and now....for the rest of my life...

 2012 was the year that I lost 31.5 kg and became a Life-time Member of Weight Watchers. I am not trying to market Weight Watchers, but I have to say that the program was a very important part of my weight loss journey, and continues to be so.

The advantage of being a Weight Watchers life-time member is that you get free visits to meetings and discount on products. But there are certain conditions you have to fulfil, such as continue to be within 2 kg of your target weight, and visit a meeting to be weighed, at least every month. The beauty of this ongoing program is it provides continuing motivation and support for me to maintain my weight.

What I have found over the last few weeks since reaching my goal weight is that it's difficult to maintain my motivation. Part of the problem is I feel I have nothing to strive for. It doesn't take much for me to skip my exercise or go outside my eating plan. I've come to the conclusion that losing weight is easy....keeping it off is a whole other ball game!

Have you ever achieved a goal and then wondered “what's next?” How do you deal with that feeling of achieving something and finding it to be an anti-climax? 

Any suggestions for long term strategies for how I can keep my weight off?

New campaign to stamp out female genital mutilation in Australia

It looks like 2013 is going to shape up as the year Australia focuses on female genital mutilation. FGM is illegal in Australia, to perform the procedure, or support the movement of girls to another country to have it done.

This week, Julia Gillard announced a range of activities aimed to find out exactly what is happening in Australia, provide education to both communities and health professionals, and review laws about FGM. The Australian College of Midwives supports this move and will be working the health minister, Tanya Plibersek to help her in any way we can.

I was talking to my husband about this the other night and he felt, as a non-health professional, that there has to be a raising of awareness of the general population, so that we not only know what FGM is, but understand the long-term implications of the procedure.  We also need to understand that FGM is a cultural, not religious, issue which in turn will help us understand how to address the problem.

What do you know about FGM? Have you come across it in your every day life? What would you do if a girl disclosed that she had had it done to her? If you are a midwife, have you ever come across it in your practice?


Image: 'haunting eyes'
http://www.flickr.com/photos/62849250@N00/542892224
Found on flickrcc.net

Disposable friends - would you like some?

One of the challenges of moving to a new place, especially a new country, is that you have to start from scratch with making friends. I have found this hasn't been too difficult in the past because I have met people through my children - at school, play groups, Saturday sports and so on. But with my move to Canberra, and being on my own, I am having to make a determined effort to get out and meet people.

I have found the most successful way of meeting people in Canberra has been via the Internet. There are two main places I go to that help me get out and about. The first place is HerCanberra, which is led by Amanda Whitley, based around a blog, as well as Facebook and Twitter. It caters for women, although I am sure there are topics that men would be interested in. Not only does HerCanberra spread the news of local events and places of interest in Canberra, but it organises F2F events.

This week I am going to my second evening dinner organised by HerCanberra. I am really looking forward to it because Amanda has told us we must all get dressed up. So I'm excited about wearing a new outfit which I have just bought, although I am stressing about what bling to wear with it, which is a whole other story.

My first HerCanberra evening dinner in November was great fun....probably because I drank a little too much wine! My only critique, as such, was that the age range was a tad too young for me. The women who attended were in their late 20s and 30s. They are more interested in their young kids, and I spent all evening hearing their birth stories, once I made the mistake of admitting I am a midwife. But at the same time, it was a good thing in my new role at the Australian College of Midwives, to hear about the issues that face birthing women in Canberra and Australia.

The second site I am finding to be a great resource is Meetup.Com. This online movement started off in the USA after 911, as a way of bringing people together, who don't necessarily want to find romantic partners, but are interested in meeting people they can hang out with and share interests. This movement seems to be very successful in Canberra with any number of interests groups – apparently, this is because the population is so transient, so people need a quick and effective to find out what's going on.

I have been to a couple of general meet-ups at the pub but don't particularly enjoy them. It feels a little weird going to the pub by myself, and I feel just a tad vulnerable in a large, mixed-gender group. However, I have also joined some smaller groups, such as the Canberra Movie Goers and Canberra Bloggers, and been to a few events and really enjoyed myself. I have met some great people...shared interesting conversations...and had fun. And at the end of each event, gone home feeling great about myself, but at the end of the day, have no ties or expectations to bog me down.

What it has got me thinking about is...does groups like Meetup.com allow us to do away with the concept of friendship, or make it more of a disposable commodity? Think about yourself...why do you have friends? For company...to go to events...share interests...and so on. But there is a downside to friendship. It has to be maintained, which means work. Friends can demand time from you...make expectations of you...cost you money. Friendship can turn nasty...friends can use and betray you. 

So are disposable friends the way to go? What do you think?

Image: '61098'
http://www.flickr.com/photos/71865026@N00/3280003051
Found on flickrcc.net

And so it begins....

The big news over the last two days is that William and Kate are expecting their first baby.

Sadly, Kate is suffering severe morning sickness, which can be the most miserable thing in the world, and really takes the shine off the good news. But it doesn't stop me (and everyone else) speculating that she's expecting twins, as morning sickness can be one symptom of multiple pregnancy!?

As a midwife I cannot help wishing that she'd be a poster girl for normal birth. How cool would it be if she had a waterbirth at home....at Buckingham Palace! However, I have a horrible feeling her elective cesarean section is already booked!



Image: 'Royal Wedding of William and Catherine Duke & Duchess of Cambridge'
http://www.flickr.com/photos/48399297@N04/5669247285
Found on flickrcc.net

Book review: Lives we leave behind by Maxine Alterio

Lives we leave behind is the latest novel by Maxine Alterio. Maxine is a principle lecturer at Otago Polytechnic, in Dunedin, New Zealand and is extremely well known in academic circles for her work on reflective practice and story telling. I have used her academic work extensively in my own studies, but this is the first time I have read any of her fiction.

Lives we leave behind is the story of two New Zealand nurses, Meg Dutton and Addie Harrington, who travel from New Zealand as young, naive, Kiwi girls seeking adventure, and wanting to do their bit to help "the boys" in the First World War. They are thrown together as they share a berth on the hospital ship Maheno, which takes them to Egypt for their first posting. At first it looks like they will never have anything in common. Addie disapproves of Meg's frivolous approach to life, whilst Meg thinks Addie is a stick in the mud. But the horrors of war and their own personal traumas forms a deep and abiding friendship.

