- Email: [email protected]
Controversy, clinical, competence and challenges-how they affect choice, control and continuity for midwives
Editorial
CONTROVERSY, CLINICAL, COMPETENCE AND CHALLENGES how they affect choice, control and continuity for midwives. Pauline Glover RM EdD FACM, Senior Lecturer in Midwifery, F[inders University Adelaide, GPO Box 2100, Adelaide SA 5001
There can be no doubts that at the current time the
students and so the list goes on. There is also the need
print, visual and oral media in Australia are fu[l of
to remember the Registered Midwife in this scenario as
controversia[ stories. The Tampa incident and the
she (or he) is continua[ly supervising someone e[se
a[legations of people throwing children into the water,
undertaking midwifery. It is a known fact that clinical
the allegations of sexual abuse cover up by the
supervision affects the way we practice and I am sure
Governor General when he was Archbishop of Brisbane,
that RMs must be very frustrated at times as they share
the rise in the costs of private health cover, the rise in
the clinical experiences. We need to ensure that the
medical costs as insurance premiums for doctors
clinical experiences are appropriately shared and that
are
tipped to increase and others both local and national.
at the end of the day everyone who is, or strives to be,
There is however, one controversial story that is not in
a midwife is able to m e e t the ACMI Competency
the media. In January, a South Australian univsersity
Standards for Midwives. These competencies have been
found that it did not have adequate insurance cover
developed as the minimum standard for midwifery
for midwifery students, medical students and faculty.
practice and need to be demonstrated to ensure that
The Univesrity's re-insurer withdrew the medical
we are safe to practice.
malpractice component of its insurance cover which left the primary insurer to seek cover e[sewhere. In effect this means that students practising in obstetrics and midwifery are not covered by the current insurance policy. The University's insurance broker has a t t e m p t e d to find cover with every insurance agency in Australia but has been unsuccessful. A submission has been sent to London to seek this cover. The events of September 11 and the HIH collapse are still having wide repercussions.
The National Midwifery News (February 2002) reported the outcome of a meeting held in July 2001 in Sydney which was called following the withdrawal of professional indemnity insurance for independent midwives. At this meeting midwives and consumer groups developed an action plan for the future of midwifery. It would seem that it is timely for midwives in the University sector to become active and ensure that when your University insurance policies are up for renewal that you do not have the problem that has
The prob[em for the South Australian university is that
occurred in South Austra[ia. I am aware that the
as the semester begins in the first week in March, the
matter was discussed at the Council of Deans of
faculty, students and midwifery advocates in South
Nursing meeting held in February so it shou[d not come
Australia will celebrate the arrival and c o m m e n c e m e n t
as a surprise to academics that this problem has
of the new Bachelor of Midwifery award knowing that
occurred.
one fight is won but another has begun. The new fight wi[[ be to ensure that adequate insurance cover can be found as soon as possible to ensure that the midwifery students can commence their clinical placements in a timely manner. With the decrease in birth numbers, the rise in women who have private health cover and the rise in intervention and Caesarean section rates the clinical experiences in the c[inica[ venues have changed. There are finite clinical experiences that are currently shared by midwifery students, midwifery reentry students, midwives who are up skilling, medica[
As midwives we are able to choose how we want to be educated and where and how we want to work. We have the capacity to control our work life by the choices we make. We can work in continuity of care models of midwifery that offer us the capacity to work in partnership with women or we can work in the hospital system offering our midwifery care in a more structured setting. Currently the independent midwives do not have this choice or control and the challenges are still before them to practice how they
VOL 15
NO I
MARCH 2002
3
want to and how women want them to.
