WORKING AS A COORDINATOR MIDWIFE IN A TERTIARY ...

Traditionally, however, within the hierarchical hospital framework, research shows
nurses and midwives are not assertive with medical staff (Timmins & McCabe, 2004).
Their research entitled ‘Nurses and midwives assertive behaviour in the workplace’
reinforced previous studies that assertiveness with medical staff and managers was
practised less frequently than with their peers. There were fears of retribution and a lack
of confidence in confrontation for both nurses and midwives in this study.
The importance of good communication between the coordinator and the registrar in the
delivery suite setting is highlighted by Isa et al., (2002) who describe the challenges for
coordinators with registrars arriving to work in the delivery suite setting for fixed periods
of time and then moving on. There is the need to build relationships with this cycle of
registrars leaving and new ones arriving. There can be a variance in skills, for example,
there may be a newly promoted senior house officer becoming a registrar for the first
time and at the beginning of their learning curve. There can be registrars who bring their
overseas cultural mores to the workplace and there can be registrars who have
comfortably practised within controlled medicalised models of obstetric care. Isa et al.,
go on to describe how it takes time and effort working with new registrars, which they
refer to as “a breaking in period” (p.22). This entails facilitating a cooperative workplace
environment based on respect for colleagues as professionals, and as people in their own
right.
There are times when the ‘knowing’ of the coordinator can positively influence outcomes
for mothers and babies, when she ‘speaks up’. What it feels like to challenge the decision
51