Monday, September 15, 2008

How to keep my hand in

One of the big issues for midwives (and any health professional for that matter) is how to keep current with clinical practice when you doing doing another full time job such as being a lecturer or researcher.

Walking the talk
On the one hand, it is vital to stay up to date and confident about clinical practice, especially when you are teaching it. I think students really respect their teachers when they see them 'walking the talk'. On the other hand, when do I fit it all in on top of my teaching, research, writing for publication, PhD studies...and, right at the bottom of the list, being a wife, mother and having a life!

There's no doubt that teaching keeps you up to date. In a lot of ways, I am probably more up to date that the average midwife, because perusing journals and reading research is part of my job. The students also keep me very grounded - I live vicariously through them. I teach clinical skills, so I do not feel I am lacking in competence. And, I have been a midwife for many years, so I do not feel I need particular experience. But having not worked in the clinical context for a while, it will be great to emerse myself in midwifery again and re-vitalize my love of working with women and their families.

The other thing that is driving this is that I have to do some clinical work next year in order to keep my practicing certificate, which I need to be able to teach.

Where, what and how?
I think the easiest way to manage this will be to take some time out and work in a maternity unit somewhere. I will be able to take two weeks from lecturing, and maybe even longer.

I could work at my local maternity unit at Dunedin Hospital, but as it is a tertiary unit (dealing with a lot of complications) I would want to be supernumerary. The advantage of that is that I wouldn't have to leave home. But I am not sure how beneficial that would be for my learning. I know I'd end up doing nothing but care for women who are having cesarean sections, and I do not want to spend my precious two weeks doing that.

Midwife shortages
I am sure I could be a locum anywhere in the country because of midwife shortages. I'd be welcomed with open arms at rural units, such as Queenstown. I mean, what could beat working there, one of the most picturesque places in the world. But at the same time, it's been a while since I've worked in the clinical context, so I'd want to feel I had lots of support, not to be the only midwife for miles around.

Or, I could take off and do something completely different, like work a stint in Samoa or Rarotonga, or even go to Australia.

Best learning opportunities
I guess I need to decide what I want to achieve in regards to my learning and midwifery competence before I decide where to go and what to do. I am also very mindful of my back and do not want to aggravate it in a setting where I will have to do a lot of bending and lifting.

What I think I will do first is go through the Midwifery Standards Review Process and get my portfolio up to date. This will help me decide what my learning aims are and how to go about achieving them.

How do you keep current if you are a health professional who is a lecturer, researcher or manager? Should a certain amount of clinical practice be part of our job requirements?

Image: 'Queenstown, New Zealand' slack13


Joy Johnston said...

Sarah, you have even considered a stint in Oz. That's lateral thinking for a NZ midwife! I would check your blog frequently if that happened.
I find that a lot of Australian midwives, particularly those who are recently graduated, are overwhelmed with guilt at the poor standard of midwifery that they are able to practise in our hospitals. The theory-practice gap is huge. Postnatal shifts are virtually post-surgical nursing, as so many women have had caesarean births.

David McQuillan said...

It's a tough one, and it's an issue that's also relevant to massage therapy education.

I would love to have some time to practice (apart from the odd bit of work on my wife), but realistically I'm stretched enough just trying to balance family, work & study commitments.

Anonymous said...

Well then... you could do a stint in Canada for that matter. In fact I do believe that my Province in particular is hoping to lure midwives from your part of the world. Seeing as we don't have HALF as many as we should.
C'mon over to the upper half of the planet... you know you want to!
tee hee.

Sarah Stewart said...

@Joy: The reason I was thinking of Oz was because there are always adverts from agencies advertising for midiwves. So I'm sure I could get a placement. But I'd probably have to take more than two weeks off to make it a workable option. Plus, there's the 'bother' of getting registration.

@David: You have a very lucky wife!!

@hbacmama: Cost would be a prohibitive factor, plus registration would be a major barrier. If I went to a pacific island, I wouldn't have to worry about getting another registration-I could practice on my NZ certificate. But you're right - I do want to visit Canada soon.

Sarah Stewart said...

The other advantage of doing a short stint in a hospital in Australia is that I would be able to become involved in primary care. The problem with the set up here in NZ, is that when you work in hospital, you tend to do mostly secondary care, which would not be my focus at this time.

The only snag with going out of NZ is that Midwifery Council may say that it my practice update needs to be in the NZ context.

Anonymous said...

... when you work in hospital, you tend to do mostly secondary care
huh? says the obvious NON midwife commenter.
Which means that you don't get the 'catchers mitts' on? or... ?
I know the cost is atrocious. Hence why I doubt we'd visit NZ unless it was the education exchange (job security). And I have doubts we'd have any extra money with all that yarn roaming the hills. ;-)

Sarah Stewart said...

The best way to ensure that I am fully competent across all areas of midwifery is to take a very small caseload. But this is difficult to manage when you have commitments to other things. And it doesn't matter whether you are on call for one client or for 60, you're still on call.