Leaving Midwifery...

[Spanielowner]

Hello all,

It’s an August Sunday morning here and I need some advice/perspective.

I have been a qualified midwife for just 18 months. I have already worked at 2 different trusts due to a house move approx. 2.5 months ago. My first year was tough as is to be expected somewhat, but was generally pretty good by the end. However, since moving to my new job 4 months ago, I am feeling completely and utterly burnt out. Their staffing ratios and shift patterns are nothing short of insanity.

I have applied and been short listed for a student health visitor role starting in January. I have also interviewed for a midwife post at another trust nearby (find out tomorrow) and I also have an interview coming up soon for an immunisation practitioner. I am still a band 5 so no pay cut with any of these thankfully.

I have just had 3 weeks off on stress leave as I get migraines regularly and the pressure I am under at work sets them off. I have been back for 2 shifts and I am already feeling like absolute sh*t. I left work 90 mins late last night (22:00) having not had a break for 9 hours. I barely slept last night, I got to bed at around midnight after a very late dinner and then work at 04:30 as my brain is just in overdrive. Today I just feel nauseous and I have a horrific migraine.

I am exhausted and burnt out. I have some potentially great options on the horizon, however I just don’t know what to do in the short term as I am fully burnt out. I’m just not coping, crying and verbally lashing out at people I love. I am getting married in 7 weeks with annual leave starting in 5.5 weeks and I don’t even think I can get through that short period. I am absolutely desperate. I have already reduced my hours from 37.5 to 22.5 but I don’t think I can even cope with that. I haven’t even been back for a full week yet and I already felt like crashing my car on my way to work was preferable than turning up.

Please don’t worry, I am not feeling liable to self-harm or hurting anyone else, I just feel mentally at my wits end and something has got to give. I think because I moved trusts I am still within my probation period (even though I have 18 months of NHS service) but maybe someone can correct me on that. Therefore I don’t know if can submit my notice and go off sick again whilst I wait it out? Of course I will have no job at the end of it but I’m not sure I care at this stage. Luckily my partner earns enough to just about keep us ticking over but we would have to cut out a lot of extras.

If I got the student HV role it would start in January. So I figure I could end up with 2-3 months without a wage. Of course, any other job I get could start much sooner.

Has anyone got any advice or perspective for me please? Anything at all appreciated.

Thanks so much.

Oh OP you really are having a tough time I've definitely been in that position, where driving to work just creates an absolute storm of anxiety. I certainly think you can take sick leave in a probation period and it sounds like you need to take some time now. Don't worry about the future right now, don't even worry about making it through the next 5 weeks. Just do something for the right now. See if you can have a few days or a week off. Your mental health is clearly suffering. You'll feel better to make decisions if you can reset a little.

Don't make any big decisions now. Get signed off work by your gp. Take a few weeks sick and recover then decide exactly what is best. You are Ill, you need to get well.

The long shifts are brutal and I really sympathise OP. How much sick pay you get depends on your length of service, if you joined your current trust with no break between your last one, and you’ve got about 18 months NHS service I think your entitlement is 6 weeks full pay in a 12 month period then half pay - but you should check that with HR. Would it impact on the HV interview? You might not be on probation, not all contracts include this, mine didn’t, I was straight in as permanent with an 8 week notice period. First and foremost you need some time out to get well again, I hope you are able to get some support xx

Sounds awful. I can fully relate. I have been qualified for about 18 years! The ups and downs are immense. The service has changed so much since I started. I often see new midwives burnt out. The service is in desperate need of support and more
Midwives but we cannot retain them. Have you been in contact with a PMA? (Professional midwifery advocate)? Or ask for occupational health referral? The training is so tough for midwifery - it would be shame to leave without getting some support first. Feel free to PM me if you want to ask anything or if I can help in any way.

Adult nurse here rather than a midwife, but I was in a pretty similar situation. Just hand in your resignation asap and if you need to go off sick, do it. I actually found once I'd made the decision I was ok working my notice though as I just didn't care anymore and knew the end was in sight!

Would you consider agency/bank work? It's good short term as you can pick and choose your shifts and you don't have the same responsibility as a permanent team member.

