patients husbands came up to the desk, a member of staff found it very hard to
understand what was been said and she found herself repeating herself. By having a person who is
able to translate on each department will totally get rid of this barrier and will be a better
environment for everyone. Even by sending some of the staff on this course rather than employing
more people can have a big impact on my service. The service believes that it is vital that
professional interpreters and translators are used to ensure safe and effective communication
between English and non-English speakers. This would be very beneficial to the staff because they
will feel more at ease when speaking to non- English speakers, and also will benefit the staff
because they will feel like they are been treated in the same way as everyone else using the service
and wont feel discriminated against.

NHS Values
My service which is run by the NHS respects the care of all of their users. These values are used and
put into practise throughout the hospital. These values will be used especially in my service. The
values which are used are:
-

patients' individual needs and experience are our first consideration;

the best results come about when patients, their carers, relatives and staff are active
partners in decision taking and in the giving of treatment and care;
we should conduct ourselves with compassion, courtesy, professionalism, integrity,
openness and respect in our relationships with patients, their families and each other;
services are best delivered when our staff are highly skilled, motivated, patient focused and
work together as a team; and
continuously improving everything we do.

http://wiki.answers.com/Q/What_is_the_NHS_mission_statement
These values must be followed for the safety and security of the staff and patients. If these are not
followed by my service it may see a downfall in people who choose to use the service. This will have
a major effect on the department and will set a bad example to others. By following the above
values can ensure that the service is run in the correct way, staff have been trained properly to do
their job. It also shows that they have had a lot of experience and have been shown good training
skills to improve their overall skills making them look more professional.

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Barriers my service has when communicating with clients

As my service is a care environment it deals with a number of different people who have come from
different backgrounds. People may suffer from different disabilities which sometimes can be passed
on throughout child birth. Down Syndrome is caused when an extra chromosome is passed on in
the pregnancy. This can happen to anyone and cannot be prevented. An extra chromosome is
usually passed on in women who are pregnant over the age of 40.
Statistics of passing on Downs Syndrome in pregnancy:
20 years - 1 in 1,500
25 years - 1 in 1,300
30 years - 1 in 900
35 years - 1 in 350
40 years - 1 in 100
45 years - 1 in 30
(Ref: http://www.bbc.co.uk/health/physical_health/conditions/downssyndrome1.shtml )
Disability- For anyone, communicating with a person who has a specific disability can be very
difficult, especially with someone who finds in difficult speaking. It is very rare for a woman with a
severe disability to become pregnant. Usually people with a disability will be advised not to become
pregnant and if they are they will usually be taken to a special hospital where they will receive the
correct amount of care they need in there pregnancy and will be helped all the way through.
Women who have a disability but still manage to function adequately and carry out day to day tasks
will be helped but will still be able to give birth normally.
In my service disability is promoted very well, the rooms are designed for people who may have a
disability, there are walk in showers, equipment used to help when going to the toilet such as bars
to pull yourself up on. Midwifes are there for you throughout your time in the hospital and will
provide you with as much care as you may need. Some women will need all the assistance they can
get whereas some women like to stay independent and do as much as they can themselves.
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A lot of the time a scan will pick up on any disability which the child may suffer from and can make
the parents aware before it is born, giving them chance to prepare. If the child will be severely
disabled some parents find it is best for the child to be aborted, as they wouldnt want the child to
suffer all its life. This can be a very difficult choice for a couple to make but in the end it will have
been there best choice as some couples say that they wouldnt have been able to cope with a
disabled child.
Disability in my service can be overcome by employing someone who fully understands the case of
the patient and can support them through the pregnancy. Usually midwifes will deal with this,
which can be difficult for them but they have to be able to show a lot more care for the woman and
be patient with them, showing them that they are been treated the same as everyone else. Thats
why one of the main skills you need to be a midwife is to be patient and show care and support to
the woman. This makes the woman feel accepted and they know that they are in the best care.
The benefit of this would be that the service users would feel happier using the service if they know
that people arent going to discriminate against them. As my service is a care environment they will
deal a lot with disability and disabled people and they will feel better if they know that the service is
treating people in the same way and making sure disabled people and fully functional people have
the same opportunities of each other.
Cultural/Language- This is one of the major barriers within my service. As the UK is a multi-cultural
society midwifes can expect to have patients from different cultures and backgrounds. This is more
reason for the hospital to employ midwifes from different cultures. Some women want a midwife
from the same culture to be there throughout they birth because they feel like they will be
understood by them more.
On my visit to my service I didnt see any midwifes who looked like they were from another culture.
This can be a difficult and awkward situation for a woman who wants their midwife to be a
particular culture.
In my service this can be overcome by either employing a wider range of midwifes making the
patients happier. A positive of this is that it would create a few more jobs to be filled but may be
difficult for the government to be able to afford to pay them which may result in a pay cut for
midwifes. A midwifes role will never not be needed in the world as there are people giving birth
around the world every minute. It is one of them jobs that will always need someone to fill the job
role, people who get into midwifery at an early age usually end up doing the same job throughout
their career. Which then lead to them been promoted. Working in the same environment for a long
period of time will get you used to the people who are using the service and may end up coming
across the same people more than once. Building up a good relationship with the patients in the end
can make them want to come back and use your service in the future or may recommend others to
use it.
The benefit of this would be if you get to see people more than once in your service, you get to
know more about them and dont feel like you cant talk to them. Having members of staff from
different cultures and backgrounds can have a positive impact on the service and can give it a better
reputation. This makes people using the service feel a lot happier if they feel like they are been
treated equally and feel part of the community.
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Problems in Pregnancy
There are many different problems that a woman and a baby can go through during a pregnancy.
These can be things which either are inherited from the parents or which have occurred by
environmental things. Inherited things can be things like cystic fibrosis and down syndrome.
Whereas environmental problems with the baby are things like smoking related problems and
alcohol related problems. With a woman having problems in her pregnancy can put midwifes on the
spot more and will have to take more care in the delivery of the baby.

