WORKING AS A COORDINATOR MIDWIFE IN A TERTIARY ...

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Conclusion Heidegger (1927/1962) and van Manen (1990) have been my constant companions and guides along this journey. This study reveals that the everyday appearance of the coordinator midwives, as they go about their daily work, is not necessarily what really ‘is’. How these women may appear to others and what is really at the core of their being may be very different. These amazing women are each enmeshed within their unique lifeworlds with a commonality that ‘being’ a midwife is the ‘essence’ of who they are. Van Manen (1990) explains it is our sense of purpose in life which sustains us. Being a midwife is the springboard from which these women leap. Coordinator midwives choose to work in the tertiary setting where many ‘grey areas’ have been identified yet their passion abides to maintain a strong, safe midwifery focus for the mothers and babies who are central to their care. The focus of this study is their experiences as coordinator midwives in the tertiary delivery suite setting, however, it must be remembered these women also have a life apart which makes up their ‘sum total’ and contributes to who they are, how they respond to situations and perhaps, why they are so resilient. Their relationality shines through in this study. They reveal their ability to work alongside people, to work ahead of time and to project themselves into worlds of unknown possibilities over which they may have little or no control, yet they return to 189
work shift after shift and reveal no indication of wanting to walk away from a job which poses immeasurable challenges. New Zealand is a small country with its total population equating to less than one major city in other parts of the world. The midwifery workforce of New Zealand is small enough to work together to ‘get it right’ for tertiary hospital coordinator midwives. Midwifery research opportunities need to be encouraged, to find out how we can do things better before more midwives leave this profession. Change can only happen with courageous leadership supported by a united midwifery workforce. The 2008 Health Workforce Annual Survey (Ministry of Health, 2008) shows 31% of midwives are currently over the age of fifty years. What will happen when these senior experienced tertiary hospital midwives retire from their profession within the current climate of midwifery staffing shortages in tertiary hospitals and high stress levels? Midwives called on to replace them may be ill prepared, due to the current lack of time for senior colleagues to pass on their expertise. This study took place within the New Zealand context of a rising birth rate and tertiary hospital delivery suite units which are increasingly busy providing care for women who require complex care. Who will want to take on the role of a coordinator midwife in a tertiary hospital in years to come unless this situation is addressed? 190
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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’
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minute, then got up and said to the
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life” (p.192). The coordinators h
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“Techne” and “phronesis” ar
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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 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: This research offers no insight int
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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