'I wish I was dead': NHS midwife writes open letter describing job as 'a black hole'

England is short of 3,500 midwives, putting enormous pressure on existing hospital staff

Charlotte England
Sunday 23 October 2016 09:22 BST
NHS workers, including a midwife and her baby (centre), gather outside a hospital in London, during a four hour strike over pay
NHS workers, including a midwife and her baby (centre), gather outside a hospital in London, during a four hour strike over pay (Getty Images)

A midwife employed by the National Health Service has written an emotive letter describing the immense pressure she faces at work.

“I am a midwife and I wish I was dead,” she said in the piece, which was submitted anonymously to local paper the Liverpool Echo, before describing her job as “a black hole destroying my world”.

She listed a huge caseload, long hours, and bullying by managers and other staff as reasons she had lost hope and could no longer do her job well, or even safely.

“I am having chest pains just thinking about the stress and worry of it all," she said.

The Nuffield Trust, an independent health charity, warned about poor morale among NHS staff in June.

“A great deal of the current focus in the NHS is on the financial challenges it faces,” chief executive Nigel Edwards said in a statement. “These are undoubtedly severe, but I think they may be obscuring a problem that is at least as serious: the state of the workforce. There are a number of inter-related components, including poor morale, bullying and looming shortages in key areas.”

The anonymous midwife described an untenable level of responsibility.

"Currently, my caseload is up to 40 women and rising, so that’s 80 lives in total that I am personally responsible for right at this very moment,” she said. “I don’t get much sleep at night.”

In July, the Office for National Statistics published 2015 birth-rate figures for England, which showed 2,903 more births than in 2014.

Responding to these figures, Royal College of Midwives director for England Jacque Gerrard said: “These latest statistics show that the baby boom is continuing, but unfortunately the number of midwives is not keeping pace.

“We are now short 3,500 midwives in England.”

In her letter the midwife wrote: “The hours are endless. Most days I don’t stop for lunch and I frequently get to the end of the day without having been to the toilet. Midwives often joke about having cast iron bladders. I’m not the only one. This is so commonplace I fear it’s becoming an accepted norm.

”There have been times when I have been out at a birth all night and gone out to do visits the next day because I don’t have space in my diary to reschedule. So I eventually get home and snap at my family because I haven’t had a minute to myself and I am so tired that I could just collapse and you can guarantee that the second I sit down to eat the phone will ring and I’ll be out to work again.”

She added that although she enjoys delivering babies, supporting women through labour and childbirth is actually only a very small part of her job.

She said she keeps her “head down” a lot of the time because management are “always looking for someone to blame," adding that the department is too short-staffed for her to take time off when she is left shaken by a difficult birth.

“I dust myself off as everyone does and it’s on to the next couple, the next birth, and what will that bring?” she said. “I am scared to attend my next birth as I’m still shaken by the last but we are short staffed at the moment so I just keep my head down and get on with the ever-growing list of things for me to do. An impossibly long list of things to do and I know I will never reach the end, it’s almost futile to try.”

She described feeling hopeless and said she was unable to do her job properly.

”I don’t feel that I am able to do my job safely, let alone provide a good standard of care,” she said.

“I trudge my way through this wretched existence and hope every day for the bullet, the heart attack, the car accident that will mercifully end it all. I resent the lies that got me here in the first place. I know that I am not alone but that doesn’t make it alright. I am waiting for something awful to happen, for some minor error or oversight to lead to a major incident. That’s when I will take the emergency exit from this life. It’s something I have planned for.”

In a statement, the Royal College of Midwives said: “This is a truly heart-rending letter. It is difficult to advise without knowing the full facts but the Royal College of Midwives would suggest the midwife contacts their line manager or human resources and perhaps seek some counseling and support as soon as possible via their GP. We would also suggest they involve their family.

“The RCM would expect any employer to respond to concerns with compassion, treat them seriously and act upon them. Anything that affects the health and well-being of staff and the safety of services must be addressed urgently.

“If a situation is as difficult as this letter suggests and mangers are not addressing the issue and supporting their staff appropriately, then we would be greatly concerned.”

The midwife's letter said: “I am unsupported, I have been the difference between life and death more times than I care to remember, seemingly unflappable in the eyes of the parents of the little lives I have rescued from the brink of extinction. They never knew of the tears I cried as I rocked back and forth on the floor of the staff toilet.

"I have been treading water for some time, I am out of my depth, the tide is drawing me further out and now I am drowning.“

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