WORKING AS A COORDINATOR MIDWIFE IN A TERTIARY ...

provide an increased opportunity for students to gain midwifery practice, thereby
consolidating competence and improving levels of confidence in new graduates” .(p.1)
Anecdotally, senior DHB midwives remark that due to acute midwifery staffing
shortages, graduate midwives do not receive the support they require in the hospital
setting. Fraser (2006) affirms this by linking the culture of a working environment where
midwives are working under high stress levels with the creation of barriers to learning in
their workplace. This in turn impacts on the coordinator’s ability to safely allocate work
to midwives during a shift.
There are also the additional unexpected challenges of caring for women who present
with no prior antenatal care, prioritizing and adjusting workloads according to demands
on the unit at that point in time, working with the unknown of family dynamics,
encountering hostility, family violence and managing obstetric emergencies. Within this
working environment, Isa et al., (2002) observe “we are very aware that secondary care
does not exist in its own right and any reference of secondary care is in relation to
specialists or secondary maternity services” (p.11). Three years after this paper was
written, the situation had not improved with Skinner (2005) reporting that midwives in
her study refer to “the ‘grey area’ between primary and secondary care” (p.178).
Anecdotally, in 2009 this ‘grey area’ remains a challenge for DHB and LMC midwives.
Stories of DHB midwives experiences in the tertiary setting by Isa et al., (2002) offer
insights which question the legal, ethical and professional responsibilities of the DHB
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