Midwifery students’ knowledge, understanding and experiences of workplace bullying, and violence: An integrative review

Background: Workplace bullying, and violence within the midwifery profession, has been a well-documented concern in health literature since the early 1990′s. However, contemporary research highlights that workplace bullying, and violence is often inflicted upon midwifery students. Workplace bullying, and violence has both short- and long-term effects on the student, including psychological trauma and poor mental health, loss of passion for the midwifery profession and absenteeism. To consider a solution to this phenomenon, current literature regarding midwifery students’ knowledge, understanding and experiences of workplace bullying, and violence has been reviewed. Objective: To explore and critique current literature on midwifery students’ knowledge, understanding and experiences of workplace bullying, and violence. Design: An integrative review. Review methods: Toronto & Remington's six-stage systematic framework was used to conduct the review, with rigour and validity for the research process. Results: Following critical appraisal, 12 articles met the inclusion criteria. Four themes emerged: (1) Prevalence and types of workplace bullying, and violence towards midwifery students. (2) Impact of workplace bullying, and violence on midwifery students’ experiences during the degree. (3) Impact of negative workplace culture on the midwifery profession. (4) The requirement to develop strategies for midwifery students to address workplace bullying, and violence. Conclusions: Workplace bullying, and violence is a global health concern within the midwifery profession with evidenced impact on midwifery students’ professional and personal lives. Organisational systems and approaches were identified as causes of a toxic clinical environment and workplace bullying, and violence, which impacted midwifery students’ experiences. Suggestions supported universities incorporating conflict resolution strategies into midwifery degree programs, to prepare midwifery students to manage workplace bullying, and violence. Tweetable abstract: Workplace bullying, and violence is a global health concern entrenched within the midwifery profession, impacting midwifery students’ professional and personal lives. Incorporating conflict resolution strategies into Bachelor of midwifery degree programs, may help prepare midwifery students to manage workplace bullying, and violence

Struggling to Be Involved: An Interprofessional Approach to Examine Māori Whānau Engagement With Healthcare Services

Aim: Explain the processes that whānau Māori used when engaging with healthcare services from an interprofessional approach. Methods: A qualitative design using kaupapa Māori methodology and constructivist grounded theory. The researchers were a registered social worker and registered nurse from New Zealand. We used semi-structured interviews with 20 Māori whānau (74 people aged 18-70 years) living in rural and urban areas in New Zealand about their engagement with healthcare services. The data analysis used constant comparative analysis to develop a substantive grounded theory to explain the processes Māori whānau use when engaging with healthcare services. Results: Māori whānau faced discrimination and constant struggles whilst engaging in health services to improve the health of their whānau member. Despite the many negative experiences, the collective orientation and the obligations of whānau contributed to their imperative to achieve the best healthcare for their whānau member. Struggling to be involvedexplains how Māori whānau experience and navigate healthcare services amid surviving the experience and being Māori, which together with a range of strategies that paradoxically assisted them to manage and survive their healthcare experience. Conclusion: Current healthcare interventions do not appear to work for Māori whānau in our study. Struggling to be involved contributes new knowledge about nature of Māori whānau engagement with healthcare services and signals areas where interprofessionals can assist with reducing health inequities for Māori

Doing the right thing! A model for building a successful hospital-based ethics committee in Nunavut

Background. There exists a need throughout the North to increase capacity to address issues of health ethics and for community members to better understand and share their perspectives on this topic. Ethics comes down to weighing rights and wrongs, evaluating differing needs and understandings, acknowledging the many shades of grey and doing our best to come up with the just, fair and moral approach to the question at hand. Northern regions must collaborate to share capacity, successes and experiences in order to meet the unique needs of northern health care institutions and move forward on this issue. While guidelines for ethical research with indigenous populations exist, little has been published about an Inuit approach to health ethics more broadly. Design . To fill a critical need and to meet accreditation standards, the Qikiqtani General Hospital (QGH) in Iqaluit, Nunavut, Canada, is in the process of building an Ethics Committee. Capitalizing on partnerships with other bodies both in northern and southern Canada has proved an efficient and effective way to develop local solutions to challenges that have been experienced both at QGH and other jurisdictions. Methods . The Ottawa Hospital Ethics Office and the active ethics committee at Stanton General Hospital in Yellowknife, NT, contributed expertise and experience, and helped provide some direction for the QGH ethics committee. At the local level, based on our shared commitment to health care ethics, the Qaujigiartiit Health Research Centre is an invaluable partner whose parallel efforts to develop a northern Health Research Ethics Board (REB) gives great synergy to the QGH Ethics Committee. Results . Passion and commitment, as well as administrative support and endorsement from health care leaders, are the aspects of successful initiatives that we have identified to date. Using the information from both the experiences of other partners, as well as information gathered at a retreat held in Iqaluit in September 2011, we are working to develop a model for the QGH ethics committee that incorporates multi-level perspectives, from that of community to that of front-line worker. Conclusion . Ideally, the scope of the QGH Ethics Committee will grow over time to include ethics education, facilitation of clinical ethical consults, ethical review of policy, advice on governance issues and involvement and support of an external northern Health REB

Reconnecting Māori in a Post-COVID-19 World: A Blessing in Disguise

Connectedness for Māori (Indigenous people of New Zealand) is considered a protective factor that maintains hauora (good health) and contributes to holistic wellbeing. A scoping review of the literature was conducted to examine how Māori maintained connectedness during COVID-19. Key themes identified were the digital divide, cultural isolation and revival of traditional practices. Māori methodology and qualitative design involved 10 individual interviews and two hui (gatherings) face-to-face and online with members of Ngāti Kahungunu (an East Coast tribe descended from the eponymous ancestor Kahungunu) from New Zealand to explore how they maintained connectedness during COVID-19. Braun and Clarke’s thematic analysis identified the following three themes: The digital divide, the pandemic seen as blessing in disguise and preventing marae (traditional meeting places) from becoming white elephants. The findings of this study will assist the community to develop a bigger project and implement protective factors to remain connected beyond physical space and place

Generating and sustaining positive spaces: reflections on an Indigenous youth urban arts program

Life in the city for any youth can be challenging without a proper support network. For Indigenous youth in particular, the unique burden of intergenerational trauma due to the residual effects of colonialism (e.g. residential schools and historical outlawing of traditional practices) can contribute to both unhealthy behaviors and a continuation of “culturally unsafe” spaces. As a response to these challenges, this article examines the positive effects that a grassroots film creation and production program in a major urban centre in Saskatchewan, Canada, had on participating Indigenous youth. Community-based researchers from the Indigenous Peoples’ Health Research Centre observed how a culturally safe space created the conditions to enable youth to become creative through the arts in an environment supported by an intergenerational network of Nêhiyaw (Plains Cree) kinship relationships called wâhkôtowin. The article also argues that the effectiveness of culturally safe spaces can benefit from recognizing the operation of ethnogenetic processes in contemporary environments