‘Competent, but not allowed to blossom’: Midwifery-trained registered nurses’ perceptions of their service: A qualitative study in Sri Lanka

Objective: To explore midwifery-trained registered nurses’ perceptions of their own profession as maternity care providers and how they identify their role, tasks, and responsibilities within a multi-professional team. Design: An exploratory qualitative study using focus group discussions and qualitative content analysis. Setting: Three selected tertiary care hospitals in the Capital Province in Sri Lanka. Participants: Twenty-two midwifery-trained RNs working in intra-partum and postpartum units. Findings: The overriding theme of the analysis was identified as ‘competent but not allowed to blossom fully in their practice’, based on two main categories: ‘provision of competent care’ and ‘working with disappointments’. Each main category had four subcategories: ‘acting with compassion’, ‘cooperation in emergencies’, ‘exceeding one’s boundaries’, ‘taking full responsibility’ and ‘deprived of utilizing special knowledge and skills’, ‘role confusion with other professional groups’, ‘lack of professional identity’, and ‘not being appreciated by others’, respectively. Conclusion: Midwifery-trained RNs conveyed a deep sense of disappointment regarding their profession as maternity care providers in Sri Lanka. Midwifery-trained RNs’ perceptions of their high proficiency are incongruent with their low sense of identity and belongingness within the multi-professional hospital-based maternity care team. This phenomenon warrants further study, considering its implications for team work and patient safety

Midwifery trained registered nurses’ perceptions of their role in the labor unit

Introduction: A Midwifery Trained Registered Nurse (MTRN) is a member of the multiprofessional maternity health care team in Sri Lanka. Her contribution to the maternity care team is poorly understood, often undermined, and undefined. In the context of low- and middle-income settings where traditional midwives play a crucial role in domiciliary care, the MTRNs role as a member of the multi-professional hospital-based maternity care team has not been well-described. Objective: The study aimed to describe MTRNs’ perceptions of their role in the Labor Unit within the multi-professional maternity health care team at five tertiary care hospitals in the Capitol Province of Sri Lanka. Materials and Methods: A descriptive cross-sectional study was conducted among 186 MTRNs working in labor rooms in the study setting. All MTRNs in the selected hospitals were invited and included in the sample. A postal survey was carried out using a pre-evaluated, pretested self-administered questionnaire, and descriptive statistics were derived. Results: All respondents were females, aged 27 to 60 years (Mean±SD: 40±8.3 years). The majority (66%) was less than 45 years old. Almost all (&gt;96%) MTRNs perceived 12 tasks of the listed tasks as their primary responsibility. Regarding other tasks, they perceived a high degree of overlap between their role and those of the doctors and midwives. Although almost all MTRNs rated the level of interprofessional collaboration from Registered Nurses (RNs) and doctors as average to good, nearly half (49%) of them rated support from midwives ranging from very poor to average. Conclusion: A high degree of perceived overlap between MTRNs’ tasks with those of the other members of the maternity care team can cause role confusion, conflicts, and poor patient care. MTRNs’ role in the Labor Unit within the multi-professional maternity health care team was controversial. Clarifying the MTRNs scope of practice will help improve interprofessional understanding of roles and responsibilities and collaboration.Financial support was provided by the World Class University Project of the University of Sri Jayewardenepura (Grant No-Ph.D./13/2012).</p