Tuesday, January 13, 2009

Midwives and the working environment

I have written several posts about the effect of the physical environment on birthing women: What women want in the place where they give birth and Effect of the environment on labour and birth. But what about the effect of the physical environment on midwives: what do midwives feel about their working environment? These questions are important for us to consider as we design our virtual birth unit in Second Life.

What I want in my working environment
I hate fluorescent lights because they give me a headache. I want to be able to safely lock my possessions away, and have somewhere I can go for a quiet cup of tea and chat. I want to be able to dim lights for labouring women, but I also want good, flexible lighting so I can see clearly when I am doing important tasks like suturing. The most important environmental thing for me is that I can carry out tasks like catch a baby, suturing or support a woman to breastfeed in an ergonomic position in which my back is supported.

What the literature says
Symon et al (2008) found that midwives want their working environment to be clean and secure, with appropriate changing facilities. They also want good lighting, and good ventilation that will reduce cross infection.

Cross (1996) reported that midiwves wanted their working environment to be secure to prevent babies being snatched, and protect themselves against harassment and violent attacks from the general public.

The Robert Wood Johnson Foundation (2008) recommends these environmental features for health professionals:
  • convenient placements of sinks, soap dispensers etc to encourage hand-washing (to prevent cross-infection)
  • acoustic conditions to minimize noise pollution
  • ergonomic work spaces to prevent physical injury
  • excellent lighting to areas where there could be a risk of needle-stick injury.
If you are a midwife or health professional, what features do you think are essential for your working environment?

Cross, R. (1996). Midwives and Management. Hale: Books for Midwives.

Robert Wood Johnson Foundation. (2008). Environmental Change Recommendations for Ensuring an Optimal Health Care Workplace. Retrieved 13 January, 2009, from http://www.rwjf.org/pr/product.jsp?id=28827

Symon, A., Paul, J., Butchart, M., Carr, V., & Dugard, P. (2008). Maternity unit design study part 4: midwives’ perceptions of staff facilities. British Journal of Midwifery 16, 4, 228- 231.

Image: 'Ward at Alpha Hospital' tahitianlime


Tania said...

A seperate office, room, space? where I can do paperwork, talk confidentially with other midwives and take my shoes off.

Sarah Stewart said...

All good points, Tania. Thanks.

Buckeyebrit said...

An intutive environment I can find my way aorund with ease, one that I dont need to bring too much into conciousness (if that makes sense)!

Pamela Harnden said...

This is really interesting because they are building a new hospital here in Blenheim ( I say new in the slackest sense of the word as some buildings are being rehasshed) the maternity unit will be new. I`m not actually on the working group one of my other self employed colleagues is but the feedback from the core and LMC has been interesting. Myself I like to complete my paperwork record taking in the same room as the woman in a discreet corner. I prefer a quiet environment where I can connect emotionally with birthing events. I do need a separate coffee room to get a meal break and take a breath and kick shoes off but other than that i like to get off the unit as quickly as possible the environment is not my favourite place but the event of birthing is.

Sarah Stewart said...

I'd be interested to hear what your colleagues think, Pam.

Carolyn said...

I agree with most of the comments here. Like Pam I like to do as much record keeping as possible in the presence of the woman but I do need an office space for some office work not directly related to a particular woman. I like having some nice music playing in the background, something pleasant and calming my personal preference is probably some nice haunting Celtic stuff of course:). Everyone's preferences will vary as to what music they might like but I draw the line on heavy metal, not the place for it at all.
I also like some art on the walls again something interesting and aesthetically pleasing and everyone's tastes will differ. I like a painting I can look at and see different things in, that can absorb me a little during the hours I will spend there.
Nice sculptures around may also help to make the space more interesting I think. Perhaps a wee water feature?
There also needs to be some consideration for families. Women may want to have other children present during the birth so perhaps we need to consider their needs also. Make sure that all hazardous equipment is well out of the reach of children. have one or two interesting things for them to do.
Overall I want this space to feel relaxing and enjoyable, somewhere I am happy to spend time and where women and their whanau will enjoy being.

Pamela Harnden said...

One of the main sticking points on the development of the new unit has been office space. Currently we have 2 offices one at postnatal end and one smaller one at the labour ward end. Core staff wanted one large office, LMC staff wanted a dividing wall with possible access door, my suggestion of padlock on LMC side didn`t go down too well for some reason! The reason core staff gave for one big office was ease of communication the main reasons LMC`s gave was possible inteference from core staff, levels of noise when staff are handing over, constant phone calls. The point about core staff constantly asking where your 'woman' is up to and constantly saying 'do you not think you should be doing....' was highlighted by one midwife recently who left a comment on my blog. There was also a debate about womens/mens toilets we only have 3 men working on the unit 2 obstetricians and the Midwife manager the decision makers wanted to have one bathroom. The staff also wanted a shower available for staff.
As far as making the unit comfortable for Whanau and family then Andrea Robertson was involved in the building of the unit in Nelson and their unit is very woman focused, I find. I like the fact that the three birthing rooms open up into a private courtyard although the unit itself seems to resemble a rabbit warren.

Anonymous said...

I want abundant parking, a secure route from my car to the birth unit- refer indoor route, really nourishing spa type facilities to freshen up in - showers, teeth cleaning - revitalising etc, good kitchen facilities , a herb and vege garden, relaxing lounge and garden

Sarah Stewart said...

Email feedback:

i want somewhere to freshen up - it can get so grubby - nice bathroom facilites to shower, clean teeth and have a wee spruce up.
good place for midwives to have a lie down? or do you think this not necessary in a normal birth environment where women ideally only arrive in est labour and progress more quickly?

Yes, I do think these things are necessary because you never how long things will take or how a labour will pan out.