The story of Addie and Meg is very engaging, especially as Meg falls in love with a British surgeon, Wallace Madison. You just know it's going to end in tears, but keep hoping that Meg gets her happy-ever-after. Addie has her own romantic challenges as the men in her life are permanently changed by both physical and psychological impacts of war. 

However, for all the personal stories that thread themselves through this book to entertain us, it is the background history and detail that captured my attention, which I feel is the real strength of this book. Alterio has done an amazing job of researching the experiences of Kiwi nurses in the First World War. The use of language, historical fact and medical details transport you firstly to the hot, stinking military hospitals in Egypt to the freezing battlegrounds in France. Being a nurse myself, and having a great interest in history, I can attest to the authenticity of Alterio's writing, which is extremely easy to follow, and doesn't bog you down with detail. Yet at the same time, little touches here and there alert you to the amount of research that Alterio has carried out.

I highly recommend this book which not only entertains but also educates, and brings the reader's attention to the dedication and bravery of these unsung heroines.

It's not about the winning, it's about the finishing...or is it?!

 Last Sunday I took part in my very first triathlon. Oh...alright....it was a baby one - 200 meter swim, 8km bike ride and 2km run - but it was bloody hard work, and a major workout for me..

The morning didn't start well. I had to cycle to get there and developed a puncture about 2km away from the start. Actually, I was a tad relieved thinking I'd have a legitimate excuse not to do it...but blow me...there was a cycle repair man who changed my inner tube in about 20 seconds flat, to my disgust.

We were split into age groups, and my group, 40+ women were the last group of people to start. The first leg of the race was the swim in Lake Burley. I have to admit to having a number of concerns about the quality of the water...and what lives in the lake! I had visions of emerging from the water...not like the beautiful Ursula Andress rising out of the sea in James Bond Dr NO....but more like a green lake monster...with limbs missing and being horribly deformed like I had an overdose of nuclear poisoning. However, the water was beautifully clear, warm and very refreshing. And I didn't get attacked by any eels or other underwater iggly wigglies, so that was a bonus.

Within seconds of the swim starting I knew I was in trouble.Everyone was powering away with their frantic crawl and I was gliding along with my geriatric breast stroke. The distance wasn't an issue for me but speed was...I was at least 10 minutes behind everyone else. So needless to say, I was last out of the lake and already had no chance of catching up.

The change over to cycling was the next nightmare. It took forever to get my running pants on because I was wet, and I got twigs and leaves stuck to me...in my shoes...knickers...not at all comfortable. The cycle ride wasn't too bad. I was pretty pleased with how well I did around the course and was celebrating that I was catching up until the official told me that I had to go around a second time....

By the time I got to my run, I could hardly put one foot in front of the other, so mostly walked the first kilometer. I ran the second kilometer because it was all down hill, and my darling friend Deborah Davis, ran with me for the last 500m, which made all the difference.

The result...I came last!

I knew I was going to be last, from the time of the swim, and the thing I was dreading the most was the pity clap as I crossed the finish line...you know what I mean...when everyone thinks...oh well, we'd better give that poor woman a clap because at least she finished...even if it was half a day after everyone else!!

Thankfully, by the time I crossed the line, everyone had lost interest and gone on to prize giving...so I didn't even get a pity clap.

What I took away from this experience is that I can do anything if I put my mind to it.  At the end of January this year, I was flat on my back with a partially prolapsed disc...and I still have permanent nerve damage to my right leg. But here I am...nine months later...a tri-athlete!

The other thing that struck me was that there are all sorts of shapes and sizes and abilities amongst us women. I tell you...those all-in-one running suits don't hide a thing. So if you have a teenage girl worried about her body, take her to an event like this to show her what real women look like...and what we can achieve.

But if one more person says to me...it's not about the winning, it's about finishing, I shall poke them in the eye!!!!

Starting to develop social media guidelines for the Australian College of Midwives

At long last I have started work on the development of draft guidelines for the use of social media by midwives, on behalf of the Australian College of Midwives. This work is partly driven by the upcoming public consultation by the Australian Health Practitioner Regulation Agency (AHPRA), and following the furore of AHPRA's initial draft consultation document.

At this stage, I am reviewing the social media guidelines of other midwifery and health organizations, both in Australia and internationally.

I am looking for examples of guidelines that:

• are proactive ie acknowledge that social media is here to stay;
• supportive of the use of social media by midwives/health professionals;
• give examples of good practice and practical tips for how we can use social media professionaly;
• doe not take a punitive approach.

If you have any suggestions of guidelines that you think may help me, please let me know. 

Image: 'twitter_Good_Bad'
http://www.flickr.com/photos/32931740@N06/3528880050
Found on flickrcc.net

Should waterbirth be offered to all women?

The Australian College of Midwives is asking for feedback on its draft Position Statement on the use of water immersion for labour and birth - click here for details of the Statement and how to submit your feedback.

I have to admit, there are two areas that I feel a tad uneasy about and am looking forward to seeing how others feel - these are my own opinions and I am not reflecting the Australian College of Midwives.

The first thing I have reservations about is the opening statement "The ACM supports the choice of all women at term to have the opportunity to access water immersion for labour and/or birth."

I think there are instances when women have risk factors that would preclude them from water immersion, so I am not sure "all women" should be in the statement. Having said that...if water immersion is restricted to just low risk women, we would be preventing women with conditions such as diabetes, who are labeled "at risk" but actually would be fine to labour in water.

I believe that every woman needs to be assessed individually at the time, and I am not sure this is reflected in the Position Statement. At the same time, we do have a lack of evidence about water immersion and the outcomes for so-called "high risk" women, so it is difficult to give an informed opinion.

The second issue that I am a little uncomfortable about is the point "All maternity services to be encouraged to provide women with access to water immersion in labour and/or birth including telemetry as required". Note: telemetry is the monitoring of the baby's heart beat using water proof equipment. Thus, women who require continuous baby heart rate monitoring can still have access to water immersion.

