Encountering the culture of midwifery practice on the postnatal ward during Action Research: An impediment to change

McKellar, Lois; Pincombe, Jan; Henderson, Ann

doi:10.1016/j.wombi.2009.02.003

Cited by 10 publications

(9 citation statements)

References 35 publications

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“…Staff attitudes are dependent on existing policies in maternity care, both national and local. A recent Australian report (McKellar et al. 2009) pointed out that changes in care are not possible when staff feel a lack of ownership in the process of change.…”

Section: Discussionmentioning

confidence: 99%

“…Staff attitudes are dependent on existing policies in maternity care, both national and local. A recent Australian report (McKellar et al 2009) pointed out that changes in care are not possible when staff feel a lack of ownership in the process of change. This emphasizes the importance of discussing research findings and care policy at the care delivery level, in order to allow staff to be part of a policy-making team.…”

Section: Being Met As An Individual and Being Given Relevant Informationmentioning

confidence: 99%

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Mothers’ sense of security in the first postnatal week: interview study

Persson¹,

Fridlund²,

Kvist³

et al. 2010

Journal of Advanced Nursing

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1 ) Mothers' sense of security in the first postnatal week: interview study. AbstractAim. This paper is a report of a study of factors which influence mothers' sense of security during the first postnatal week. Background. Mothers' sense of security the first postnatal week is not thoroughly elucidated in the literature.Methods. An interview study with a qualitative descriptive design was carried out, using thematic content analysis. Fourteen mothers from three hospital uptake areas in Southern Sweden were interviewed using focus group discussions and individual interviews between May 2008 and March 2009. Findings. Postnatal sense of security was dependent on support from staff, support from family and the capacity and health of the woman and the baby, and these themes had categories and sub-categories, including: Being met as an individual, Being given relevant information, Being prepared for the time after birth and Having someone to turn to -knowing who to ask, Having partner and/or significant others close at hand, Mother's and the baby's own resources, Being assured that her own physical health was good, and Having planned follow-up regarding the baby's health after discharge. Conclusion. Staff attitudes should be continually discussed at all units providing maternity care. These discussions should include attitudes towards the father and the significance of his presence for the wellbeing of the family. Continued postbasic staff education in, for example, counselling and communication is necessary if services are to be improved so that parents' individual needs can be met. Preparation for the early postpartum period is important and all information given must be consistent, in particular information about breastfeeding.

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Section: Discussionmentioning

confidence: 99%

Section: Being Met As An Individual and Being Given Relevant Informationmentioning

confidence: 99%

Mothers’ sense of security in the first postnatal week: interview study

Persson¹,

Fridlund²,

Kvist³

et al. 2010

Journal of Advanced Nursing

View full text Add to dashboard Cite

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“…The coping strategies identified -task orientation, workload reduction and resistance to change -have all previously been reported among stressed and overburdened midwives both in the UK and Australia (Hunter et al 2008;McLachlan et al 2008;McKellar et al 2009;Deery and Hunter 2010). They enable midwives to regain some control over their daily activities (Dykes 2006;Deery and Hunter 2010).…”

Section: Mechanisms Supporting Non-compliance: Coping Strategiesmentioning

confidence: 93%

“…UK, Australian and Swedish studies all describe postnatal wards as bureaucratic, stressful, task-orientated environments where midwifery encounters with women are often formulaic and brusque (Deery 2005;Lindberg et al 2005;Dykes 2006;McKellar et al 2009). This is likely to make introducing support interventions, which require a more relational approach to care, particularly challenging.…”

Section: Introductionmentioning

confidence: 99%

‘Oh no, no, no, we haven׳t got time to be doing that’: Challenges encountered introducing a breast-feeding support intervention on a postnatal ward

2015

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Citation: Hunter, L., Magill-Cuerden, J. and McCourt, C. (2015). 'Oh no, no, no, we haven't got time to be doing that': Challenges encountered introducing a breast-feeding support intervention on a postnatal ward. Midwifery, 31(8), pp. 798-804. doi: 10.1016Midwifery, 31(8), pp. 798-804. doi: 10. /j.midw.2015 This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent Implications for practice:Midwives and maternity support workers need to be able to control their time and space, and feel able to provide the relational care they perceive that women need, before breastfeeding support interventions can be successfully implemented in practice. Frustration with current ways of working, and a willingness to consider other approaches, could be harnessed to initiate change that would benefit health professionals and the women and families in their care. However, without appropriate leadership or facilitation for change, this could alternatively encourage learned helplessness and passive resistance.Hunter L, Magill-Cuerden J, McCourt C 2015 2

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“…These challenges have been exacerbated in midwifery in the UK in recent years by a rising birth rate, a national shortage of midwives and a growing number of women entering pregnancy with complex social and physical needs (Hunter and Warren, 2014). Overstretched maternity services are a trend shared with other countries, and have resulted in time-pressed, frustrated and exhausted midwives-potentially leading to a rushed, brusque or chaotic approach to care (Lindberg et al, 2005;Dykes, 2006;McLachlan et al, 2008;McKellar et al, 2009;Deery and Hunter, 2010). Recent observational research found that time pressures on a UK postnatal ward were exacerbated by midwives having little control over their time, the organisation of their space or access to the women in their care (Hunter, 2014;Hunter et al, 2015).…”

Section: Workplace Stressmentioning

confidence: 99%

Mindfulness in maternity: Evaluation of a course for midwives

Warriner

Hunter

Dymond

2016

British Journal of Midwifery

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Stress and burnout are endemic in the NHS and the midwifery profession, having a negative impact on the health and wellbeing of individual midwives and on retention and recruitment for the profession as a whole. Stress can also have a negative impact on the care of women as midwives seek to manage their stress levels by employing strategies such as task orientation. As part of a larger project to engage staff in personal and workplace wellbeing, the Oxford University Hospitals NHS Foundation Trust maternity services provided staff with the opportunity to learn the practice of mindfulness meditation. An 8-week course was made available with the intention of supporting staff to manage stress and anxiety, increase resilience and self-compassion, and improve the culture of the organisation as a whole. Evaluations carried out immediately post-course and after 4-6 months indicated a positive impact in both personal and organisational domains.

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Encountering the culture of midwifery practice on the postnatal ward during Action Research: An impediment to change

Cited by 10 publications

References 35 publications

Mothers’ sense of security in the first postnatal week: interview study

Mothers’ sense of security in the first postnatal week: interview study

‘Oh no, no, no, we haven׳t got time to be doing that’: Challenges encountered introducing a breast-feeding support intervention on a postnatal ward

Mindfulness in maternity: Evaluation of a course for midwives

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