WORKING AS A COORDINATOR MIDWIFE IN A TERTIARY ...

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care and insight into aspects of provision of LMC midwifery care within the tertiary hospital setting. In addition they understand and apply their knowledge to the associated legislative requirements; they also show they possess strong leadership skills, expert communication skills, wise decision making and apparently strong levels of resilience. Especially with the current national midwifery staffing shortage, the position of coordinator midwife should hold kudos. It needs to be a sought after position interested midwives can strive to be appointed to for their career advancement and which accords appropriate financial remuneration. Two of the three tertiary hospitals where these coordinators are employed have specific job descriptions attached to the coordinator’s role with managerial level salaries. Questions are unasked and unanswered in this study regarding midwives working at the tertiary hospital where midwives are allocated the role of coordinator with no formal job description or appointment to this position. How do these midwives feel? What preparation do they receive when they are allocated this level of responsibility and how do they manage the added responsibilities when they are thrown into situations of coordinating which may not be of their choosing, where their responsibilities are significant and where their pay is that of a staff midwife? New Zealand is a small country where consistency between District Health Boards with regard to midwifery appointments requires consideration. This requires further research. 181
There is a career pathway for DHB midwives – the Quality Leadership Programme (QLP), with its highest level of attainment entitled ‘Leadership Midwife’. The leadership role of the coordinator midwife is shown in this study to be multi-faceted and complex. It is unknown whether midwifery managers link the QLP professional development programme as a pathway to midwives becoming coordinators and whether this pathway prepares midwives for the diversity and complexity of skills required to become a coordinator midwife. Anecdotally coordinators have told me theirs is a role ‘you learn on the job’. Coordinators clearly highlight their lack of time to teach colleagues and express their concerns regarding skill mixes during shifts. Midwives are required to complete comprehensive education in line with Midwifery Council of New Zealand Annual Practising Certificate requirements, however the complexity of tertiary hospital midwifery care, the lack of time and the current limited funding to specifically address education in the provision of complex tertiary midwifery care requires acknowledgement at DHB, NZCOM, Midwifery Council of New Zealand, New Zealand Nurses Organization (NZNO), Midwifery Employer Representation and Advisory Service (MER<strong>AS</strong>), and government levels. Auckland University of Technology (AUT) offers a ‘complex care’ paper in partnership with National Women’s Hospital (Complex Care Course, 2008). This is an exciting and significant step forward in recognition of the knowledge and clinical skills tertiary 182
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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
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herself desperately trying to engag
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Sally offers a story with a differe
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subsequent three ‘nightmare’ ad
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decision to augment the labour base
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environment is well described by Ca
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eginning of January so she was bran
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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 and 176: The responsibility coordinators und
Page 177 and 178: CHAPTER SEVEN Discussion Summary of
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: cohesiveness and teamwork. Alice su
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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