I just need to be clear...it's not telemetry I have a problem with...I think it's fabulous if it supports more "at risk" women to have access to water immersion. What I am concerned about is that the minute it is included into the ACM Position Statement, some midwives and doctors will take it as an opportunity to push continuous fetal monitoring for all women, including "low risk" women, which is not evidence based practice, but widely supported in areas.

What do you think?

If you have any comments about either these issues or any other aspects of this Position Statement, please make a submission as per these instructions.

Image: 'untitled'
http://www.flickr.com/photos/48819968@N00/2925295583
Found on flickrcc.net

My big fat bum!

I grew up hating my bottom. Right through to my adult years, I was forever hearing someone say (usually my mother!)..."you've got your Granny Gammon's bottom"...and it wasn't meant as a compliment. At the same time, I was told I had good childbearing hips...whatever that meant! At 16, you are more interested in whether you can get into a pair of skinny jeans...not that you can push out a 10 pound baby!

Needless to say, I  have had a complex about my bum all my life, especially as a young woman. And it hasn't got any better over the last few years as I have put on weight. I have always done my best to cover it up, and in my mind's eye, it has been as huge as a mountain! I never asked my hubby "does my bum look big in this?" because I always thought I knew what the answer would be - to be fair, my hubby has never said my bum looks big.

But now I have lost weight, I am down to the size I was when I was in my early 20s, and it's dawned on me that my bum wasn't fat at all. I spent all those years hating my bum, and having a poor image of myself, but really, my bum was a perfectly normal. Now, I regret those wasted years...instead of worrying about my bum, I should have been out and about enjoying it.......shaking my booty!


I am not going to hate my bottom any more. I'm going to embrace it and love it, and clothe it in tight (well...not too tight) jeans! OK...it's a lot saggier than it was 30 years ago...but I am going to make the most of it, because in another 20 years, I'll definitely have something to worry about!!

What part of your body do you love....and hate?

Shame on the Warriors rugby team!

I generally do not take much notice of what's going on with rugby league because I am more a union girl - go The Highlanders!! However, news about the latest sponsorship deal that The Warriors have recently negotiated has got my dander up.

Earlier this week, The Warriors - the biggest New Zealand rugby league team - announced they have struck a sponsorship deal with the Chinese-owned New Zealand formula milk company, Fernbaby. This deal includes the Junior Warriors wearing the company's logo on its shorts next year, with The Warriors wearing the logo on their shorts 2014-2015. This news not only has implications for New Zealand, but also Australia, because obviously The Warriors spend a lot of time playing in Australia.

There are several reasons why I am concerned about this move.

Firstly, this marketing move contravenes the World Health Organization International Code of Marketing of Breast-milk Substitutes. Many countries have enacted the Code into legislation, but as far as I can tell (and I'd love to be put right if I've got this wrong) the New Zealand and Australian governments support the Code but have not integrated it into legislation.

Secondly, by endorsing Fernbaby, The Warriors will be encouraging its fans to use formula feed. Keeping in mind that many of the fans of the Warriors come from communities who need to be encouraged to breast feed for as long as possible as a means to reduce health problems such as diabetics, obesity, asthma and SIDS, this is hugely problematic.

I am not the only person concerned - the Infant Nutrition Council has stated that this move clearly contravenes voluntary as well as regulatory marketing codes. The snag is that Fernbaby is not a member of the INC, so I would imagine the company isn't terribly worried about adhering to any voluntary  codes.

What really annoyed me was the arrogant attitude of The Warriors chief executive Wayne Scurrah who said he wasn't concerned about "how breast-feeding advocates and the general public might react to the Fernbaby sponsorship."

Well, I disagree! I think he should be very concerned. If he wants to attract more women and families to games, then he's going the wrong way about it. And, as for The Warriors being supportive of the community, well...it's clear they do not give two hoots about the community. All they are interested in is making money, and not promoting a "breast is best" message, which would be far more beneficial for their fans...let alone the poor people they will be targeting in Asian countries, where both Fernbaby and The Warriors want to increase their market. 

I am thinking about what I, and the rest of the midwifery community in New Zealand and Australia, can do to lobby against these sorts of cynical marketing ploys, and put pressure on The Warriors to think again about this sponsorship deal. Any ideas?

Image: 'Skyline'
http://www.flickr.com/photos/11821713@N00/6892502081
Found on flickrcc.net

How can I keep veggies growing in pots hydrated during Canberra's hot summer?

I am living in a flat on the 6th floor of an apartment in Canberra. Luckily we have a really decent balcony, so I should be able to grow some veggies in pots this summer. Apparently the summers in Canberra get quite hot so I thought I'd have a go at growing chillis, capsicums and cucumbers - all plants that were not so easy to grow when I was living in Dunedin.

The only snag is that I will be away for periods of time during the summer and am concerned about how I can keep the plants hydrated, so they do not die while I am away.

Any suggestions about how I can manage this problem?

My new job: professional development officer for the Australian College of Midwives

Those of you who follow my blog may vaguely remember me saying back in August that I was moving to Canberra to take up my new role as professional development officer at the Australian College of Midwives. I have hardly said a word about my new job since because a. I have been far too busy settling into the job and getting my head around what I am supposed to be doing, and b. I have been thinking how I can continue to blog my personal opinion without compromising my professional position.....am still thinking about that one.

Busy...busy...busy
I am loving my new job. It is very busy and varied, and whilst I feel like I am struggling to keep up some times, I will never be able to complain of boredom. Midwifery is on the cusp of  amazing changes in Australia, and I am delighted to be part of it.

Portfolio
I do all sorts of things from posting links up on our Facebook page to supporting the development of position statements. My main jobs at the moment are:

• supporting private practicing midwives;
• supporting and developing the Australian Baby Friendly Hospital Initiative;
• supporting our application to become a registered training organisation;
• developing midwives' use of telehealth; 
• supporting projects such as the up and coming education summit in February 2013, and the ACM structural review.

