What are your tips and tricks for getting "back to midwifery basics"?

I am on the editorial committee of the Australian Midwifery News and we're looking for articles for the next edition which has "back to midwifery basics" as its theme. The deadline for submission to the editor is the 10th April, but I am sure that can be negotiated if you would be interested in submitting an article.

This has got me thinking about what I would say about how to get back to midwifery basics.

There are lots of things, especially clinical tips and tricks, that I could talk about, but I feel they all lead back to four key 'back to midwifery basics' principles:

• Work in partnership with women, preferably in a continuity model of care, to build a relationship so that both woman and midwife have trust and confidence in each other. This will lead to better clinical outcomes for women and improved job satisfaction and autonomy for midwives;
• Facilitate informed choice and decision-making by ensuring women have access to evidence-based information. Further, that women are supported to fully understand the implications of their decisions and able to plan their care. This is especially important to do in the antenatal period so that women are prepared for labour and birth, and once the baby comes. It needs time and care, and cannot be done in 5 minute antenatal appointments!
• Resist medical interventions that are unnecessary, unproven, have no impact on clinical outcomes and may even be harmful eg continuous fetal monitoring in labour.This takes time, strength and persistence; however, the maternity services are crying out for strong midwifery leadership in this area.
• Treat women and their families with respect, kindness, dignity, compassion and cultural sensitivity (not racism).   

 

If you are a midwife, what do you feel we should be "getting back" to? If you are a pregnant woman, what "basics" do you believe midwives should be focusing on?

Image: Chlot's Run https://www.flickr.com/photos/chiotsrun/5908995656

A new, free e-portfolio for midwives and nurses

For years now I have been exploring and experimenting with online systems to develop a universal e-portfolio for midwives and nurses that they could use from day one of their undergraduate education; for the rest of their careers.

I would have loved to have seen this come via the profession or (with a little hesitation) the regulator. However, this vision has not materialized, not least because of funding constraints.

So, it was with great interest that I have had a look at a new e-portfolio tool provided free of charge to Australian midwives and nurses by Ausmed. Ausmed is a company that specialises in nurse (and midwifery) CPD, providing online education, conferences and e-news update.

The Ausmed tool is very easy to use and can be downloaded as an app on one's portable device, as well as a web-based application. Portability is a very desirable function as it allows midwives and nurses to record their CPD and learning activities in real time, which facilitates greater accuracy and engagement. I know that I forget to record what I have learned after a study day etc, and am much less motivated to engage with my portfolio as time goes by. So being able to record on the job, so to speak,  makes life much easier, especially when it comes to meeting registration requirements for the Nursing and Midwifery Board of Australia (NMBA).

What I like about this tool is you can record activities other than the standard conference or study day, such as reading or mentoring, as well as reflect on your learning.  

You are able to upload documents, such as attendance certificates, as evidence of your learning and activities. There is also an ability to download a report as a pdf. 

As well as recording activities, the app allows you to develop a learning plan, which is the other component of the NMBA CPD requirement. 

The other thing I like is a section called "Fast CPD" which has short articles focused on particular topics of interest that update or teach. The only snag is that there are very little articles of relevance to midwives - hopefully that will be rectified soon.

The other cool thing the app does is keep a track of CPD hours and lets you know how many hours you must record in order to meet NMBA requirements, and how many more days you have to meet the requirement before the end of the registration year. 

My concerns about this innovation is that it is managed by a commercial company, who clearly say in their Privacy Policy that they will use your information for purposes such as analytics, marketing and research. They even say in their Privacy Policy that they may "disclose your personal information to overseas recipients for the purposes of providing services or products to you". I would be very careful about information I save in the app/tool, and especially careful about disclosing information relating to patients, clients or healthcare.  

Ausmed does say "Please contact Ausmed using the information contained at the bottom of the Ausmed Websites, our emails, and this Privacy Policy to restrict Ausmed's collection, disclosure and use of your Personal Information." This 'opt out' system is designed so that we are unlikely to do so; again, my advice is to very carefully read and consider the Privacy Policy and its impact on you as a health professional. 

I would also carefully read all the terms and conditions because I am not clear about the IP of content stored in the e-portfolio. The terms and condition say "grant us a perpetual, non-exclusive, royalty-free, irrevocable, worldwide and transferable right and licence to use that content in any way". This needs to be clarified by Ausmed.

Other questions I have that I will check out with Ausmed include:

• Where are the servers that keep our information? Are they in Australia liable to Australian laws, or overseas?
• What are Ausmed's long term plans for the app? Will it remain free, or will a fee be introduced soon?
• How often are backups carried out? What are the chances that data will be lost? 
• Is there a limit to the amount of data that can be uploaded into an entry?

In conclusion, the Ausmed CPD organiser, or e-portfolio looks like a very easy and relevant tool for midwives and nurses. However, it is being offered by a commercial company, so it's worth being aware that there will be something in it for Ausmed, and think about how that may impact on your professional practice.

Have your say! Consultation on the new Australian Maternity Services Framework

 

A pubic consultation is now open on the new Australian Maternity Services Framework. It's imperative that anyone with a stake in maternity; midwives, women, families, nurses, grandfathers...in other words...everyone....has their say! 

The 2010-2015 Maternity Services Plan came to an end a while ago.  A lot of good ideas and actions were embedded in the Plan, such as a commitment to midwifery continuity of care and support of Birthing on Country. There have been some successes, but we still have an incredible amount of work to do to address such outcomes as caesarean section rate of over 30%; twice the mortality rate of indigenous babies compared to non-indigenous babies, and suicide is still a leading cause of maternal mortality.   

One of my concerns with this new document is that it is a "framework" and not a plan. This means that the government outlines a "vision" and "principles" but abdicates the responsibility for implementation and evaluation back to the states and territories. This will lead to further inconsistency and inequities around Australia, which increases risk to the maternity services.

I am pleased to see that cultural safety and woman-centred care are key principles, but continuity of midwifery care is not identified as an enabler despite very strong, high level evidence that it makes a considerable difference to clinical outcomes. There is a brief mention of continuity of midwifery care toward the end of the Framework, and no talk of 'birthing on country' at all, which is very disappointing. 

My overall impression is that the Framework is very focused on screening for and preventing medical complications, which is right and proper, but lacks a more holistic, community approach to improving care for women and their families. 

Have you reviewed the Framework? What do you think? What do you think the Framework does well, and what additions would you like to see?

Don't forget! Have your say!: https://www.getinvolved.qld.gov.au/gi/consultation/3805/view.html

I am a nurse again!

After all these years of midwifery, I have reactivated my nurse registration.

I am bucking the trend in Australia because an increasing number of midwives are letting go of their nurse registration. This is because of a number of reasons, not least because midwives do not identify as nurses, and do not want to have to maintain two sets of regulatory requirements.

You could be forgiven for wondering how on earth I have managed to register as a nurse when I have such a prominent midwifery role. I have to say that it was a lot easier than I thought because so much of what I do in my day job can also be applied to nursing.

I don't have any plans to dash off and become the next Florence Nightingale. But I do think it's handy to have my nursing registration up my sleeve in case I ever decide to do something different one day, like work in a rural or remote area of Australia.

Are you a midwife who also has a nurse qualification? Have you maintained your nurse registration, or let it go?  How easy is it to maintain two professional registrations in your country?