Inherited Disabilities

Cystic Fibrosis- this is a rare condition which affects how the lungs
work and makes it difficult for the body to digest food. A baby
inherits cystic fibrosis through his genes, which means he is born
with it. Cystic fibrosis is caused by a faulty gene that controls the
way salt is absorbed by the body. Too much salt and not enough
water is allowed to pass into the body's cells. This turns the
secretions into a thick, sticky mucus. This mucus blocks the airways
in the lungs and clogs the digestive system.
Cystic fibrosis affects only one in 2,400 babies born in the UK (Dodge 2007), so it is a rare condition.
Your midwife will take a few drops of blood from your baby's heel. The blood is tested in a
laboratory. The test does not always give a straightforward answer. If a follow-up is needed, your
doctor may carry out a sweat test. This will look for levels of salt in the baby's sweat, which will be
high if the baby has cystic fibrosis. About one in 25 people in the UK carry the cystic fibrosis gene. A
person with just one gene for cystic fibrosis will not be ill from it. They might not know they have
the gene at all.
Some of the symptoms of cystic fibrosis are things like:
frequent chest infections and asthma
jaundice that persists longer than in most babies
poor growth
persistent diarrhoea
constipation

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Downs Syndrome- this is a genetic condition known as

trisomy, where a person inherits an extra copy of one
chromosome. People with this have three copies of
chromosome 21 rather than the usual two. This additional
chromosome changes appearance of the body and results in
problems physically and intellectually. It affects around one in
1,000 babies born in the UK - about 750 babies a year - and is
the most common inherited cause of learning disability.
People with Down's syndrome tend to look different to others; they tend to have eyes that slant
upwards. Some other facial features include smaller ears, a flat back of the head and protruding
tongue. People with the syndrome also tend to be shorter than average with poor muscle tone and
have short, broad hands with a single crease across the palm.
This disability is also linked to the child having a learning disability and may need extra help when
carrying our different learning tasks, it usually does allow the sufferer to lead a reasonable normal
lifestyle. As it stands there is no cure for downs syndrome but with todays technology these extra
chromosomes can be picked up on scans, but nothing can be done about it. It is then up to the
parents of the unborn child whether they want to go along with the pregnancy and watch their child
suffer or have the baby aborted. This can be a very hard decision for some families but usually is
worthwhile in the long run.

Environmental Disabilities

Problems affected by smoking- this is linked to having a baby

with a low birth weight. Babies born from women who smoke
during their pregnancy are significantly smaller than those
born to women who don't smoke. Low birth weight is one of
the main causes of illness and disability in babies, and also
increases the risk of the baby being stillborn. Smoking in
pregnancy increases the risk of cot death by four times if you
have between one and nine cigarettes a day. This rises to an
eight times higher risk of cot death if you smoke 20 cigarettes or more a day.
Smoking during pregnancy has also been linked to the baby having problems with their mental
development which can lead to them having a short attention span and hyperactivity. The further
into pregnancy you smoke, the greater the risk of complications. By stopping smoking during the
first half of your pregnancy your baby is more likely to have a healthy birth weight. If you continue
to smoke throughout your pregnancy you should expect your baby to have a low birth weight. So,
by stopping smoking or cutting down as early as possible will make the risks smaller.

