Advertisement
Research Article|Articles in Press

The experience of rural midwives in dual roles as nurse and midwife: “I’d prefer midwifery but I chose to live here”

      Abstract

      Objective

      To explore and describe the experiences of working in the dual role as nurse and midwife in rural areas of far north Queensland, Australia.

      Method

      The methodology was informed by Heidegger's interpretive phenomenological philosophy and data analysis was guided by van Manen's analytical approach. Data was generated by conversational interviews. Eight midwives working in a dual role as midwife and nurse were interviewed individually.

      Findings

      Three themes were identified: Making choices between professional role and lifestyle: “Because I choose to live here”; Integration of maternity and general nursing: “All in together this fine weather” and: “That's part of working in a small place”.

      Conclusion

      Participants recognized that in rural areas it is important to be a multi-skilled generalist; however they were concerned that midwifery skills could be eroded or even lost with the diminishing amounts of midwifery work available. Appropriate re-structuring of maternity services could provide better use of the midwifery workforce in rural centres, and reduce the current problems associated with transferring birthing mothers to larger facilities. Further research is needed to examine the extent to which the requirement to work in a dual, or multifaceted role is an impediment to the recruitment and retention of midwives to rural areas.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Women and Birth
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Hatem M.
        • Sandall J.
        • Devane D.
        • Soltani H.
        • Gates S.
        Midwife-led versus other models of care for childbearing women.
        Cochrane Database of Systematic Reviews. 2008; : 4
        • Jackson D.
        • Mannix J.
        • Daly J.
        Retaining a viable workforce: a critical challenge for nursing.
        Contemporary Nurse. 2001; 11: 163-172
        • Ireland J.
        • Bryers H.
        • Teilingen E.
        • Hundley V.
        • Farmer J.
        • Harris F.
        Competencies and skills for remote and rural maternity care: a review of the literature.
        Journal of Advanced Nursing. 2007; 58: 105-115
        • Francis K.
        • Mills J.
        Sustaining and growing the rural nursing and midwifery workforce: understanding the issues and isolating directions for the future.
        Collegian. 2011; 18: 55-60
        • Monaghan J.S.
        • Walker J.
        Delivery in the Bush: maintaining a skilled midwifery workforce in rural and remote Tasmania.
        in: Good health-Good country: 6th National Rural Health conference, Canberra, ACT2001
        • Fahey C.M.
        • Monaghan J.S.
        Australian rural midwives: perspectives on continuing professional development.
        Rural and Remote Heath. 2005; 5
        • Harris F.
        • Teijlingen E.
        • Hundley V.
        • Farmer J.
        • Bryers H.
        • Caldow J.
        • et al.
        The buck stops here: midwives and maternity care in rural Scotland.
        Midwifery. 2011; 27: 301-307
        • Reiger K.
        The politics of midwifery in Australia.
        Annual Review of Health Social Sciences. 2000; 10: 53-64
        • Lane K.
        Midwifery: a profession in transition.
        Australian Journal of Midwifery. 2002; 15: 26-31
        • Brodie P.
        The invisibility of midwifery – will developing professional capital make a difference (D. Mid).
        University of Technology, Sydney, Sydney2003
        • Tunc T.
        • Kutanis R.
        Role conflict, role ambiguity, and burnout in nurses and physicians at a university hospital in Turkey.
        Nursing and Health Sciences. 2009; 11: 410-416
        • Polit D.F.
        • Beck C.T.
        Nursing research: generating and assessing evidence for nursing practice.
        Lippincott, Williams and Wilkins, New York2008
        • Moloney M.F.
        Hermeneutic research doesn’t take a PhD.
        Journal of Nursing Scholarship. 1997; 29
        • Schneider Z.
        • Elliot D.
        • LoBiondo-Wood G.
        • Haber J.
        Nursing research: methods, critical appraisal and utilisation.
        2nd ed. Elsevier, Marrickville2005
        • Gill P.
        • Stewart K.
        • Treasure E.
        • Chadwick B.
        Methods of data collection in qualitative research: interviews and focus groups.
        British Dental Journal. 2008; 204: 291-295
        • Koch T.
        Establishing rigour in qualitative research: the decision trail.