My hopes for the future
My goals for the next couple of years are:

• to increase transparency and communication and collaboration amongst members of the College and the wider midwifery community;
• to explore ways that we can support each other so that we are one integrated group of midwives, who work together to promote midwifery, as opposed to breaking off into fragmented groups;
• to work out how I can continue to use social media in my new position;
• and, to work out how to integrate my interests in education and research into my job. 

If you're an Australian midwife, what are your hopes for the midwifery profession over the next couple of years?

Getting settled in Canberra

I have just realised it has been about a month since I wrote a blog post, which is virtually unheard of since I started blogging back in 2007. The main reason for this is because I have been very busy settling into my new home and job in Canberra, Australia. So I have promised myself that I am going to catch you all up with my news, and develop a new routine that helps me get my blogging mojo back again.

No one wants to move to Canberra!
I must admit, when I first got my new job, I was a little concerned about moving to Canberra. Everyone I spoke to, especially Australians, said......"Why on earth do you want to move there! Nothing happens in Canberra...it's the most boring place in Australia". I have to say that I have been very pleasantly surprised now that I have started to settle here....Canberra has much more going for it than you would think.

Initial impressions
My feeling is that Canberra is more a place for families and more "mature" people like myself who are interested in family-friendly events and environments, than raging night clubs. There's two theatres...lots of fabulous little cafes and restaurants...and great places to run/cycle/walk, if you're interested in keeping fit. There's events on all the time, so much so, I struggle to make up my mind what to do every week. I have to say that we don't get the really big concerts and sporting events here, but Sydney is only 3 hours away, so if I am desperate to go to an international show, I can always take the bus up and back...in a day, if I wish.

My top 5 things to do in Canberra

1. Go to the Farmer's Market on Saturday mornings. It has just about everything there with regards to fresh food except for a decent cheese stall. But as I am still on my diet, I am not allowed to eat much cheese, so I appreciate not having to deal with the temptation of buying it.
2. Walk around the lake. We are having beautiful spring weather, so I have been making the most of the fact I can walk around the lake to work. I saw a duck-billed platypus the other day, and at the moment there are plenty of cute little ducklings out on the water. 
3. Visit the Australian War Memorial. I have heard it criticised as an exploitation of a very serious issue to gain tourist visits. But I have found it to be a very sensitive place to go and reflect on the horrors of war, and human bravery and endurance.
4. Explore the back streets to find interesting and "happening" cafes. It isn't obvious in Canberra where to go for good food and relaxing conversation, compared to places such as Melbourne. So you have to put in a little effort and hunt around for places to go. I have been getting ideas from the numerous free magazines about Canberra that can be picked up from supermarkets, as well as HerCanberra.
5. Afternoon tea at the Hyatt Hotel. This is a lovely experience. Maybe not quite as posh as afternoon tea at The Savoy, in London - I was disappointed that there was no minimum dress code, especially as I made the effort to dress up in a dress and high heels. But you can eat all you like, which makes the afternoon really good value for money.

Long story short...I do miss Dunedin and have been heard to say that there is no where in the world like Dunedin on a good day. But I am loving Canberra and have a feeling I am going to become very fond of my new home. I do miss the sea, but the lovely weather here is going to make up for being land-locked.

So if you're ever in Canberra, let me know and I'll introduce you to its little, hidden treasures.

Image: 'We Will Remember Them'
http://www.flickr.com/photos/40195741@N00/3216771987
Found on flickrcc.net  

Any suggestions for how I can live stream an AGM meeting?

One of the things I have to look into over the next couple of weeks is how I can organise the live streaming on the Internet of the Australian College of Midwives' AGM.

I think it has to be closed, so I need to think about how I can "allow" midwives to join, but I need to check up on that. I also want this to be an easy but effective process...it has to be good quailty, yet not cost a fortune in equipment or IT-support.

So, would love to hear from anyone with suggestions on how I can go about setting this up. What equipment did you use? What advice would you give me? What pitfalls should I try to avoid?

Image: 'The most expensive webcam of all times?'
http://www.flickr.com/photos/37803129@N00/199247527
Found on flickrcc.net

Will you be my friend? The use of social networking for midwifery professional development

I have been privileged to have had the opportunity to work with Annette Dalsgaard Vilain over the last couple of years on various projects, including the Virtual International Day of the Midwife. Annette is a Danish midwife and educator who I met online...I can't remember how/where/when! Needless to say, we have been able to utilize the collaborative nature of social media to work together, support, and learn from each other. All this has resulted in a paper that we wrote collaboratively, for the journal of the Danish Association Midwives, entitled "Will you be my friend? The use of social networking for midwifery professional development".

We wrote this article because of our concern that most the midwifery literature about social media is quite critical and  focuses on the risk of using social media as health professionals. We wanted to rectify this somewhat, and provide more balance, talking about how social media can be used for professional development, and citing the VIDM as a case study.

Will You Be My Friend

AHPRA's draft social media policy: sensible advice or attack on freedom of speech?

The Australian Health Practitioner Regulation Agency (AHPRA) is responsible for the regulation of nursing and midwifery in Australia, amongst other professions. AHPRA has just called for feedback on a draft policy for the use of social media in healthcare. The draft policy has been taken off the AHPRA website but can be found here: http://www.impactednurse.com/pics5/somedraft.pdf

I am in the throes of preparing a response, as a practitioner who successfully (or so I think) uses social media, and has learned a few lessons along the way.

Let me say right from the start....I welcome all comments and advice about using social media with respect, and following all rules and regulations about patient privacy and confidentiality. I am also delighted to see that APHRA has acknowledged the rise of social media.  I am also making these comments as an individual - they do not necessarily represent the views of the Australian College of Midwives.

My initial reaction to this draft policy is the underlying premise is that social media is a very risky activity for health professionals to engage with, and demonstrates a lack of understanding of how social media can be used - to increase communication, collaboration, transparency, sharing, research, education and community engagement. There is a lack of understanding of how consumers want health practitioners to engage with them.

The draft policy ignores the fact that social media is so much a part of life now. Instead of educating practitioners to use it professionally and effectively, it is taking a punitive approach. This will not work because social media is so embedded in what we do, and it is impossible to tease out our private use from the public use. It will also be impossible to police.

