WORKING AS A COORDINATOR MIDWIFE IN A TERTIARY ...

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TABLE OF CONTENTS Table of Contents…………………………………………………………………………i Attestation of Authorship ....................................................................................... vi Acknowledgments ........................................................................................................... vii Abstract ........................................................................................................................... viii CHAPTER ONE Orientation to the study .....................................................................1 Introduction .................................................................................................................1 Who is this study about? .....................................................................................1 Setting the Scene .........................................................................................................2 The New Zealand midwifery system ..................................................................2 Continuity of midwifery care ..............................................................................6 The primary / secondary interface and ‘transfer of care’ ....................................7 Birth planning .....................................................................................................9 The tertiary delivery suite setting ......................................................................10 The responsibilities of the coordinators role .....................................................11 This Research……………………………………………………………………....13 Methodology ..............................................................................................................14 Why phenomenology? ......................................................................................14 Phenomenology and seeing into ‘the heart’ of the coordinator’s life world .....16 The impetus for this study; my personal journey ......................................................16 My Pre-understandings Interview .............................................................................20 Standing back and looking in ............................................................................20 Feeling safe .......................................................................................................22 i
My perspectives of partnership in the tertiary setting .......................................25 My pre-assumptions of stress in the delivery suite workplace .........................26 Summary ....................................................................................................................28 Overview of the Thesis ..............................................................................................29 CHAPTER TWO Literature Review ............................................................................31 Introduction ...............................................................................................................31 The Realities of the Tertiary Delivery Suite Setting .................................................32 New Zealand perspectives of secondary and tertiary hospital midwifery dynamics from the outside ‘looking in’ ......................................................34 New Zealand perspectives of secondary and tertiary hospital midwifery dynamics from the inside ‘looking out’ ......................................................35 The ‘Emotion Work’ and the ‘Shadow Work’ of Midwifery ....................................42 “Is it reasonable to aim for happy healthy midwives?” ....................................44 Risk Management and Resilience .............................................................................47 Communication and Decision Making ......................................................................50 The New Zealand Midwifery Workforce and ‘Feeling Safe’....................................52 The Heart of Midwifery Leadership ..........................................................................56 Summary ....................................................................................................................60 CHAPTER THREE Research Methodology ................................................................62 Introduction ...............................................................................................................62 Heidegger’s Phenomenology .....................................................................................63 Phenomenology .................................................................................................63 What is a phenomenon? ....................................................................................64 Being and Dasein ..............................................................................................64 Time and Temporality .......................................................................................65 Facticity .............................................................................................................65 ii
Page 1: WORKING AS A COORDINATOR MIDWIFE IN
Page 5 and 6: Summary ...........................
Page 7 and 8: Attestation of Authorship I hereby
Page 9 and 10: Abstract This phenomenological stud
Page 11 and 12: is deemed by the midwife manager wh
Page 13 and 14: pregnancy and childbirth experience
Page 15 and 16: The Department of Labour (2006) rep
Page 17 and 18: secondary midwifery care” (p.11).
Page 19 and 20: DHB coordinators is how they embrac
Page 21 and 22: No national or international resear
Page 23 and 24: Methodology Why phenomenology? The
Page 25 and 26: change” (p.157). To this end, I a
Page 27 and 28: holding my daughter at birth to bre
Page 29 and 30: My Pre-understandings Interview Eve
Page 31 and 32: come to work, how do they manage on
Page 33 and 34: midwife, whilst ensuring safe pract
Page 35 and 36: ‘unknowing’ resulted in tension
Page 37 and 38: Summary My pre-understandings revea
Page 39 and 40: entitled; The Luxury of Time, ‘Th
Page 41 and 42: The Realities of the Tertiary Deliv
Page 43 and 44: New Zealand perspectives of seconda
Page 45 and 46: hospital. Their objective was to ra
Page 47 and 48: provide an increased opportunity fo
Page 49 and 50: whereas now when she responds to ca
Page 51 and 52: The ‘Emotion Work’ and the ‘S
Page 53 and 54:
unrecognized and may be conducive t
Page 55 and 56:
demands, job resources and their di
Page 57 and 58:
midwife, representing “working th
Page 59 and 60:
the sense of value nurses attribute
Page 61 and 62:
of a consultant is described by Isa
Page 63 and 64:
in a sustained way and are not inte
Page 65 and 66:
following accepted procedures” (p
Page 67 and 68:
same. This reveals the variance in
Page 69 and 70:
subconscious, becomes the basis for
Page 71 and 72:
CHAPTER THREE Research Methodology
Page 73 and 74:
What is a phenomenon? Heidegger (19
Page 75 and 76:
new meaning and truth. An added dim
Page 77 and 78:
space, things, the body and others
Page 79 and 80:
Participant Recruitment My workplac
Page 81 and 82:
Anonymity and Confidentiality For m
Page 83 and 84:
Interview venue Participants chose
Page 85 and 86:
Two coordinators knew what they wan
Page 87 and 88:
I made tentative notes about themes
Page 89 and 90:
Literature research I delved into a
Page 91 and 92:
Geanellos (1998) offers alternative
Page 93 and 94:
Summary In this chapter, I have ide
Page 95 and 96:
Irene explains: Being the coordinat
Page 97 and 98:
I work, the difficulty is the staff
Page 99 and 100:
weather storms better than others j
Page 101 and 102:
for her as coordinator. This story
Page 103 and 104:
An anonymous quote is cited by Mall
Page 105 and 106:
which reflects on the colleagues sh
Page 107 and 108:
Alice explains what it feels like f
Page 109 and 110:
Alice reveals she has to subconscio
Page 111 and 112:
Irene reveals there are different r
Page 113 and 114:
egarding this overspill or emotiona
Page 115 and 116:
professional supervision” (p.13).
Page 117 and 118:
Summary This chapter reveals how co
Page 119 and 120:
CHAPTER FIVE Time as lived The cloc
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eveals her interpretation of what i
Page 123 and 124:
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 and 176:
The responsibility coordinators und
Page 177 and 178:
CHAPTER SEVEN Discussion Summary of
Page 179 and 180:
‘Needing to know’ Coordinators
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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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