How do new midwives’ early workforce experiences influence their career plans? An integrative review of the literature

Aim To explore how the early workforce experiences of new midwives influence their career plans. Background Each year, thousands of new midwives graduate from entry-to-practice midwifery courses, gain professional registration, and enter the workforce. Despite this, the world continues to face a shortage of midwives. The first five years of clinical practice, commonly referred to as the early career period, can be highly stressful for new midwives, contributing to early attrition from the profession. Supporting the transition from midwifery student to registered midwife is vital if we are to grow the workforce. Whilst the early career experiences of new midwives have been more broadly explored; little is currently understood about how these can influence their career plans. Methods Following Whittemore and Knafl’s (2005) five-stage process, an integrative review was conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Nineteen studies met the criteria for inclusion. Thematic analysis was undertaken to organise and present the findings. Findings Thematic analysis, guided by the review question led to the identification of three overarching themes: ‘the need for support’, ‘sustaining health and wellbeing’, and ‘being able to provide safe and effective midwifery care’. Conclusion Very little research to date has specifically explored how the early career experiences of new midwives influence their career plans, particularly within the Australian context. Further research is required to better understand how the early workforce experiences of new midwives can either strengthen their commitment to the profession or contribute to the decision to leave midwifery prematurely. This knowledge would provide a basis for the development of appropriate strategies to minimise early attrition from the midwifery profession and promote career longevity

Workplace violence in the Australian and New Zealand midwifery workforce : A scoping review

Aim The aim of the study is to identify and map what is known about workplace violence involving midwives in Australia and New Zealand. Background Research from the United Kingdom demonstrates that workplace violence within maternity services is a pervasive issue with significant and wide-ranging clinical, individual and organisational consequences. To date, little is known about this issue within Australian and New Zealand maternity services. Evaluation A scoping review, guided by Arksey and O′Malley's framework, was conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Just one identified study aimed to explore midwives' experiences of workplace violence. A further nine arrived at related results or themes. Key issues Workplace violence is present in a variety of forms across maternity services in Australia and New Zealand. Its prevalence is, however, yet to be understood. Workplace violence causes physical and mental health issues for midwives, premature workforce attrition, and jeopardizes the quality and safety of maternity care. Conclusions Workplace violence has been acknowledged as one of the key contributing factors towards premature attrition from the midwifery profession, with new graduate midwives most likely to leave. With the midwifery workforce ageing and evidence of serious clinical implications emerging, workplace violence needs urgent research and organisational attention. Implications for nursing management Workplace violence is a key contributing factor towards recruitment and retention challenges for managers. To help tackle this, managers have a key role to play in identifying and effectively addressing workplace violence by acting as positive role models, taking a zero-tolerance approach and fostering collegial relationships. Managers, holding key clinical leadership positions, are pivotal to ensuring all complaints raised are handled with transparency and consistency regardless of one's position within the clinical hierarchy and organisational structure

Social media influencers' impact during pregnancy and parenting : A qualitative descriptive study

Pregnant people and parents engage with social media networking sites seeking support and information that is shared in a relatable way. Engaging with social media influencers (SMIs) and their followers, however, may have both affirming and harmful effects. SMIs can facilitate information-sharing, discussion, and supportive behaviors, but engaging with SMIs can lead to negative experiences and exposure to misinformation. To date, little is known about the impacts of following influencers during pregnancy and early parenthood. The aim of this study was to explore how engaging with SMIs impacts pregnant people and parents of children aged 5 or under in Australia. A qualitative descriptive approach was taken. Qualitative data from 85 anonymously completed online written surveys were thematically analyzed using Braun & Clarke's six-step process. Five overarching themes and two subthemes were identified. The first theme, “Comparisons of self,” held two subthemes: “Unfavorable comparisons of self to SMIs” and “Favorable comparisons of self to SMIs.” Additional themes were “A virtual community of inspiration and togetherness,” “Sharing of information, opinions & experiences,” “Gatekeeping self-efficacy,” and “Credibility.” The findings of the study indicated that discordance between influencer-mediated expectations of parenthood and a person's actual experience may affect well-being and perceptions of parental self-efficacy. Information sought from influencers may substitute for face-to-face education by clinicians. Health professionals who are also influencers may possess the ability to provide evidence-based information. This content, however, is not without risk for bias or incompleteness

The impact of social media influencers on pregnancy, birth, and early parenting experiences : A systematic review

Background Pregnant and new parents are increasingly engaging with social media. The impacts of engaging with social media ‘influencers’ and ‘bloggers’ during a time of heightened vulnerability to influence, in particular, merits exploration. Aim To systematically review the literature to identify what is known about how following social media ‘influencers’ and ‘bloggers’ impacts pregnant and new parents’ experiences and decision-making. Methods A search of CINAHL, World of Science, Medline, EMBASE and Google Scholar databases was undertaken in January 2023 to identify the literature focusing on the impacts of engaging with influencers or bloggers as pregnant or new parents. The reference lists of the included papers were hand-searched. Data were extracted from each paper, tabulated, and thematically analysed. The review was reported using the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Findings Seventeen papers met the inclusion criteria and were included in the final synthesis. Thematic analysis revealed four overarching themes, which were ‘sharing information’, ‘support’, ‘identity’, and ‘monetisation’. Discussion Social media influencers provide a network of peers amongst whom discussions, supportive behaviours, and information sharing take place. However, concern arises around the potential for combative interactions, the risk for transmission of misinformation, and the potential impacts of following influencers who are also qualified health professionals. Conclusion Existing research suggests that engaging with social media influencers can be both beneficial and harmful for pregnant and new parents. At the current time, it is unclear how exposure to the benefits or harm impacts personal experiences and decision-making