One of my main recommendations is to turn this policy on its head, and take the opportunity to educate practitioners in a positive way, using guidelines. I have always appreciated the UK NMC's guidelines - they offer practical advice, yet recognise the benefits of social media. Another recommendation will be for AHPRA to work with practitioners and consumers who are currently working effectively and professionally with social media, in order to educate themselves, as well as pick their brains about the issues.

For other views, see Impacted Nurse, writing "New AHPRA social media policy: we may be in big trouble here", and the comments that come after this post by Croakey, "Is AHPRA on the right track re social media use by health professionals? A chance to let them know your views…"

Please let me know what you think?

• Is AHPRA uninformed about social media, or is it right to be so concerned about practitioners' use of SM? 
• Is AHPRA unrealistic in its expectations, or has it completely missed the point of social media?
• Is AHPRA attacking freedom of speech and our ability to advocate and discuss healthcare practice in public, or is it right to suggest we should not wash our dirty laundry for all to see?
• Will the policy be a supportive measure, or drive practitioners use of social media "under-ground"?

I'd love to hear your views. Or, contact AHPRA directly: socialmediaconsult@ahpra.gov.au by the 14th September - public consultation will occur in October/November.

Image: '50 Social Media Icons'
http://www.flickr.com/photos/10883933@N07/3652495533
Found on flickrcc.net

What can be "free" and what should be paid for in the non-profit sector?

One of the challenges I am currently thinking about, as I settle into my new job,is how to make money from education in the non-profit sector.

Three weeks ago I moved jobs from working for Otago Polytechnic, Dunedin, as an educator, to professional development officer at the Australian College of Midwives (ACM) in Canberra, Australia. I haven't been in my new job for very long, so can't tell you too much about it, because I'm still getting my head around what it entails. However, the main tension I have already come up against is moving from an environment where I was encouraged to develop open access education and resources, and free learning opportunities for the community under an open intellectual property policy, to working for a small non-profit organization that has to do everything it can to make money and be financially viable, within a closed IP framework.

This is causing me to think very carefully. How can I continue to work for national and international midwifery collaboration, which includes open sharing of resources and ideas, yet protect the financial interests of the organization I work for? How can I make money by providing professional development opportunities to midwives in Australia, yet stay true to the philosophy of open access education? Is it possible to do this in the non-profit sector? Is it even appropriate or relevant?

I would love to hear from anyone who is in the same situation and work for non-profit organizations? How do you keep a balance between making money, yet contributing to collaboration and education development in the wider community? What can be "free", and what should be paid for?

Crazy times!

I am about to facilitate a number of workshops about the use of social networking in the UK and Denmark. So as I wait in Christchurch airport for my plane, I have been reflecting on my use of social networking, and the message I want to leave the participants of my workshops.

The last few weeks and months have been quite crazy and as a result, I have changed the way I use social networking. 

I have badly neglected my blog, because I haven't had the time, energy or motivation to put the thought I need into writing posts. I have even noticed that I am using Twitter infrequently, which is quite unusual, because my custom is to use it extensively to keep in touch with professional friends and news. 

What I have noticed is an increase in my use of Facebook. This is partly because it doesn't take long to post up a quick sentence about daily activities, or share an item of interest. The slightly more complex reason, I think, is that as I have moved jobs and countries (more about that later), Facebook has allowed me to keep in contact with personal friends and family – most of them do not use Twitter. And Facebook allows me to have far more control over what I say, and to whom, as opposed to Twitter, which is a much more “free for all” approach. 

I am thinking that my message is:

• social networking can be used in a variety of ways; 
• different tools meet different needs; 
• social networking is a very fluid thing that changes as life changes; 
• keep your mind open and don't stop exploring and engaging with people. 

How has your use of social networking changed, or not as the case may be, over the last 12 months?

Goodbye to the Educational Development Centre at Otago Polytechnic...

Those of you who are kind enough to follow my blog will have noticed that I haven't written many posts over the last couple of months. This has in part been because I have been faced with some difficult life choices, largely in connection with my job.

My job at Otago Polytechnic, Dunedin was disestablished back in June. I was offered the opportunity to apply for newly-created jobs, either as a staff developer, or an online technical support-type person. However, both jobs failed to include any teaching or research, which I felt would be a backward step in terms of my career as an academic. And I did not want to become a technology back-end support person.

At the same time, I was made aware of a position that had just become available, which I applied for - professional officer for the Australian College of Midwives in Canberra, Australia. This job had my name all over it because it was working to develop midwifery in Australia, support midwives, develop education programs, manage the ACM social media, and so on. I am very pleased to say I have got the job, and actually started work in Canberra this week. 

Needless to say, I am extremely sorry to leave Otago Polytechnic after all these years. I have learned so much from my colleagues, especially in the School of Midwifery, and the Educational Development Centre. This new job moves me away from academia, so I will have to think about how I keep doing the research work that I love in this new environment, and maintain my teaching and learning skills, and education connections. 

So for the time being, I wish to thank the wonderful team I have been working with over the last few years for all their love and support: Catherine Lindsay, Heather Day, Terry Marlar, Maxine Alterio, Kate Timms-Dean, Ron Bull, Peter Brook, Veronique Olin and Bronwyn Hegarty - you guys really are the best!! I will miss you more than you will know.

What got me started on my "omg! I'm nearly 50...must get fit and healthy before it's too late" campaign"

I have been on my "OMG! I'm nearly 50...must get fit and healthy before it's too late" campaign for nearly a year now, and as a result, have been asked to write a small piece for our local community paper....so here it is.

This time last year I sat myself down and had a very serious talk with myself. I told myself that if I didn't get on and sort myself out, there was a serious chance that I wouldn't live to be very old. Pregnancy and childbirth, an office job sitting for 10 hours every day at a computer, and menopause had done some serious damage. My blood pressure was so high, it was a miracle that my head hadn't exploded. I was walking around feeling as if I was in a constant fog. I had no energy, no motivation, and felt so stressed that I could barely face the next day. Every time I took a breath, I put on another kilogram of weight, and was now 92kg (15 stone), which is morbidly obese. My blood sugar levels were on the verge turning diabetic, and my cholesterol levels were increasing. I have a family history of high blood pressure and diabetes, so knew if I didn't do something serious about my lifestyle, I might not live any older than my Gran, who died just after her 65th birthday.