Have you only been in the new trust a few months? I get that staffing ratios can be horrendous but I think bad staffing ratios combined with a new trust is a bad mix…….if it was just the staffing ratio would it be better? Will things improve with time as you settle in?

Can you talk to the ward manager or professional development midwives?

Saying that there’s definitely life outside of midwifery. If you thjnk you’d enjoy HV go for that….I’ve no idea what their stress levels/burn out/work load is like so make sure you’re going in with your eyes wide open. Got to be better than long shifts on an under staffed ward though.

I have semi retired midwifery friends doing covid vaccines at band 5 and enjoying it. You could also look into whether you can do your cosmetic training for stuff like lip fillers and Botox……a midwifery friend does this and has set her own business up…..not sure if she’s a nurse as well….but maybe you can do it just as a midwife.

I could have written this post, I have just left midwifery after an almost exact experience. It’s just not worth it.

HV is a completely different ball game, you can really give excellent focused care, there are obviously some harrowing cases but you see that equally in midwifery if only for a short time.

The caseload numbers are not as horrific as continuity, the hours give you a better work/life balance and there is no drama or bullying (where I work anyway) but I think this is more down to the fact the pressure isn’t there!

As previous posters have said, go sick, take some time to re evaluate and give yourself some breathing space!

I can fully sympathise with your situation because I experienced the same as a qualified midwife. I made the jump to health visiting and it suits me well. In the meantime, try speaking to your employers. They may be able to offer you something to take the pressure off. They probably don't want you to leave, and I would give them a chance to make adjustments for you. My solution, until I qualified as a HV, was to do bank work, only on wards where I was comfortable. The fact that it was bank, and I could walk away if I wanted to, relieved the pressure.

I'm starting health visiting next month, I'm currently a nurse with the HV team so do everything a HV does but not with families who are Level 4.

What I do know is, there's a National shortage of HV's and the stress on HV's is massive. There's a lot of staff sickness due to stress. Many who have taken early retirement as well.

Just be aware of the stress if that's the direction you choose.

Another example is, HV's caseloads should be up to 250. They are currently around 380.

I’m sorry you are experiencing this - I would wager that just about every newly qualified midwife does go through this, I certainly did ( 16 years ago!) The rotational aspect is unsettling, even though I appreciate you need to do it to get experience in all areas but you’re just beginning to find your feet then have to move to a new area.

I fully understand the ‘ not-really-but-what-if-I -crashed ‘ fantasies. I actually used to go out walking late at night in unsafe areas in a similar mind frame. Your physical and mental wellbeing has to be the priority so I would recommend seeing your GP and taking it from there. At least take some space / leave before making the decision to resign.

The staffing issue seems to be a current issue nationally (a lot of Trusts can’t fill bank / agency shifts and senior managers have had to come out and do clinical shifts but many shifts are still left unfilled). It may be Covid related, but regardless I think midwifery is currently in crisis.

Despite all of the above I’m glad I stayed. I’m currently doing a non clinical role which I love - no more shift work ! - but best of all I get to stay in a profession which allows me to speak up and advocate for women.

Only you will know what is ultimately the right decision for you. Good luck with whatever you decide and as a PP offered, feel free to PM if you’d like.

Having got through the training and found that your current trust has staffing issues I'd suggested seeing if it's the role or the trust.

So, first of all protect your mental health and get signed off sick. Don't think this is going to get better in a couple of weeks, you need time. Think about trying some bank work so you have that distance from your employer you can't get at the moment. Speak to people at other trusts you could work at, is it any better there?

I think you need time to make a decision, when you're this stressed you don't make good decisions. Take care.

OP, can you take a few days initially just to rest up before making any big decisions.

I completely get it. I left midwifery, which I loved, after 12 months as I felt completely unsupported in my role and we were so short staffed it felt dangerous and my nerves were shredded by the end of every shift.

I am training to be a health visitor and qualify in 2 weeks. It does come with its own stresses, mainly massive caseloads and a lot of staff shortages here too, however the lack of shifts/nights or weekends make it so much more manageable for me and I see much more of my family.

Many in my cohort have left, some have left for while and gone back. Bank work is a good idea if you have an area you feel comfortable in.