Letters to the Editor
We know that the midwifery workforce is aging and we know that there is a problem with recruitment and retention of midwives. We also know that many small community organisations and groups are currenUy affected by rising insurance premiums. Many are just shutting their doors. We do not want and cannot have midwifery shutting the doors. We have to be proactive in ensuring that the controversies that face us today
The article by Liz Newnham in the December journal used a reference of the wonderful work Effective Care in Pregnancy and Childbirth by Erskin, Chalmers and Kierse, when I am sure Liz meant Enkin, Kierse and Chatmers. I thoroughly enjoy the new format, keep up the good work.
become our challenges for tomorrow. We need to keep
Ron Hastie
a watching brief on events and plan to prevent
KYM, Royal Hobart Hospital
disasters happening. For the moment this means that Universities must ensure that the medical malpractice
EDITOR'S NOTE
component of their insurance policy is not withdrawn. If this happens and we cannot provide medical
Thanks for this Ron. You are of course correct. Myself
malpractice insurance for the clinical component of
and the Editoriai Board wiU take more care when
the education program with the student in a
checking references. I am just glad that everyone
supernumerary capacity, will we have the 'theoretical'
knows the wonderful work of Enkin, Kierse and
midwife? What responsibility does the midwifery
Chaimers.
employer have to ensure that they have a midwifery
Pauline Glover
workforce? Could they pay a wage for students to work as a Registered Nurse in the midwifery setting? How would they define the role of the Registered Nurse as different to the rote of the midwifery student? How would the activities that they do be classified? What of the student who is not a Registered Nurse undertaking
International Midwives Day
the three - year Bachelor of Midwifery? Does the state/ territory health department have any responsibility to
5th. May 2002
ensure a competent and appropriately educated workforce? What will happen if insurance cannot be secured? It is clear that there is controversy and many issues
The National Office of the College will be distributing Lucina Rose p i n s to sell.
still ahead for midwifery in this country. We need to be ever seeking clinical opportunities for our students that enhance their learning and understanding of the
Tattoos Blooming Midwifery (IMD) to sell
role of the midwife that is cognisant of the need to keep the woman as the centre of care. We need to rise to challenges that face midwifery and work together to ensure that the choice, control and continuity for midwives is achieved.
Posters M i d w i f e r y Today - c o m p l i m e n t a r y ACMI C o l l e c t i o n available as per brochure Calendar of events for the States is b e i n g d e v e l o p e d . Please s e n d i n f o r m a t i o n about State Activities to the National Office b y 12th. April, 2002. J o h n s o n s ' b a b y M i d w i f e of the Year Awards w i l l be made to State Recipients and to the National Awardee
Further inquiries please contact [email protected] or tel: 1300 360 480
4
AUSTRALIAN COLLEGE OF MIDWIVES INCORPORATED
CONTROVERSY, CLINICAL, COMPETENCE AND CHALLENGES how they affect choice, control and continuity for midwives. Pauline Glover RM EdD FACM, Senior Lecturer in Midwifery, F[inders University Adelaide, GPO Box 2100, Adelaide SA 5001
There can be no doubts that at the current time the
students and so the list goes on. There is also the need
print, visual and oral media in Australia are fu[l of
to remember the Registered Midwife in this scenario as
controversia[ stories. The Tampa incident and the
she (or he) is continua[ly supervising someone e[se
a[legations of people throwing children into the water,
undertaking midwifery. It is a known fact that clinical
the allegations of sexual abuse cover up by the
supervision affects the way we practice and I am sure
Governor General when he was Archbishop of Brisbane,
that RMs must be very frustrated at times as they share
the rise in the costs of private health cover, the rise in
the clinical experiences. We need to ensure that the
medical costs as insurance premiums for doctors
clinical experiences are appropriately shared and that
are
tipped to increase and others both local and national.
at the end of the day everyone who is, or strives to be,
There is however, one controversial story that is not in
a midwife is able to m e e t the ACMI Competency
the media. In January, a South Australian univsersity
Standards for Midwives. These competencies have been
found that it did not have adequate insurance cover
developed as the minimum standard for midwifery
for midwifery students, medical students and faculty.
practice and need to be demonstrated to ensure that
The Univesrity's re-insurer withdrew the medical
we are safe to practice.
malpractice component of its insurance cover which left the primary insurer to seek cover e[sewhere. In effect this means that students practising in obstetrics and midwifery are not covered by the current insurance policy. The University's insurance broker has a t t e m p t e d to find cover with every insurance agency in Australia but has been unsuccessful. A submission has been sent to London to seek this cover. The events of September 11 and the HIH collapse are still having wide repercussions.
