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On labour ward

The labour ward is a high pressure environment where a positive workplace culture is paramount.

In maternity care intra- or interprofessional communication have been identified as critical contributory factors to negative outcomes in several official investigations/reports:

General tips

  • Be kind, civil and respectful
  • Use first names only to break down barriers
  • Foster a culture of openness that encourages asking for help
  • Treat all members of the team as equally important and valued
  • Be helpful to each other, no task should be beneath anyone
  • Establish clear escalation policies
  • Adopt structured communication tools such as SBAR

The labour ward presents particular challenges. It can be useful to reflect on your experiences on labour ward to try to determine which factors might be negatively influencing your behaviour in this setting.  Below are some of these challenges and targeted ways you might address them.

External influences such a workload and lack of rest breaks

See "influence of external factors"

Multidisciplinary working

See Module 4 Question 4 "Team and multidisciplinary working"

High intensity clinical situations

RCOG Improving human factors and situational awareness "mini-toolkit"

Human factors on RCOG eLearning

The importance of learning from adverse events.  The following have been reported in maternity:

  • A lack of skill when giving constructive feedback
  • Fear of criticism and causing upset
  • A culture of avoiding receiving feedback

Feedback

Learning from Excellence (PDF)
Use of appreciative inquiry (PDF)

Psychological safety on The King's Fund website

Emotional wellbeing after adverse events

See Module 4, Question 4 Staff wellbeing

Schwartz rounds on Point of Care Foundation

Need for strong and compassionate leadership

See Module 4, Question 4 "Set the tone and lead from the front"

Handover

See Handover

 

For those looking to affect departmental change we recommend exploring Module 4 "I am responsible for a department that has a problem with bullying or undermining".