Thursday, March 27, 2008

Off to Rural GPs conference

I am off to Christchurch for a few days to attend the New Zealand Rural General Practice Network conference. I am presenting a paper on e-mentoring.

This is the conference that Carolyn and I submitted several papers to on social networking for professional development and they were all rejected. As a second thought, I was eventually invited along to do my thing on e-mentoring.

This network mainly consists of GPs and I know that they were not too keen on hearing from midwives. I think that is because of the historical and on-going power struggle between the two professions. I think this is a real shame because if ever there was a case for collaboration, then it is here in the rural context of New Zealand.

So, I'm off to the lion's den. Will let you know how I get on. If the worst comes to the worst, I can always go shopping instead!


Carolyn said...

I heartily agree that we should be able to share and collaborate with our rural GP and rural nurse colleagues. What a shame that it is so hard. When midwives and GPs do have good working relationships it is so much better for all concerned including the communities they serve. What is needed is mutual professional respect. Anyway good luck and lets hope it is a bit of bridge building.

Anonymous said...

Well done Sarah for putting yourself out there at this forum. There are midwives out there working really well with rural GP's as they don't have any one else to support them. Inter-disciplinary skills based education is one way forward I think. I did some of this last year with a neat group of rural nurses down on the west coast and the one GP who works there and it was fab. We all learnt from each other and I for one who knew very little about the rural nurse role was blown away by what they do which includes providing well child services and postnatal care as there are is a shortage of midwives in this region.
We do need to work together for the benefit of women and babies.

Sarah Stewart said...

I absolutely agree with this Catherine, and do wonder what we, the midwifery profession, can do to facilitate more of this inter-professional collaboration. What do you think we can do at a national professional level to try to break down some of these historical barriers?

Anonymous said...

whatever it is - we need to be mindful of our lived history as a profession of midwives in this country - and remain protective of our scope of practice and our autonomy - so that women retain their control over maternity services. That is the mandate we have been trusted with. We also need to maintain continuity of care as much as possible.

Sarah Stewart said...

Yes, I completely agree with that Rae, and am very mindful that we do not lose all that we have fought for over the years.

But sometimes I do wonder if we have thrown the baby our with the bath water in New Zealand. And, I wonder if now that we are maturing as a profession with our own legislation and funding contract if we could start to look at how we could collaborate with other health professions, especially with research and postgraduate education. In the rural context, this becomes even more urgent because of the issues of retention and recruitment.

One of the things we may have to look at is how we collaborate and share resources as we keep more of our students studying in the community especially in rural communities, rather than bringing them to the campus in the city. If we are doing it, the same as medicine and nursing, then it may make sense to share resources such as computers, teaching space clinical labs etc. What are your thoughts on that?

Anonymous said...

I see collaboration as more than just sharing spaces and tools - it is about respecting difference and having a genuine willingness to share power and not infringe on the emergence or objectives of any one profession - traditionally medicine has struggled (and continues to I believe) with this. What are your suggestions for managing that so that any collaboration does not deteriorate into the oppression of one profession by another to the detriment of choice for the public?

Sarah Stewart said...

I'm probably being incredibly naive and living in cloud cookoo land, but I think that networking with key people is one way we can go about this. I know that NZCOM has been struggling with this for years but I guess that we have to keep on trucking and not be defensive about who and what we are as midwives.

Anonymous said...

Collaboration at a national level is best left to our individual professional organisations and the NZCOM holds regular meetings with the colleges of O&G and Gp's. We can all improve the services we offer and resolve any local issuses by role modeling positive proactive, mutually beneficial respectful relationships with local Gp's. I do wonder if these 'problems' we are talking about are really still happening or is this ongoing retoric from the post 1990's? In the very rural area up here at the top of south island the midwives and Gp's communicate well with each other. This is vital as the Gp will arrive as part of the team to assist in an emergency as often the ambulance attending is staffed by St John's volunteers not a para medic as in an urban area. For example with a case of shoulder dystocia at home or in a primary unit it's the midwife who directs each person who arrives or is there to assist and gives them a job. There is no time for personal ego's when dealing with an emergency.
Its up to each of us to make a difference and this does not mean giving up our autonomy or the partnership midwifery continuity of care model. By doing this we are actually working within the boundaries of our scope of practice which clearly requires us to collaborate with other health professionls. In some instances we actually do need to all work together as a team and consider who the team members are and their roles when we need them.
As for postgraduate education and reseach personaly I feel this should be done seperately unless its skills based inter-disciplary education until we are at that place where we as midwives are not viewed by others in a subordinante role to Dr's. But it is up to each of us to enable this to happen and not play out the "nurse subordinate person" role. If you look at research as an example often the "research" midwife undertakes the bulk of the actual research in the form of data collection and analysis with minimal acknowledgment once the research is completed and published in a medical journal. My stuff here as its such a shame that not more midwifery research is published as its unethical to undertake research and not publish the results. Realistically to get adequet research funding either here in NZ or over overseas it is quite impossible at present for midwives to get what's needed for large scale research unless they collaborate with other medical professionals as they have more clout, or are percived as such by funders. As for postgrad education sharing resources is ok but you always need to consider whose actually in control and how do they benefit? I am dead against midwifery education being provided by Dr's as they come from a sickness model not the wellness model that supports our practice as midwives. A vital aspect of developing midwifery as a profession as well as respecting each other is to support education of midwives by midwives. We have extemely talented educators out there in both educational institutions and DHB's so lets support them in their role as it does get kinda hard at times.
'If its going to be its up to me'. How we actually perceive ourselves as individuals and professionals makes all the difference whilst staying true to the midwifery philosophy. No one has power over us unless we give it to them.

Sarah Stewart said...

Thank you very much, Catherine, for your very considered response. I think it is a very interesting conversation to have and one that no doubt will continue in a number of domains, not least education and research.