In one review analysed, a midwife had been assigned to care for two women in early labour, one of whom had been violent towards a midwife; the second woman was in early labour and then progressed unexpectedly quickly.
“Midwife 2 became distracted while providing care to another patient. She lost sight of the time and importance of monitoring the fetal heart of [the] baby.”
Distractions are an important cause of loss of situational awareness, and in this case having two competing tasks was a problem. It is easy to see how having two complex patients would push one over the threshold of working memory and allow distractions to creep in. In this example, the major distractor was the emotional difficulty of dealing with a woman who had been violent. The midwife could not concentrate properly on the other women she was caring for.
Things you can do
Many hospitals have adopted visual barriers to prevent interruptions during safety-critical tasks, for example by displaying written “Do not interrupt the drug round” messages during medication administration.