        Journal of Advanced Nursing. 1994; 19: 976-986
        • van Manen M.
        Researching lived experience.
        State University of New York Press, London, Ontario1990
        • Barreca S.
        • Wilkins S.
        Experiences of nurses working in a stroke rehabilitation unit.
        Journal of Advanced Nursing. 2008; 63: 36-44
        • Whitehead D.
        The academic writing experiences of a group of student nurses: a phenomenological study.
        Journal of Advanced Nursing. 2002; 38: 498-506
        • Hegney D.
        • McCarthy A.
        Job satisfaction and nurses in rural Australia.
        Journal of Nursing Administration. 2000; 30: 347-350
        • Molinari D.
        • Monserud M.
        Rural nurse job satisfaction.
        Rural and Remote Heath. 2008; : 8
        • Hegney D.
        • McCarthy A.
        • Pearson A.
        Effects of size of health service on scope of rural nursing practice.
        Collegian. 1999; 6: 21-26
        • Lauder W.
        • Reel S.
        • Farmer J.
        • Griggs H.
        Social capital, rural nursing and nursing theory.
        Nursing Inquiry. 2006; 13: 73-79
        • Lenthall S.
        • Wakerman J.
        • Opie T.
        • Dollard M.
        • Dunn S.
        • Knight S.
        What stresses remote area nurses? Current knowledge and future action.
        Australian Journal of Rural Health. 2009; 17: 208-213
        • Daniels Z.
        • Vanleit B.
        • Skipper B.
        • Sanders M.
        • Rhyne R.
        Factors in recruiting and retaining health professionals for rural practice.
        The Journal of Rural Health. 2007; 23: 62-71
        • Hunsberger M.
        • Baumann A.
        • Blythe J.
        • Crea M.
        Sustaining the rural workforce: nursing perspectives of worklife challenges.
        The Journal of Rural Health. 2009; 25: 17-25
        • Mills J.
        • Birks M.
        • Hegney D.
        The status of rural nursing in Australia: 12 years on.
        Collegian. 2010; 17: 30-37
        • Krebs J.
        • Madigan E.
        • Tullai-McGuinness S.
        The rural nurse work environment and structural empowerment.
        Policy, Politics and Nursing Practice. 2008; 9: 28-39
        • Pinikahana J.
        • Happell B.
        Stress, burnout and job satisfaction in rural psychiatric nurses: a Victorian study.
        Australian Journal of Rural Health. 2004; 12: 120-125
        • Richards H.
        • Farmer J.
        • Selvaraj S.
        Sustaining the rural primary healthcare workforce: survey of healthcare professionals in the Scottish Highlands.
        Rural and Remote Heath. 2005; : 5
        • Ashcroft B.
        • Elstein M.
        • Boreham N.
        • Holm S.
        Prospective semistructured observational study to identify risk attributable to staff deployment, training, and updating opportunities for midwives.
        British Medical Journal. 2003; 327 (Available from: www.bmj.com [02.04.10])
        • Hegney D.
        • McCarthy A.
        • Rogers-Clark C.
        • Gorman D.
        Retaining rural and remote area health nurses.
        Journal of Nursing Administration. 2002; 32: 128-135
        • Hegney D.
        • McCarthy A.
        • Rogers-Clark C.
        • Gorman D.
        Why nurses are attracted to rural and remote practice.
        Australian Journal of Rural Health. 2002; 10: 178-186
        • Kaye D.
        • Mwanika A.
        • Sewankambo S.
        Influence of the training experience of Makerere University medical and nursing graduates on willingness and competence to work in rural health facilities.
        Rural and Remote Health. 2010; : 10
        • Brodie P.
        Addressing the barriers to midwifery – Australian midwives speaking out.
        Australian Journal of Midwifery. 2002; 15: 5-14
        • Kildea S.
        • Kruske S.
        • Barclay L.
        • Tracy S.
        Closing the gap: how maternity services contribute to reducing poor maternal infant outcomes for Aboriginal and Torres Strait Islander women.
        Rural and Remote Health. 2010; : 10
        • Tracy S.
        • Barclay L.
        • Brodie P.
        Contemporary issues in the workforce and education of Australian midwives.
        Australian Health Review. 2000; 23: 78-88
        • McKenna L.
        • Rolls C.
        Bachelor of midwifery: reflections on the first 5 years from two Victorian universities.
        Women and Birth. 2007; 20: 81-84
        • Kildea S.
        Risk and childbirth in rural and remote Australia.
        in: The art of science and community – sharing country know-how. 7th National Rural Health conference, Hobart2003