When I was going through the same thing someone on mumsnet told me midwifery is a qualification, not a life sentence
You are allowed to step away for your own mental health. And whatever you decide to do, you will always be a midwife, and yoyr training will always be there if you decide to return, or will give you the skills to go on to a new role. Good luck

Thank you all for your lovely kind and very genuine comments. I was back at work today, and the ward was very well staffed. I had a much better today, however it was still non-stop so not exactly easygoing (I wouldn’t expect this though in any line of work, let alone NHS!)

So last week I had an interview for another trust as a midwife and got offered the job today. They said in the feedback that they were actually highly impressed with my interview and test paper (CTG interpretation etc.) so I was properly chuffed! After feeling like a really awful and incapable midwife since I joined my current trust due to the frankly unreasonable demands placed on me, it was just the little lift I needed.

I still haven’t quite made a decision on what to do, however at least now I have a way out. I still have a the trainee HV role and an immunisation practitioner role to interview for, so options still open for now.

I am tempted to go for the midwife role and see how the others go, and potentially jot them down for experience in the future if I decide to switch roles for less urgent or pressing reasons, such as maybe family commitments etc (I hope that makes sense!)

I genuinely felt in crisis on Sunday though after my experience on Saturday, it was just the straw that very nearly broke the camels back. However, I managed to pull myself back together somehow. Probably knowing I was gonna hear back about that job today helped a lot. Plus, myself and my partner had all but agreed that I was going to hand my notice in today regardless of the new job outcome because I can’t continue like this. So maybe that helped too.

Thanks again for all your kind words and advice, reading them all really did help - you’re all so thoughtful to take the time to reply. With any luck I won’t have to go back to my current role after my wedding! 🤞🏻

Hi OP, do you have any update?

I'm a 3rd year stmw wanting to apply for my SCPHN-HV training immediately after qualifying.

Midwifery just isn't a doable job. It's impossible.

Would love to hear how it turned out for you.

Hi PepperSpray,

I’m now in term 3 of my SCPHN training with only 9 weeks to go. I absolutely love the job, it’s a much better work/life balance compared to midwifery and the culture of the trust I’m in is genuinely caring. There are a few characters shall we say but you get that everywhere. It is a far cry from the absolute toxicity that seems to have infiltrated midwifery management in every trust I’ve worked in (that’s three!)

I’m now so much happier, married and loving my job. My husband has been the most supportive he could ever have been, literally my saviour. If you have someone like that in your life (not necessarily a partner) then hang on to them because you’ll need it if you’re doing the SCPHN course! It’s so challenging but amazing, I’ve really enjoyed my training. The job itself is definitely full on in its own way and there are some really difficult cases but it’s not the same level of physically and mentally damaging stress that midwifery caused for me. I hope whatever you decide to do it all works out for you! X

@Spanielowner I'm absolutely delighted to read your post! Well done.

I was a band 4 community nursery nurse for 3 years before I started my mw training and I miss health visiting so much.

I just keep thinking, why waste my time doing my mw preceptorship when I know I want to go back to HV long term. Midwifery is horrendous right now. I've seen such dangerous practice due to staffing and I don't want to risk my pin in this way once qualified.

You've made me feel like I'm making the right decision. I felt like I was making a mistake wanting to leave midwifery before I'd even got started.

Best of luck with the rest of your training, it sounds like you're doing fab. X

I left midwifery over 20 years ago as I could see the way it was going. It’s a wonderful job if you are allowed to do it properly, unfortunately we weren’t.
Get out in the community, it’s great.

@PepperSprayFirstApologiseLater1
oh wow, that’s amazing that you had the experience of being a band 4 CNN first! Sounds like you will fit right into the fold, they’d be absolutely delighted to have you back after your MW training I’m sure! I sometimes wonder how on earth it took me this long to find health visiting… anyway, I’m here now so that’s all that matters 😁 Good luck!! Hopefully you will get on the SCPHN course without any difficulty whatsoever! X

@KangarooKenny
couldn’t agree more. My first job as a NQM was in the community with 2 weekly rotations onto labour ward. I loved that job and my community role but I hated my stints on labour ward. If staying in midwifery then there’s no doubt that community is the place to be. It’s not without its problems either, but it’s a far cry better than the degenerate knuckle-draggers that manage the workforce within the hospitals! 😂

Im a nurse in the community now and much prefer it. There’s lots to complain about, but it’s much better than midwifery was.