My first weeks as a Newly Qualified Midwife (NQM) on Labour Ward were better than I expected. I was excited to come into work, I trusted that I knew enough to get started, I trusted that I wouldn’t be asked to look after a high risk diabetic women on a VRI sliding scale with a penicillin allergy and a fear of needles.
I trusted that what was expected of me and my clinical skills and clinical judgement aligned.
I worked shifts alongside some of my previous supervisors and other NQMs, and in those first few weeks was met with many hugs. Working with other NQMs also provided a sense of camaraderie, during our induction we created a chat to keep in touch and this space has been a valuable and cherished outlet, not only to ask about shift swaps, but to exchange reflections, learnings and experiences.
The jump from student to autonomous practitioner is huge, in ways hard to imagine before you are fully in it. Every day you’re learning more than you thought is possible, and although some shifts were harder than others, on the whole it felt like a steady upward curve of learning.
Then it hit me, months in, suddenly I was more anxious at work, I felt like I didn’t know enough. Objectively I could tell myself I did, but rationalising my brain didn’t make the feeling in my body go away. I started questioning if this is what I wanted to do, I felt tired by the shifts, drained by the conveyor belt nature of working in a large and busy obstetric unit. I no longer trusted that I knew what to do. And that felt scary, did I make the wrong choice? Am I only now realising it?
Then I remembered (and was reminded by colleagues) about transitional shock. I guess a part of me thought I had avoided it because the first few months felt smooth but I didn’t, I’m not sure anyone does. Transitional shock as defined by Duchscher https://pubmed.ncbi.nlm.nih.gov/19183235/ is the experience of “initial professional adjustment in terms of the feelings of anxiety, insecurity, inadequacy and instability it produces”. I know it is helpful to name the feeling and did find solace in being able to describe what I felt, knowing it was a common and shared experience. That in itself was not enough though, it didn’t make the feeling go away.
So I reached out for help, I spoke with colleagues and fellow NQMs, being honest about how I was feeling. I reached out to my health board’s practice education facilitators to attend a clinical supervision session. I jumped on the opportunity to book onto core mandatory training as soon as possible to give myself access to tangible information. I protected my days off away from work and midwifery.
The anxiety and the uncertainty is still there, and I guess I need to accept that it will be there until it passes. Not fight it, accept it as part of the process and trust that this moment of “I cannot do this” is what happens during transition, into a midwife, the way we as midwives support women and birthing people through those moments of transition right before birth.