The early workforce experiences of midwives who graduated from two different education courses in Australia

Sheehy, Annabel Dorothy

The early workforce experiences of midwives who graduated from two different education courses in Australia

Sheehy, Annabel Dorothy

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Publication Type:: Thesis
Issue Date:: 2016

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Field	Value	Language
dc.contributor.author	Sheehy, Annabel Dorothy
dc.date.accessioned	2016-09-21T01:00:59Z
dc.date.available	2016-09-21T01:00:59Z
dc.date.issued	2016
dc.identifier.uri	http://hdl.handle.net/10453/52938
dc.description	University of Technology Sydney. Faculty of Health.	en_AU
dc.description.abstract	[Background] There are workforce shortages in the nursing and midwifery professions in Australia. Many factors have been associated with these shortages such as high workloads, an inadequate skill mix, low nurse/midwife-to-patient/woman ratios, and heightened acuity, all of which can lead to professional burnout for staff. Connected to these shortages are perceptions of inadequate remuneration, experiences of bullying and work-related stresses, the lack of managerial action to tackle these issues and a perceived lack of opportunities for career diversity and progression. Much of this is well known in the nursing discipline, however it is unclear how these factors are similarly impacting midwifery and therefore, research into the workforce experiences of Australian midwives is timely. [Objective / Purpose] To explore early workforce participation trends, experiences and choices of midwives who graduated from one Australian university (graduating years 2007 and 2008). Participants were educated either in Bachelor of Midwifery or Graduate Diploma of Midwifery programs (n = 113). Further objectives of the study were to identify work environment and personal factors that may influence workforce experiences, and to compare any workforce trends by midwifery course. [Methods] A sequential explanatory mixed methods design was conducted. Phase 1 survey collected mainly quantitative demographic and workforce participation data. Three validated instruments were also used: Maslach Burnout Inventory (MBI); Practice Environment Scale of the Nursing Work Index (PES-NWI); and Perceptions of Empowerment in Midwifery scale (PEMS). Due to sample size restrictions, analysis was restricted to non-parametric measures including frequency distribution and simple correlations (p ≤ 0.01). Phase 2 was a qualitative study using semi-structured interviews with qualitative content and contextual analysis. [Results] In Phase 1, the survey response rate was 66 percent (n = 75). Fifty-nine were working as midwives, half of them in full-time employment. Personal factors contributing to workforce choices were only a cause of concern for a small number of midwives. The main reason for having exited from the profession was child rearing. There was a low degree of burnout and high levels of empowerment. Inadequate clinical resources and ineffective managerial support in the workplace were also identified. Bachelor of Midwifery participants were older than the Graduate Diploma midwives but no other relationship between the midwifery course and any of workforce measure existed. In Phase 2, 28 participants were interviewed. Three themes, each comprising of subthemes, were generated: (i) ‘sinking and swimming’; (ii) ‘needing a helping hand’; and (iii) ‘being a midwife… but’. The initial transition into midwifery was overwhelming for most participants, particularly when providing intrapartum care. Coping within the experience was dependent upon support. Job satisfaction was strongly related to the midwife-woman relationship and working to the full scope of practice ability, both which encouraged midwives to remain in midwifery. Dissatisfaction stemmed from poor remuneration, inflexibility of rostering, high workloads and poor managerial approaches. Experiences of bullying were ubiquitous. Factors inducing midwives to stay in the midwifery profession were not the absence of those that caused dissatisfaction. The midwife-woman relationship sustained their practice despite those factors that generated job dissatisfaction. [Conclusion] Elements of the early workforce experiences of these midwives paralleled many of those evident in the Australian nursing profession and similar workforce factors contributing to job satisfaction and dissatisfaction were identified. The midwife-woman relationship was a source of job satisfaction and inspired these midwives to remain in midwifery. Exiting the profession- temporarily or permanently- was mainly due to child rearing. [Implications for practice] Any vacuum created by eliminating factors of job dissatisfaction will require an amplified investment of factors that bring job satisfaction in order to have genuine content in midwives. Strategies that deliver transitional support, rostering flexibility, leadership training and address workplace bullying, will be ameliorative in the face of staffing shortages. Employment models that enhance relational aspects of midwifery are integral for job satisfaction in midwives. Health systems and services have a duty to support the continued professional development and accessibility of career progression for midwives, to allow individuals to cultivate their midwifery skills and work to their potential.	en_AU
dc.format	Thesis (PhD)
dc.language.iso	en_AU	en_AU
dc.relation	https://opus.lib.uts.edu.au/bitstream/10453/52938/6/02whole.pdf
dc.rights	info:eu-repo/semantics/openAccess
dc.rights	The author owns the copyright in this thesis including all reproduction and reuse rights for the work. The work may not be altered without the permission of the copyright owner. Attribution is essential when quoting or paraphrasing from this thesis.
dc.rights	au.edu.uts.lib/ppc
dc.subject	Nursing and midwifery in Australia.	en
dc.subject	Workforce shortages.	en
dc.subject	High workloads.	en
dc.subject	Inadequate skill mix.	en
dc.subject	Low midwife-to-woman ratios.	en
dc.subject	Poor remuneration.	en
dc.subject	Inflexibility of rostering.	en
dc.subject	Poor managerial approaches.	en
dc.subject	Bullying.	en
dc.subject	Maslach Burnout Inventory (MBI).	en
dc.subject	Practice Environment Scale of the Nursing Work Index (PES-NWI).	en
dc.subject	Perceptions of Empowerment in Midwifery scale (PEMS).	en
dc.subject	Job satisfaction.	en
dc.subject	Professional development.	en
dc.title	The early workforce experiences of midwives who graduated from two different education courses in Australia	en_AU
dc.type	Thesis	en_AU
utslib.copyright.status	open_access