I took control of my life in two ways. Firstly, I joined Weight Watchers and started to follow a nutritional plan. The second thing I did was join a gym and sign up with Craig for weekly sessions. It was scary at first. I was horribly intimidated by all the gorgeous young people at the gym, compared to me...old, fat and ugly. It was also scary working with Craig at first, because I didn't know how he could possibly relate to me being young, male and fit. However, the weekly sessions became a vital part of my progress because they kept me motivated and on track. In other words, I could kid myself, but not Craig. He gave me weekly plans to follow, taught me how to use the gym equipment, and helped me get over my gym shyness. He tested and challenged me, but I never felt he judged me, and he always tailored things to meet my needs. I'll be honest, this has not been cheap. I have made sacrifices and given up other things to pay for my sessions with Craig. But I have seen it as an investment in my future, both on a physical and psychological level.

A year later, the benefits to my physical and mental health have been huge. I have lost 29.5 kg (4.5 stone) and now have a normal BMI. My blood pressure, blood sugar and cholesterol are normal. I am fitter than I have been for years, and I have started running for the first time in my life. I have a new job, and I can wear my wedding ring again for the first time in 24 years. Looking back, I would say the hardest part was recognizing that I had to do something with my life, and taking the first step to make changes. But once I made that step and put support measures in place, such as working with Craig every week, everything else fell into place. Who knows, I still might not live past 65 years, but at least now I have the ability to enjoy every day of my life.

Ante natal care goes virtual at Caboolture

I am always interested to hear of online initiatives in healthcare, especially in the maternity services. So I pricked up my ears when midwife Jillian Clarke told me about a new website that has just gone live.  

The Caboolture Hospital Maternity and Newborn Service (Queensland, Australia) has just launched a website that allows pregnant women and parents to register online with the hospital and gives access to up to date information: http://www.health.qld.gov.au/caboolture/maternity

It is my understanding that eventually, the website will provide the ability for women to have live chats with midwives. 


What interests me is....what drives pregnant women to use online chat facilities, such as websites like this, or Facebook pages, rather than phoning a hospital or talking to a midwife? What do you think?

More from midwives about what they need to meet their CPD needs

I was talking to midwives the other day about continuing professional development and what they need to meet all their professional requirements and professional learning needs. Here is one midwife, Jillain Clarke from Brisbane, talking about how she needs the opportunity - CPD has to be accessible, flexible and provided on her terms, to meet her individual needs.


http://www.youtube.com/watch?v=fbmp1mv03PI&list=UUjnS6QDJ7RVEcg8pDaMcjRQ&index=2&feature=plcp

What do you think of what Jillian is saying? Do you think she's being unrealistic? How would you like CPD to be delivered?

Hearing from midwives about their professional development needs

The other day I used Facebook and Twitter to ask midwives what they needed to meet their professional development needs. All the old chestnuts cropped up such as time and access. Here is the "Storify" I made up with everyone's responses. It has some interesting commentary on the whole issue of COP.


http://storify.com/SarahStewart/what-do-australian-midwives-need-to-meet-their-pro

What do you think of the comments these midwives made? Are there any you would disagree with, and why?

How to prepare for a virtual job interview

It's been my observation that there is an increase in virtual job interviews, and by that, I mean interviews using web conference technologies such as Skype. Companies cannot afford to fly candidates to a face-to-face interview. Yet, phone interviews lack the ability to see the candidate, and note the subliminal messages that body language give off. A number of people I've spoken to lately have been interviewed with Skype and webcam. The beauty of using these techniques is that it saves money, but also allows the interviewers to see candidates.

For candidates, virtual interviews bring their own challenges. Here are a few tips from my own experience to help you prepare for a virtual job interview.

1. Check that the technology works

• Ask to have a quick run through with the technology before the interview, to make sure everything works both at your end, and at the interviewer's end.
• If you have to give a presentation, make sure the interviewer has any resources that go with it in plenty of time, so that he can check that everything works, such as a PowerPoint presentation.
• If you are using resources such as a PowerPoint presentation, use several means of getting the file to the interviewer eg via email and a web site such as SlideShare, so that you're doubly sure the interviewer has what he needs. 
• Wear a headset because this improves the quality of the audio.
• Be aware that sometimes web cam impacts on the quality of the internet connection. I suggest that you agree with the interviewer that if this is the case, have the webcam on at first when you do your introductions, and then turn it off.
• Discuss with the interviewer what Plan B will be if the technology doesn't work on the day.

2.  Make sure your environment is right

• Check the lighting, so that you can be seen by the interviewer. If you have the lighting behind you, your face will be dark and not seen easily.
• Make sure you feel relaxed eg your computer is at the correct height; you have a comfortable chair; the room temperature is not too cold or hot; you have a glass of water by your side (but not too near the computer that you knock water all over the keyboard!)

3.  Practice  

• Have a practice run with a friend, so you are comfortable with using the technology, and the "feel" of this mode of interview. If you're not used to working in this online environment, it can be a little off-putting. Practicing will give you a feel for working in a situation where you don't have the same messages you get when you're interviewed in a face-to-face situation. 

4. Dress appropriately

• Don't fall into the trap of wearing pj bottoms because no-one can see them. Wear the same clothing that you'd wear in a F2F interview. This will help get you in the mood and remind you to behave professionally. 

5. Check how you look on camera

• Web camera always shows up my wrinkles, so next time I have an interview I am going to wear a little make-up to hide the wrinkles and add colour to my face. 
• Check that the clothes you plan to wear do not drain the colour from you on camera.

6. Get rid of any distractions

• Get rid of anything that will interrupt or distract you during the interview. Put the cat out...send the baby to childcare...turn off all your phones...
• Close down any unnecessary programs, websites or pop-ups that you won't be using, that may act as a distraction.  This is especially relevant to real-time communication programs such as Twitter, or chat programs such as gTalk.
• Set your Skype status to "Invisible". This will stop your contacts will disturbing you, but you can continue to use Skype in a normal way. But remember to warn your interviewer that that is what you're doing, or else he will not be able to see you in his contacts list.