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Problems affected by alcohol- drinking alcohol can have a big impact

on the health of your unborn baby. Frequent, heavy drinking during
pregnancy puts you as a mother at risk of having a miscarriage or
premature birth. It can even increase the chance for the baby to be
stillborn. By cutting out drinking alcohol all together through the
pregnancy will have a big impact on the babys health. Alcohol
drinking through pregnancy has been linked to them becoming
hyperactive.
There are many symptoms that your baby may have been affected
with. These are things like developing a smaller brain, small head, deformed body structure, organ
deformities and skin problems. All of this can be prevented by not drinking alcohol and taking more
care in your body.

Part D
Evaluation
Overall I feel that my service provides a very good care service. When I carried out my 1-2-1
interaction with a midwife named Lucy I was very impressed with the environment that I saw. The
environment was very clean and had a number of different opportunities for the patients. The
midwife I did my 1-2-1 interaction with was a very kind and supportive woman. As I had met her
before from when my cousin was in having a baby I found it was a lot easier to speak to her. Her
body language was put across as very professional. She used very good body language, I found that
she listened to everything I was asking, and she used very good eye contact, looking at me
throughout the conversation. I find that in a conversation if a person is using good eye contact it
shows that they are listening to everything I am saying.
I was expecting to see Lucys behaviour change as it was a formal interaction but I feel that she was
acting professionally and answered the questions with ease. She didnt hesitate with answering
them and I feel I benefitted a lot from this interaction and was able to get a clear picture of how
someones body language can change through social pressure.
The main things in her behaviour I was looking for was a change in her body language from how she
speaks to her work colleagues. I didnt find much of a change but if I was to do the same interaction
with someone I hadnt met before I think I would have found totally different results in the
behaviour of the person. I needed to look for things like how she responded to my questions and
how she was sat when answering the questions. I did find the conversation drift off onto another
subject? No I found she responded brilliantly to my questions, the subject stayed on what I was
asking her. The only time the conversation broke off was when Lucy was called into one of the
rooms but that was un preventable and I couldnt have done much about it. She came back into the
room and carried on with the interaction which I found very professional.

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When I carried out my group interaction I found this didnt run as well as I thought it would. I think
this is because of the situation and the person I was talking to. The people I did my group interaction
with were a couple who were patients in the ward I was on. The woman was there to be induced as
her pregnancy had over run. I feel that because of this situation it was hard for the woman to act
normally because she will have been scared in what she was about to be faced with.
Lucy had to be in the room with me at all times because of safety reasons and wouldnt be able to
stay in the room alone with the couple. Lucy stayed out of the conversation let me get on with it
because she knew what I had to do and what I had to look for. While I was doing my interaction I
had to look for the body language of the couple when asking the questions. They didnt know what I
was looking for and were told I was a trainee midwife.
I found that the body language of the couple Jess and Simon was very poor. Jess body language
was good; she was sat on the bed with a magazine, she had her legs crossed and was sat up straight;
she listened to all of my questions and managed to answer them all. The questions I was asking
werent very formal. They were questions you would expect a midwife to ask a patient so she didnt
really have to feel any pressure in answering them. Jess used good eye contact and listened well to
me asking the questions and managed to give a quick reply.
On the other hand her boyfriend Simon used very poor body language; he didnt say a word and
didnt answer any of the questions I asked. He sat in the chair slouched with his feet on the bed. This
automatically showed me that his body language was poor and he didnt react very well to been
asked questions by strangers. He didnt use any eye contact and only looked at me and said hi
when I entered the room.
Overall I feel that my 1-2-1 interaction flowed a lot better than the group interaction because all the
qualities of a good communication were met. Eye contact remained throughout the interaction; this
showed me that she was listening. We sat at her desk facing each other so we both kept our
personal space. I feel that she was speaking professionally to me and felt relaxed as her speech was
slow. She also made sure that I fully understood what she had said.
By the staff in my service using good communication skills this shows that the staff are fully capable
of speaking to people and been careful on how they present their body language to others. Using
poor body language can give people false opinions of you and you may come across to someone in a
different light which can be very un professional in a job like a midwife.
To conclude I feel that my service Calderdale Royal Hospital Labour Ward are a fantastic care
service and always try their hardest to provide a friendly care service to patients. I can see this by
the way they communicate with people and the levels of care that they put across to their patients.
I have completed 2 witness statements and included them in my appendix. This can be used as my
primary research as proof that I carried out my interactions.

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How well my service communicated?

