A historical account of the governance of midwifery education in Australia and the evolution of the Continuity of Care Experience

Tierney, Olivia; Sweet, Linda; Houston, Donald; Ebert, Lyn

doi:10.1016/j.wombi.2017.09.009

Cited by 25 publications

(25 citation statements)

References 13 publications

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“…Midwifery has taken a different professional career path to nursing over the last 20 years, with midwives in Australia being separately registered and educationally prepared [15, 16]. Midwives are not commonly located in community-based practice with the vast majority of midwives working in hospitals [15].…”

Section: Introductionmentioning

confidence: 99%

Developing a community-based nursing and midwifery career pathway – A narrative systematic review

et al. 2019

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Introduction Community nursing and midwifery is changing in response to a shift in care from hospital to home, brought about by increasing costs to care because of an aging population and increasing chronicity. Until now, community nursing positions and scope of practice has been dependent on service focus and location, which has led to the role being unclearly defined. Lack of appeal for a career in community practice and a looming workforce shortage necessitates a review into how community nursing and midwifery transition to practice is supported. Methods This review sought to identify, assess and summarize available evidence relating to transitioning into community nursing and midwifery practice as a speciality. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. A narrative synthesis was then undertaken on papers that examined community nursing and midwifery pathway perspectives which define, and enable or inhibit a contemporary pathway. Thematic analysis used a theoretical framework developed for early career and rapid transition to nursing specialty practice. Results There is a paucity of research that identifies community nursing and midwifery as a discreet scope of practice. Twelve papers were eventually included in the review. Verbatim findings were extracted from the papers and clustered into categories based on the chosen theoretical framework. Major themes were ‘the self’ (professional and personal); ‘transition processes’; and, a ‘sense of belonging’. Sub themes included narrative identifying inhibitors and enablers in each theme. Discussion No definition of community practice or pathway was identified in nursing, although midwifery was clearly defined. Community nursing practice was described as generalist in nature although specialist knowledge is required. Being part of the community in the professional sense and personal sense was considered important. The importance of transition was identified where pre-entry exposure to community practice was seen as important. Stages in transition to practice were recognised as pre-entry; incomer; insider; and, a sense of belonging. The process of transition should be planned and individualised acknowledging past experience whilst acknowledging the specialist nature of community-based practice.

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Section: Introductionmentioning

confidence: 99%

Developing a community-based nursing and midwifery career pathway – A narrative systematic review

et al. 2019

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“…Some midwifery academics and organisations, such as the Australian College of Midwives, have expressed concern that the competing ideologies of nursing science -which is closer to a medical model of care -and midwifery can be confusing for students and counterproductive to their education as effective midwives (Kinnear, 2017;Leap et al, 2017). Despite the introduction of national registration and accreditation standards for midwifery education in Australia in 2010 (Sheehy et al, 2019;Tierney et al, 2018), concern remains that graduates of nursing/midwifery double degree programs are not able to produce midwives who align with current midwifery philosophy and are able to meet the needs of developing continuity of care models in Australia (Tierney et al, 2018).…”

Section: Literature Reviewmentioning

confidence: 99%

“…Midwifery education and the pathway to a midwifery qualification has undergone change in Australia since the burgeoning recognition of midwifery as a separate profession. Historically in Australia midwifery was subsumed within nursing and the pathway to a midwifery qualification was postgraduate education of already qualified registered nurses (Gray & Smith, 2017;McKenna et al, 2013;Tierney, Sweet, Houston, & Ebert, 2018). Additional pathways now available include undergraduate Bachelor of Midwifery programs, which were first introduced in Australia in 2002 (McLachlan, Newton, Nightingale, Morrow, & Kruger, 2013), and four year undergraduate double degrees in nursing and midwifery https://doi.org/10.1016/j.colegn.2019.07.004 1322-7696/© 2019 Australian College of Nursing Ltd.…”

Section: Introductionmentioning

confidence: 99%

“…This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/). (McLachlan et al, 2013;Tierney et al, 2018). These pathways were made possible as a result of considerable campaigning, research and effort by committed midwifery leaders and academics over the last few decades (Gray, 2019;Leap, Brodie, & Tracy, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Double degree destinations: Nursing or midwifery

et al. 2020

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Background: Double degrees in nursing and midwifery have evolved in Australia as a proposed solution to possible impending shortages of qualified midwives in the healthcare workforce. The double degree is seen as a more acceptable option in non-metropolitan areas in particular. Concern has been expressed however, about dilution of midwifery philosophy and graduates' opportunities in respect of future clinical practice. Aim: This study aimed to provide a better understanding of motivations and intentions of students who undertake the Bachelor of Nursing Science/Bachelor of Midwifery double degree. Methods: A cross-sectional survey design was employed at four universities that offered double degrees in nursing and midwifery in three states of Australia. Students enrolled in first and fourth year of a double degree and graduates of a double degree were invited to complete an online survey comprised of Likert scales and items requiring free text responses. Quantitative data was analysed using SPSS and thematic analysis was used to analyse the qualitative data. Findings: Participants indicated a clear preference for midwifery as a career with this preference increasing for each cohort at each stage of study. Discussion: Primary reasons for selecting a double degree were perceived increased opportunity for employment and use of nursing skills to enhance midwifery practice in a population with growing co-morbidities. A strong identification with midwifery philosophy and identity was also demonstrated. Conclusion: An understanding of motivations and career intentions of students undertaking double degree studies can inform future program development and workforce planning.

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“…With significant changes to midwifery education programmes and clinical practice in Australia (which advocate the ICM philosophy of midwifery and that pregnancy and childbirth are normal physiological processes), it is no longer routine practice for midwives to undertake a comprehensive antenatal physical examination for pregnant women (Chalmers, Mangiaterra, & Porter, ; Tierney, Sweet, Houston, & Ebert, ). However, it is beneficial to provide additional education for midwives on cardiac history, as well as assessment to address specific clinical issues for RHD for Indigenous women and recent migrants, as a component of culturally sensitive antenatal care (Bharj et al, ; Clarke & Boyle, ).…”

Section: Introductionmentioning

confidence: 99%

Cardiac conditions in pregnancy and the role of midwives: A discussion paper

et al. 2019

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Aim This paper provides an overview of the two broad categories of cardiac conditions observed in pregnancy (congenital and acquired). It also identifies the midwives' role in the childbirth continuum and includes assessment, track and trigger systems and management during labour and delivery. Design Discussion paper. Methods Data were collected by reviewing international evidence and by searching computerized databases. Results Research has identified that women with associated risk factors of a cardiac condition who delay pregnancy have an increased risk of experiencing cardiovascular complications in pregnancy with poorer outcomes. The Three Ps in a Pod clinical initiative in the United Kingdom highlights working as a team in multidisciplinary programmes to improve mothers' care and save lives. Midwives play a key role during pregnancy and need to be appraised in relation to cardiovascular disease observed in pregnancy, its potential risks and anticipated problems and within the continuum of care.

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A historical account of the governance of midwifery education in Australia and the evolution of the Continuity of Care Experience

Cited by 25 publications

References 13 publications

Developing a community-based nursing and midwifery career pathway – A narrative systematic review

Developing a community-based nursing and midwifery career pathway – A narrative systematic review

Double degree destinations: Nursing or midwifery

Cardiac conditions in pregnancy and the role of midwives: A discussion paper

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