7. Think about the name of your Skype account

• Use a professional name for your Skype account, which looks a lot better than using a name like "fluffysexkitten", unless you're being interviewed for a job as a stripper!

8. Look at the camera

• When you're being interviewed, look at the camera all of the time. If you keep looking away, the interviewer won't be able to connect with you....and you might end up sending the message that you're easily distracted or bored.
• It's easy to forget that someone is on the other end of the camera watching you, and fall into the trap of thinking you're on your own and no one can see you. So don't let your guard down and do something inappropriate, like picking your nose!

Have you ever attended a virtual interview, either as interviewer or interviewee? What was your experience? What tips would you pass on to job hunter?

References
How to handle a virtual job interview. Lindsay Olson. 2012. http://money.usnews.com/money/blogs/outside-voices-careers/2012/03/06/how-to-handle-a-virtual-job-interview

Job interviews: Tips for the virtual interview. Charles Purdy. 2011. http://www.monsterthinking.com/2011/04/18/job-interviews-tips-for-the-virtual-interview 

Image: 'The most expensive webcam of all times?'
http://www.flickr.com/photos/37803129@N00/199247527

A question for midwives. What do you need to meet your professional learning needs?

I have been doing a lot of thinking lately about midwives' professional learning needs....what they are....what impacts on them....who or what dictates what the learning needs are. And what do midwives need to meet those needs?

Obviously there are the statutory and professional requirements that midwives have to meet, as well as the local expectations of employers.  There's the requirements around meeting women's needs and practicing evidence-based midwifery. And then there's the formal education requirements of courses that midwives undertake.

So much to think about....

What do you need, as a midwife, to meet those professional learning needs? How are your needs being met now...and what would you like to have in place in the future?

Image: '"we are doing this together"'
http://www.flickr.com/photos/48819968@N00/1235218128

Would love to hear your ideas about this question: How to develop a national support program for health professionals?

I have been asked to put together some thoughts and a presentation for a non-profit organization that works with a group of health professionals. What the organization is interested in, is my ideas for a national program that would provide support to this particular group of health professionals.

The organisation also wants the presentation to have a little razzle dazzle. I refuse to use Prezi because I cannot get on with it, for all the tea in China.

So I am looking for ideas. What technologies could I use and embed into my presentation?

But even more important, what key points do you think I should consider when thinking about how an organization can support health professions? 

Image: 'Were thinking of you'
http://www.flickr.com/photos/26406919@N00/291488094

A horrible fright!

I had a horrible fright this morning!

I woke up and thought I was having a heart attack.

All I could hear was a heart beat...going very fast...much faster than my usual slow plodding rate...

This is it...I thought...about to go into cardiac arrest...there's no one here to help me....my life rushed in front of my eyes.

But wait...what a relief....

I realised the cat was sitting on top of my head and it was her heart I could hear!

Whew...I get to live another day!

Time to re-think midwifery conferences?

I have been following the discussion about the sponsorship of midwifery face-to-face conferences by infant formula and baby product companies, in the Facebook group: British Journal of Midwifery- You can't be Serious! The argument is that conferences are too expensive to run without sponsorship from these companies. My feeling is that if we have to compromise our professional integrity for the sake of a free pen and conference bag, then maybe it's time to re-think conferences and their appropriateness as professional development.

Too expensive?
Conferences have always been a popular mode of professional development for midwives. If nothing else, they are an opportunity to get away from the daily grind of life, family and work. Midwives love nothing more than meeting up with colleagues and having a good natter. I have often heard them saying the best part of a conference is the dinner when everyone lets their hair down, and when the serious networking is done. But I was recently horrified to see that a conference I was planning to attend later this year was charging $155 for the conference dinner, and $80 for the welcome reception. Honestly....I could feed my whole family at a restaurant for $150!! I don't know about you...but I just cannot afford those kinds of fees.

Effective learning?
Apart from being a financial and sustainability issue, conferences are now considered to be an ineffective model for professional development. Rather than one-off meetings that use a "one-size fits all" approach, professional development is effective when it takes a long-term view of learning, and is designed to meet individual learning needs. There also needs to be follow-up, and on-going support for professional development activities to have concrete outcomes.

Time to re-think?
I think it is time to re-think face-to-face conferences as a mode of professional development. Whilst they will always have their place, I think we need to be open to other ideas, and be creative about our approach to PD.

If we continue to value face-to-face meetings, I believe we need to consider how we can make them more affordable so that we do not need to rely on sponsorship. This may need us to turn the traditional conference format on its head...that expensive, luxury conference dinner has to go!

Are you up for it?!



References

TR Guskey. 1999. Evaluating professional development. Corwin Press. 

Lynn Anderson and Terry Anderson. 2010. Online Conferences: Professional Development for a Networked Era. Information Age Publishing.

S Stewart, M Sidebotham, and  D Davis. 2012.  International networking: connecting midwives through social media. International Nursing Review.

S Kildea., L Barclay. & P Brodie. 2006. Maternity care in the bush: using the internet to provide educational resources to isolated practitioners. Rural and Remote Health, 6, 1–12.

C McIntosh. 2007. Wise Women's Web: Rural Midwives' Communities of Practice.

J Patterson. & D Davis. 2007 New Zealand midwives and tertiary study. New Zealand College of Midwives Journal, 36, 13–19.

Birthzillas, wars and midwives

I have had many midwives say to me over the last few months that they don't want to engage with social media...that's it's a waste of time....and that it is irrelevant to their roles as midwives. I believe they are wrong. And it's the "Birthzilla" post that brought it home to me.

Online wars
If there's one thing I have noticed on the Internet, it is that there are many vocal opinions about childbirth. Nothing gets the blood heated (or nasty bullying) like an article on birth - the more extreme it is, the more comments it attracts. This is becoming particularly noticeable in the Australian media. Laureen Hudson, a social media expert, has talked about "war"...and that's what it feels like at times.

