One thing that has been effective against this that I have seen. On the initial midwifery assessment form that was devised specifically to meet the needs of the unit the wording says. FHR______ CTG indicated Yes/ No Indication__________________
Time done ________ Time VMO notified of result___________. This means that the person doing it has to justify on paper why they are doing it. Also leaves room to write VMO insistence with no indication which they dont like seeing on paper. Seems to have resolved the issue of routine admission traces and it hasn't been raised again since.

Andrea Q

On Friday, September 17, 2004, at 06:04 PM, B & G wrote:

I have a dilemma. CTG's- we all know research has proven admission CTG's are of no benefit however when there has been a verbal workplace directive by the Director of O & G as a litigation risk management that all admissions to Birth Suite have a routine baseline CTG and you have been diligent to carry out this with and made entry in the notes to the effect indication for CTG as per policy. I have since found out that a person doing her masters has been auditing clients charts to see how many CTG's there have been done and now wants to interview the clinicians/midwives to discuss why we did the CTG? "To highlight the lack of clinical knowledge of midwives when they put everyone on a CTG" in Birth Suite she verbally informed me when questioned.
 
I feel now that not only we clinicians are in conflict with the Dr's over being told we have to do a CTG on admission, us clinician are now being treated as bloody mugs from a midwife researcher. It was only when I contacted the researcher for an explanation what her notice on the board that appeared today requesting us to write down the clients UR and our name on a piece of paper did I find out about this research. I feel abused, violated and to be honest so pissed off that a midwife has such little regard to midwives professional conduct and clinical care when we often have little control over medical directives. Another example is IVC for VBAC do we really need it. I have questioned many times why baseline CTG's to the point I was being ignored by registrars and they would go to other midwives to make sure an admission CTG be done. I capitulated as I was subjected to horizontal violence from medical staff and other midwives to the point I just do CTG's but always asking what the indication is and noting it in the notes.
 
I do not believe this research is ethical and of no benefit to anyone other to show just how stupid we are in obeying medical directives. If we can have case loading with midwifery led care this question would not come up.
 
Am I over reacting, any suggestion what I can do?
I lock forward to your responses.
 
Barb

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