Abstract:

[Background] There are workforce shortages in the nursing and midwifery professions in Australia. Many factors have been associated with these shortages such as high workloads, an inadequate skill mix, low nurse/midwife-to-patient/woman ratios, and heightened acuity, all of which can lead to professional burnout for staff. Connected to these shortages are perceptions of inadequate remuneration, experiences of bullying and work-related stresses, the lack of managerial action to tackle these issues and a perceived lack of opportunities for career diversity and progression. Much of this is well known in the nursing discipline, however it is unclear how these factors are similarly impacting midwifery and therefore, research into the workforce experiences of Australian midwives is timely. [Objective / Purpose] To explore early workforce participation trends, experiences and choices of midwives who graduated from one Australian university (graduating years 2007 and 2008). Participants were educated either in Bachelor of Midwifery or Graduate Diploma of Midwifery programs (n = 113). Further objectives of the study were to identify work environment and personal factors that may influence workforce experiences, and to compare any workforce trends by midwifery course. [Methods] A sequential explanatory mixed methods design was conducted. Phase 1 survey collected mainly quantitative demographic and workforce participation data. Three validated instruments were also used: Maslach Burnout Inventory (MBI); Practice Environment Scale of the Nursing Work Index (PES-NWI); and Perceptions of Empowerment in Midwifery scale (PEMS). Due to sample size restrictions, analysis was restricted to non-parametric measures including frequency distribution and simple correlations (p ≤ 0.01). Phase 2 was a qualitative study using semi-structured interviews with qualitative content and contextual analysis. [Results] In Phase 1, the survey response rate was 66 percent (n = 75). Fifty-nine were working as midwives, half of them in full-time employment. Personal factors contributing to workforce choices were only a cause of concern for a small number of midwives. The main reason for having exited from the profession was child rearing. There was a low degree of burnout and high levels of empowerment. Inadequate clinical resources and ineffective managerial support in the workplace were also identified. Bachelor of Midwifery participants were older than the Graduate Diploma midwives but no other relationship between the midwifery course and any of workforce measure existed. In Phase 2, 28 participants were interviewed. Three themes, each comprising of subthemes, were generated: (i) ‘sinking and swimming’; (ii) ‘needing a helping hand’; and (iii) ‘being a midwife… but’. The initial transition into midwifery was overwhelming for most participants, particularly when providing intrapartum care. Coping within the experience was dependent upon support. Job satisfaction was strongly related to the midwife-woman relationship and working to the full scope of practice ability, both which encouraged midwives to remain in midwifery. Dissatisfaction stemmed from poor remuneration, inflexibility of rostering, high workloads and poor managerial approaches. Experiences of bullying were ubiquitous. Factors inducing midwives to stay in the midwifery profession were not the absence of those that caused dissatisfaction. The midwife-woman relationship sustained their practice despite those factors that generated job dissatisfaction. [Conclusion] Elements of the early workforce experiences of these midwives paralleled many of those evident in the Australian nursing profession and similar workforce factors contributing to job satisfaction and dissatisfaction were identified. The midwife-woman relationship was a source of job satisfaction and inspired these midwives to remain in midwifery. Exiting the profession- temporarily or permanently- was mainly due to child rearing. [Implications for practice] Any vacuum created by eliminating factors of job dissatisfaction will require an amplified investment of factors that bring job satisfaction in order to have genuine content in midwives. Strategies that deliver transitional support, rostering flexibility, leadership training and address workplace bullying, will be ameliorative in the face of staffing shortages. Employment models that enhance relational aspects of midwifery are integral for job satisfaction in midwives. Health systems and services have a duty to support the continued professional development and accessibility of career progression for midwives, to allow individuals to cultivate their midwifery skills and work to their potential.

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http://hdl.handle.net/10453/52938