One recent example of these "online wars" is the post  "Birthzillas: when it’s all about the birth, not the baby", written by Mia Freedman, a few days ago. In this post, Mia talks about birth plans and the danger of focusing on the experience of birth,  to the detriment of the baby.

Scaremongering
This post garnered over 1,150 comments (which is a huge number for a blog post) with a diverse range of opinions. What has struck me is two things. Firstly, the amount of unsubstantiated, mis-information that is spread about. For example, Rita says "Homebirth has a 3x greater risk of fetal demise…how can anyone say they’re thinking of the baby when they choose it?" This is a very scary statement with no reference, no context, and is certainly is not my understanding of the research around home birth.

Cyberbullying
The second thing that is apparent is the passion displayed by commentators, and in some cases, darn right rudeness and nastiness. One commentator, who identified herself as a senior student midwife wrote,

"This article is a prime example of pure stupidity and ignorance. I am nearly registered as a midwife, and I can tell you that just because you have had a couple of babies, does not make you an expert in the safety or the science of birth...... Read the evidence and get your opinions off such a public forum! People are too ignorant and unaware to be exposed to this kind of crap – it only adds to the problem!"

The problem with this sort of comment is that it can incite further nastiness, and does not contribute constructively to discussion. And I am concerned about how it reflects on the midwifery profession.

I think it is important for midwives to get involved with discussions such as this, to provide evidence-based research to counteract the erroneous information that is propagated in some areas. But there are a couple of tricks to engaging in these discussions.

1. Know your evidence
Make it your aim to provide evidence-based information in a way that can be understood by the average mum, and link to that information, so mothers can check it out for themselves.

2. Do not engage in an emotional way
You must remember that everyone is entitled to their opinion. And also be mindful some writers like to be deliberately provocative to increase readership and comments (don't we all!). The aim of the game is to educate people, not get into flame wars. Here is Tara Moss's response to the Birthzilla article: In defence of birth plans. Tara resists the temptation to be rude, derogatory or patronising, but rather writes a reasoned, balanced response - a lesson for us all to remember.

3. Remember you are representing your profession
I'll be the first to admit that I have got caught up in flame wars. And however much you disagree with a writer, you must remember that you represent the profession as a whole. If you're in doubt about the topic of the discussion and the evidence you can contribute, my advice would be not to engage at all. Or at the very least, wait 24 hours before you comment, or run it by someone else before you post.


Do you comment in online discussions? What tips would you pass on about how to do it safely and professionally? Have you ever got yourself into "trouble" online? What did you do about it?


Image: 'untitled'
http://www.flickr.com/photos/48819968@N00/2926118160

VIDM 2012: Last committee meeting

We had our last Virtual International Day of the Midwife 2012 committee on Sunday evening. Here are the decisions and action plan that we agreed for the next few months, and for VIDM 2013 - you can find my report and much of the rationale for our decisions here: The Virtual International Day of the Midwife 2012: Final report

VIDM 2012 Last committee meeting
http://www.scribd.com/doc/98165816/VIDM-2012-Last-committee-meeting

Will the Virtual Birthing Unit ever make a come-back?

The other day I gave a talk in Second Life (SL) to the American Association of University Women,  Department of Women’s, Gender and Sexuality Studies at The Ohio State University, about midwifery in New Zealand, and the Virtual Birthing Unit, at the invitation of Dr Sharon Collingwood.

This was the first time I had been in SL for ages. I was very nervous about it, especially because there is now a new viewer. But I got around OK, and there were no technical hitches.

Learning in virtual worlds
My talk was the usual one I give about the challenges we face in educating midwifery students, and how simulation in virtual worlds such as Second Life can provide opportunities for authentic, yet safe learning. However, the Virtual Birth Unit has not been taken up in a global sense, because it was really a bit before its time ie it was too complex and time-consuming for lecturers and students who only had limited digital skills.

The future?
The issues that impact on the provision of adequate and quality clinical experience for healthcare students are not going away.  And as educators become more experienced with online technologies, and more programs are delivered in a blended way, I think the Virtual Birth Unit will come into its own.

I am not sure if it will be successful as it is - it may well be "re-born" in another form, in other virtual worlds such as Open Sim. And clearly there are a lot of things about sustainability to think about, when embedding an initiative such as this in an education program. But for the first time in over 18 months, I am feeling a lot more positive about the future of the Virtual Birth Unit and simulation in midwifery education.

How to make your CV stand out in the crowd?

I have been thinking about CVs lately, and wondering how to develop a CV that stands out, especially amongst other job applicants.

Video CV
There is quite a lot of talk about alternative formats, such as video CVs. This one by Graeme Anthony made quite a splash a couple of years ago. The snag with video, is you have got to know what you're doing, and make a proper job of it. I would imagine an amateur effort is likely to turn employers right off. And there's the issue of time...skimming through 300 odd paper CVs will be a lot easier than watching 300 videos.

LinkedIn
Some people are advocating LinkedIn as a CV. The problem with LinkedIn is that it takes a generalised approach to job hunting.  In other words, you cannot tailor your profile to suit specific jobs, in the same way you can with traditional CVs. Also, you are stuck with the LinkedIn format...there is little room for creativity.

Visual CV
Another way to provide a visual CV, other than video (and easier), is with a presentation software such as PowerPoint (like this one by Nicole Jenssen) or Prezi (such as this one by Kelsey Brannan). Or,  you can jazz up your CV with software specifically designed for the purpose,  such as Vizualize.me - here is my vizualize.me CV, which I made by directly importing my LinkedIn profile.

Creative CVs - a bridge too far?
Alison Doyle from About.Com says you don't see many paper CVs about these days. That might be true in the creative industries, and in the USA and UK, but it isn't true in health or education....and certainly is not true in New Zealand or Australia. But maybe it's time to change...are you prepared to risk it?!

Have you ever submitted a creative CV? What format did you use? How did you get on?

BTW: If you're interested in the difference between LinkedIn and paper CVs, have a read of this article by Gerrit Hall and the fascinating conversation that follows - there is some really interesting information about how recruiters look at CV etc: 6 Things on Your LinkedIn Profile That Shouldn’t Be on Your Resume