Overall my opinion of my service was great. When I first entered my service I did feel quite nervous.
When I was greeted by Lucy she made me feel welcome because I had met her before. This eased
the situation and made me feel more welcome. After this I didnt feel un comfortable about talking
to her.
I feel that my service provides a very good care service for everyone using it. This has to be
remained throughout the service for the reputation of the hospital to remain satisfactory. The staff
need to use all the skills they have been taught to make sure this happens. The staff are taught in
training sessions about how to show the right amount of care to the patients. This skill needs to be
maintained throughout to make the patients feel comfortable. I feel that my service does this very
well as the patients always seem pleased with the care that they are shown. If this skill is met then
people are more likely to use the service from the reputation it has.

Staff to Staff Communication

I feel that all the staff communicated very well with each other and their patient. This automatically
shows me that they have a very good positive care environment. On the visit to my service the staff
all got along with each other. They all spoke to one another and all looked like they felt comfortable
speaking to each other. This must be a good working environment for all of the staff if they all get
along with each other. Getting along with people in any job is vital for the welfare of the staff and of

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the patients. It caused the environment to be calm and made it a very friendly and open
environment.
The staff in my service was all of mixed ages. There were little groups they looked to be in but they
all did speak to one another. In my 1-2-1 interaction I think there were about 6 or 7 midwifes on
duty. They were all wondering in and out of the staff room and all communicated well with each
other. They didnt stay in the room long and only tended to come in when they wanted a drink or a
biscuit. There were chairs in the middle of the room that were in the shape of a semi-circle. This
showed me that when they are on breaks that they do sit down and have a chat together.
Having good staff to staff communication in any workplace is vital for their welfare. Getting on with
your own staff can make you enjoy your job even more and because you get on so well with the
staff they become more like family if you see them every day which makes conversations easier and
less awkward between one another. Maintaining this skill makes the working environment better
and showing the relationship between two staff can make patients feel at ease.
Reference:
"You can tie back almost every employee issue -- attendance, morale, performance, and productivity -to communication," says Fred Holloway, an HR adviser in Medford, Oregon.
Good staff communication is vital in a care setting so everyone knows what is going on and they all
know exactly what is been done in the service. Poor communication can result in misunderstandings
and cause the service users to feel like the staff dont know what they are doing if they are failing to
communicate well together.
Staff to Me Communication
When I went to do my 1-2-1 and group interaction I feel that they staff communicated very well with
me. They offered me answers to all of my questions and I feel like they spoke to me in a polite way.
The midwife Lucy who I spoke to showed a lot of care and support and acted in a friendly way. She
held doors open for me and listened to everything I had to say and responded with a suitable reply.
This made me realise that I was been spoken to properly and I wasnt getting discriminated against.
The staff in my service were all very nice, they all said hello when they saw me and all seemed very
happy to be there.
Having friendly staff can make the job a whole lot easier. By getting along with everyone in the
service makes people enjoy the service a lot more and if they are been treated in the correct way
they are more likely to be more relaxed.
As the staff were all very polite to whoever they spoke to this made me think that the service was
very well run and had a lot of people there supporting them. I feel that I was spoken to in the right
way as a visitor of the ward and I feel that because of the behaviour they were presenting in their
body language that they would speak to others like that and treat them in the same way which is
good in any care environment.

Staff to Patients Communication

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I feel that the staff have to communicate the best with the patients because they are the ones using
the service and they will want to show a good impression of the care that they present in their care
service. I found that the staff spoke to the patients in a very polite way and the patients didnt feel
like they had to hold back anything and felt like they could ask the midwifes anything. At one point
I heard a couple talking to a midwife about personal things like where they lived and what job they
do. This shows me that the patients dont feel like they have to hold anything back and know that
because the midwifes have a caring job that they will understand and listen to what they have to
say.
The staff spoke to the patients in a very polite way. They were always asked how they were feeling
and were supported all the way through up to giving birth. This shows the high standards of care
that the midwifes put across in their job.
The staff were all women therefore the women may have felt easier speaking to them about any
problems knowing that they will have a high understanding. The patients were respected and
listened to. The midwifes did everything they could to support the women which I found extremely
positive.
Reference:
The best way to improve communication is to establish an organizational culture of opened doors,
collaborative sharing and supportive management
This quote comes from the Management Skills Advisor this encourages staff to communicate well
with their patients to make sure they are doing their job correctly. Using this in my service will be
very beneficially, especially to make the levels of communication higher. This will show the care and
support the staff which is portrayed in my service.
Overall
Overall my service presented across to me a very high standard of care and how they communicate
with their patients and service users. All staff were very polite and I was very impressed with my
service. It is defiantly a service I will look into working for in the future as I feel I would benefit a lot
from the high standards of care they show in their work.
I will defiantly go back to my service to do similar activities again and would recommend my service
to others as well. I found that they were a brilliant care environment and manage to suit the needs
of all its users.

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