WORKING AS A COORDINATOR MIDWIFE IN A TERTIARY ...

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Gould (2000) writes “medical knowledge is thoroughly interwoven into the midwifery profession” (p.425). Coordinators know there are midwifery solutions and they want to be able to teach and share their knowledge. They use their techne and their phronesis, however within the busyness of the delivery suite unit where staffing acuity is a constant challenge, they do the best they can and this is the way it is. 167
CHAPTER SEVEN Discussion Summary of the Key Themes This study reveals the coordinator is an expert midwife in addition to being the leader, the broker, the mediator and the peacemaker; she can see the bigger picture and wisely takes action whenever required. The stories in the preceding three chapters reveal the complexities of what it feels like to be in this position of responsibility and the multiple skills coordinators possess to be effective in their role including complex clinical midwifery knowledge, wisdom, instinctive ‘knowing’ and a woman focused philosophy of care. The tertiary hospital environment is the focal point where the skills of obstetricians, anaesthetists, sonographers, medical and surgical specialists, LMC midwives, DHB midwives, nurses and ancillary staff merge. These skilled people cannot work in isolation. They are part of a team with the united objective of offering the highest possible standard of care to mothers and babies who require assessment, treatment and care within this setting. Each of these professionals holds their own personal lens, with different cultural mores and philosophies in relation to the situations they manage. It is the coordinator midwife in the delivery suite setting who is the ‘pivot’ or ‘hub’ for everyone and of everything that happens in the unit. In her pivotal position, she has the 168
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WORKING AS A COORDINATOR MIDWIFE IN
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My perspectives of partnership in t
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Summary ...........................
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Attestation of Authorship I hereby
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Abstract This phenomenological stud
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is deemed by the midwife manager wh
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pregnancy and childbirth experience
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The Department of Labour (2006) rep
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secondary midwifery care” (p.11).
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DHB coordinators is how they embrac
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No national or international resear
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Methodology Why phenomenology? The
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change” (p.157). To this end, I a
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holding my daughter at birth to bre
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My Pre-understandings Interview Eve
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come to work, how do they manage on
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midwife, whilst ensuring safe pract
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‘unknowing’ resulted in tension
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Summary My pre-understandings revea
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entitled; The Luxury of Time, ‘Th
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The Realities of the Tertiary Deliv
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New Zealand perspectives of seconda
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hospital. Their objective was to ra
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provide an increased opportunity fo
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whereas now when she responds to ca
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The ‘Emotion Work’ and the ‘S
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unrecognized and may be conducive t
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demands, job resources and their di
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midwife, representing “working th
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the sense of value nurses attribute
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of a consultant is described by Isa
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in a sustained way and are not inte
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following accepted procedures” (p
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same. This reveals the variance in
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subconscious, becomes the basis for
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CHAPTER THREE Research Methodology
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What is a phenomenon? Heidegger (19
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new meaning and truth. An added dim
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space, things, the body and others
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Participant Recruitment My workplac
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Anonymity and Confidentiality For m
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Interview venue Participants chose
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Two coordinators knew what they wan
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I made tentative notes about themes
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Literature research I delved into a
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Geanellos (1998) offers alternative
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Summary In this chapter, I have ide
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Irene explains: Being the coordinat
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I work, the difficulty is the staff
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weather storms better than others j
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for her as coordinator. This story
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An anonymous quote is cited by Mall
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which reflects on the colleagues sh
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Alice explains what it feels like f
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Alice reveals she has to subconscio
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Irene reveals there are different r
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egarding this overspill or emotiona
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professional supervision” (p.13).
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Summary This chapter reveals how co
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CHAPTER FIVE Time as lived The cloc
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eveals her interpretation of what i
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We had a woman needing to go for a
Page 125 and 126: herself desperately trying to engag
Page 127 and 128: Sally offers a story with a differe
Page 129 and 130: subsequent three ‘nightmare’ ad
Page 131 and 132: decision to augment the labour base
Page 133 and 134: environment is well described by Ca
Page 135 and 136: eginning of January so she was bran
Page 137 and 138: I didn’t even have the midwife’
Page 139 and 140: minute, then got up and said to the
Page 141 and 142: life” (p.192). The coordinators h
Page 143 and 144: “Techne” and “phronesis” ar
Page 145 and 146: egarding who is assigned to the shi
Page 147 and 148: who hadn’t even been orientated t
Page 149 and 150: the staff would respond to her dire
Page 151 and 152: case of going in and demanding to k
Page 153 and 154: “support from midwives in the sec
Page 155 and 156: When Irene is invited into a room s
Page 157 and 158: anaesthetist as to what is safe for
Page 159 and 160: skill mix. Her knowledge regarding
Page 161 and 162: ‘I’m already overseeing three w
Page 163 and 164: experiences which contribute to her
Page 165 and 166: this is her opportunity every day w
Page 167 and 168: (2004) writes “the place of birth
Page 169 and 170: shoes and a gown on and be ready fo
Page 171 and 172: Irene was skilled and able to view
Page 173 and 174: suggested they did a pH 9 on the ca
Page 175: The responsibility coordinators und
Page 179 and 180: ‘Needing to know’ Coordinators
Page 181 and 182: Facing the ‘known’ and the ‘u
Page 183 and 184: which may involve empathizing, reas
Page 185 and 186: Coordinators take their emotional w
Page 187 and 188: solutions - which offers resonance
Page 189 and 190: cohesiveness and teamwork. Alice su
Page 191 and 192: There is a career pathway for DHB m
Page 193 and 194: will enhance tertiary level clinica
Page 195 and 196: The stories shared by coordinators
Page 197 and 198: This research offers no insight int
Page 199 and 200: work shift after shift and reveal n
Page 201 and 202: GLOSSARY Coordinator/Charge midwife
Page 203 and 204: REFERENCES Barnes, I. (2006). Copin
Page 205 and 206: Code of Health and Disability Servi
Page 207 and 208: Edward, K. (2005). The phenomenon o
Page 209 and 210: Health Emergency Management in New
Page 211 and 212: Kennedy, H. P. (2002). The midwife
Page 213 and 214: Ministry of Health. (2002). Notice
Page 215 and 216: Pairman, S. (1999). Partnership rev
Page 217 and 218: Smythe, E. (2000). “Being safe in
Page 219 and 220: Van Manen, M. (2007). Phenomenology
Page 221 and 222: midwifery coordinator/charge midwif
Page 223 and 224: Whom do I contact for further infor
Page 225 and 226: I agree to take part in this resear
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