Midwifery care of HIV positive mothers in Australia

Capper, TS ORCiD: 0000-0003-3464-1423What is HIV? Human Immunodeficiency Virus (HIV) is a communicable virus that is spread through some body fluids. Untreated HIV infection can severely compromise the immune system by attacking and destroying CD4 cells, leaving it vulnerable to infection and disease, later resulting in Acquired Immunodeficiency Syndrome (AIDS). There are two types of HIV infection, HIV-1, and HIV-2. HIV-1 accounts for 95% of all HIV infections and is the type most commonly seen in Australia (Avert, 2019)

The implementation of a feedback tool for mothers that have participated in the Continuity of Care journey with midwifery students at Central Queensland University

Capper, TS ORCiD: 0000-0003-3464-1423Abstract: Central Queensland University (CQU) offer a Bachelor of Midwifery (Graduate Entry) course to Registered Nurses that wish to become Registered Midwives. The program is offered full time over 18 months and spans four terms. Students are required to complete a theoretical component which is delivered online, attend three face to face residential schools, complete 896 hours of clinical practice, and in addition to this, recruit and follow ten women through pregnancy, birth and the postnatal period. Students must spend at least ten hours with each woman which equates to a further minimum of 100 clinical hours spent with Continuity of Care (CoC) women

Midwifery students go to prison

Capper, TS ORCiD: 0000-0003-3464-1423Descriptive paper that summarised a project that links midwifery students with incarcerated pregnant women

Australian midwifery student's perceptions of the benefits and challenges associated with completing a portfolio of evidence for initial registration: Paper based and ePortfolios

Capper, TS ORCiD: 0000-0003-3464-1423© 2019 Portfolios are used in midwifery education to provide students with a central place to store their accumulative evidence of clinical experience for initial registration in Australia. Portfolio formats can be paper-based or electronic. Anecdotal discussion between midwifery students in Queensland debated the best format to document the requirements for the Australian Nursing and Midwifery Accreditation Council (ANMAC) standard 8.11. Midwifery students using paper-based portfolios envisioned that an ePortfolio would be streamline, simple, safe to use, and able to be used anywhere with WIFI, while some students using an ePortfolio expressed a desire to have a paper-based portfolio as a hard copy. This situation called for evidence of a comparison to resolve the debate. The aim of this study was to investigate midwifery students’ experiences of the benefits and challenges between paper-based and ePortfolios when compiling evidence to meet the requirements for initial registration as a midwife in Australia (ANMAC, 2014)

How is cultural safety understood and translated into midwifery practice? A scoping review and thematic analysis

Aim To identify and understand the scope of the literature published since January 2008 that explored Australian midwives understanding of cultural safety and how this is translated into their practice when caring for First Nations women and families. Background Recognition and understanding of First Nations peoples history and culture and the impact this has on the health and wellbeing of women and their families is essential if the midwife is to promote culturally safe and respectful maternity care. The role and responsibilities of the midwife in ensuring that their practice is culturally safe are now reflected in the Australian professional midwifery codes and standards. Whilst midwifery academics’ awareness of cultural safety and how it is taught within midwifery education programs have previously been explored, at present, little is known about midwives’ understanding of cultural safety, and how this translates into their clinical practice. Methods A Scoping Review was undertaken following Arksey and O’Malley’s five step process. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses – Scoping Review extension checklist. Twelve studies met the criteria for inclusion. Thematic analysis was used to analyse the data and organise the results. Results Thematic analysis, guided by two predetermined review questions led to the identification of six overarching themes: ‘Awareness of deficiencies’, ‘The importance of meeting women’s diverse needs’, ‘Understanding relationships as a foundation for culturally safe care’, ‘Working in partnership with others’, ‘Providing individualised care’ and ‘Fostering effective relationships and communication’. One sub-theme of the first theme was identified, this was named ‘Seeking an understanding of culture’. Conclusion Australian midwives’ level of understanding of cultural safety and how it is translated into their midwifery practice when caring for First Nations women and their families differ widely. Midwives across Australia require increased and equitable access to appropriate opportunities to improve their knowledge and understanding of cultural safety. Whilst theoretical learning on cultural safety has a place in all midwives annual mandatory training requirements, this should ideally be supplemented, where possible, with opportunities for immersive practice in communities. Immersion was considered the optimal way to gain rich knowledge and understanding to strengthen culturally safe midwifery practice. Continuity models of midwifery care which incorporate the principles of cultural safety should be consistently implemented across Australia. These models enable midwives, women, families, communities, and Aboriginal Support Workers to work in collaboration towards achieving optimal outcomes for mothers and babies

Midwifery student's perceptions of completing a portfolio of evidence for initial registration: A qualitative exploratory study

Capper, TS ORCiD: 0000-0003-3464-1423© 2020 The Australian Nursing and Midwifery Accreditation Council (ANMAC) has set regulatory standards, that require midwifery students to verify how they have met ANMAC standard 8.11 requirements prior to registration as a midwife. The most common formats for recording achievement of the ANMAC requirements are paper-based or electronic portfolios. Research was conducted to compare student's experiences of completing their university portfolio format. Focus group interviews were held at two south east Queensland universities. This study has found that there is disparity between universities in the level of detail documenting evidence of midwifery experiences. The paper-based portfolio was criticised for not having sufficient space for the students to explain the extent of their experiences, in contrast students completing the ePortfolio felt their reflective entries were excessive. Some students felt the portfolio was not being used to its full potential with suggestions that all experiences that fall within the midwife scope of practice should be recorded as evidence of practice experiences. Students felt the current ANMAC Standard 8.11 requirements limit the range of experiences and are repetitive in requiring up to 100 recordings for some experiences. No nationally agreed format exists of how students are required to document their required ANMAC experiences