The National Midwifery News (February 2002) reported the outcome of a meeting held in July 2001 in Sydney which was called following the withdrawal of professional indemnity insurance for independent midwives. At this meeting midwives and consumer groups developed an action plan for the future of midwifery. It would seem that it is timely for midwives in the University sector to become active and ensure that when your University insurance policies are up for renewal that you do not have the problem that has
The prob[em for the South Australian university is that
occurred in South Austra[ia. I am aware that the
as the semester begins in the first week in March, the
matter was discussed at the Council of Deans of
faculty, students and midwifery advocates in South
Nursing meeting held in February so it shou[d not come
Australia will celebrate the arrival and c o m m e n c e m e n t
as a surprise to academics that this problem has
of the new Bachelor of Midwifery award knowing that
occurred.
one fight is won but another has begun. The new fight wi[[ be to ensure that adequate insurance cover can be found as soon as possible to ensure that the midwifery students can commence their clinical placements in a timely manner. With the decrease in birth numbers, the rise in women who have private health cover and the rise in intervention and Caesarean section rates the clinical experiences in the c[inica[ venues have changed. There are finite clinical experiences that are currently shared by midwifery students, midwifery reentry students, midwives who are up skilling, medica[
As midwives we are able to choose how we want to be educated and where and how we want to work. We have the capacity to control our work life by the choices we make. We can work in continuity of care models of midwifery that offer us the capacity to work in partnership with women or we can work in the hospital system offering our midwifery care in a more structured setting. Currently the independent midwives do not have this choice or control and the challenges are still before them to practice how they
VOL 15
NO I
MARCH 2002
3
want to and how women want them to.
Letters to the Editor
We know that the midwifery workforce is aging and we know that there is a problem with recruitment and retention of midwives. We also know that many small community organisations and groups are currenUy affected by rising insurance premiums. Many are just shutting their doors. We do not want and cannot have midwifery shutting the doors. We have to be proactive in ensuring that the controversies that face us today
The article by Liz Newnham in the December journal used a reference of the wonderful work Effective Care in Pregnancy and Childbirth by Erskin, Chalmers and Kierse, when I am sure Liz meant Enkin, Kierse and Chatmers. I thoroughly enjoy the new format, keep up the good work.
become our challenges for tomorrow. We need to keep
Ron Hastie
a watching brief on events and plan to prevent
KYM, Royal Hobart Hospital
disasters happening. For the moment this means that Universities must ensure that the medical malpractice
EDITOR'S NOTE
component of their insurance policy is not withdrawn. If this happens and we cannot provide medical
Thanks for this Ron. You are of course correct. Myself
malpractice insurance for the clinical component of
and the Editoriai Board wiU take more care when
the education program with the student in a
checking references. I am just glad that everyone
supernumerary capacity, will we have the 'theoretical'
knows the wonderful work of Enkin, Kierse and
midwife? What responsibility does the midwifery
Chaimers.
employer have to ensure that they have a midwifery
Pauline Glover
workforce? Could they pay a wage for students to work as a Registered Nurse in the midwifery setting? How would they define the role of the Registered Nurse as different to the rote of the midwifery student? How would the activities that they do be classified? What of the student who is not a Registered Nurse undertaking
International Midwives Day
the three - year Bachelor of Midwifery? Does the state/ territory health department have any responsibility to
5th. May 2002
ensure a competent and appropriately educated workforce? What will happen if insurance cannot be secured? It is clear that there is controversy and many issues
The National Office of the College will be distributing Lucina Rose p i n s to sell.
still ahead for midwifery in this country. We need to be ever seeking clinical opportunities for our students that enhance their learning and understanding of the
Tattoos Blooming Midwifery (IMD) to sell
role of the midwife that is cognisant of the need to keep the woman as the centre of care. We need to rise to challenges that face midwifery and work together to ensure that the choice, control and continuity for midwives is achieved.
Posters M i d w i f e r y Today - c o m p l i m e n t a r y ACMI C o l l e c t i o n available as per brochure Calendar of events for the States is b e i n g d e v e l o p e d . Please s e n d i n f o r m a t i o n about State Activities to the National Office b y 12th. April, 2002. J o h n s o n s ' b a b y M i d w i f e of the Year Awards w i l l be made to State Recipients and to the National Awardee
Further inquiries please contact [email protected] or tel: 1300 360 480
4
AUSTRALIAN COLLEGE OF MIDWIVES INCORPORATED