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What makes a good midwifery manager? Satisfaction vs Dissatisfaction in the workplace

Reducing stress and fatigue among maternity staff is key to reducing baby deaths and brain injuries during childbirth, according to a detailed new analysis published by the Royal College of Obstetricians and Gynecologists.

This ‘each baby counts’ initiative confirms that “Decision-making is more difficult when staff feel stressed or tired”.

“This report shows that there is a need for additional support for our maternity staff and units so that every mother and every family has the healthiest possible outcome from pregnancy and birth,” said Judy Ledger, founder and chief executive of the charity Baby LifeLine.

This news supports my own research quest, as I work to find new interventions to support midwives in work-related psychological distress.

This state of affairs also suggests that it may be prudent to do all that we can to ensure midwife satisfaction in the workplace. In fact, anything good in the workplace has to be safer/better than the bad stuff right?

At the 31st International Confederation of Midwives’ Triennial Congress held in June 2017, I stumbled upon an interesting research presentation on what could promote satisfaction/dissatisfaction in the midwifery workplace. More specifically, the characteristics of midwifery management behaviors were used to demonstrate what might promote satisfaction and dissatisfaction in managerial relationships. I will translate my brief notes from the session here:

In promoting workplace satisfaction, a midwifery manager:

  • Is supportive
  • Respects, values and appreciates midwives
  • Is an advocate for staff
  • Follows through on promises
  • Facilitates new ventures and learning
  • Cares for staff
  • Is aware of stressors

In promoting workplace dissatisfaction, a midwifery manager:

  • Is punitive
  • Is demanding
  • Is inconsistent
  • Is ineffectual
  • Is ‘Terrible’
  • Tolerates or perpetrates bullying
  • Does not listen

Not a big shock here right?…I mean it’s not rocket science. Nevertheless, this knowledge must be shared in order to promote healthy workplace cultures in the pursuit of excellence in maternity care.

The best midwifery care can only be delivered by midwives at their best…. Can we all begin to set our working day by these rules? Can we all be a little kinder? caring?..respectful to one another?

fist pump

This was just one of the many things learnt at this year’s 

In time, I will try to share more about why 

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

 

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“Midwifery…It’s about the birth of humanity…” #zepherinalecture17

This is just a short post to summarise this year’s  hosted by the . What an inspiring day in midwifery it was.

Zepherina Veitch (1836-1894) was a midwife who put her energies into the cause of midwifery reform. I can identify with this, as my own work focuses largely on supporting the midwifery profession. As we improve….we make reforms. I whole heartedly want midwives to become leaders and agents of change for a better future. I just happen to believe that the midwifery profession will only reach it’s true potential once midwives are adequately supported in the workplace.

Much of the lecture given by the inspiring   was focused upon ‘the woman’s experience’. Whilst we all aspire to deliver the best experiences for the women we care for, I couldn’t help but add on these words to each phrase ‘and midwives too’…

cover image for caring to change reportBut then this document appeared.

Caring to change

How compassionate leadership can stimulate innovation in health care…

Here, we begin to see how compassion in the workplace can stimulate excellence in the healthcare services….If we care to change. Compassionate leadership turns into a compassionate workplace culture…

This lecture also focused on the development of humanised care in favour of medicalised care. A no brainer right?…Perhaps we can ‘humanise’ the workplace for midwives too?

After all….We need more midwives right?

But the pinnacle of this event was seeing the pinnard being handed from today with her final flourish and welcome to  …the new president of the Royal College of Midwives

Also…a huge congratulations go to Onya,   and – new fellows of the . 👏🏽👏🏽😀💜

But at the end of the day…I got to meet some of the most inspirational midwives…one of those being the wonderful  …I can certainly recommend next year’s  ..come along and be inspired!.. Because we all need a little positivity in our lives! You get it with midwifery….”It’s about the birth of humanity…” after all…

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤

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Debunking Midwifery Myths

New article published here: Oh baby: seven things you probably didn’t know about midwives

…please share it widely!

dad with baby

As I am now coming to the end of my PhD (With lot’s of new and exciting things on the horizon I hope), I have been delving into the depths of the largest global online survey of midwives to date – the voices of over 2470 midwives in 93 countries!

Not only is this really an awesome and very important piece of work… it also holds some quite harrowing findings for our beloved midwifery profession. Yet this report also indicates that – if the voices of midwives are listened to, and if midwives are enabled to overcome gender inequalities and assume positions of leadership – quality of care can be improved for women and newborns globally. Wow….OK…we had better get to work then!

ALSO…

“Professionally, 89% of respondents reported that a clear understanding of what midwifery involves is critical for change to take place. Concerns were also expressed over the perceived devaluing of midwifery combined with the increasing medicalisation of birth.”

 

baby on blue

Professionally, the participants expressed concern about a lack of understanding of what “midwifery” is, the devaluing of the midwifery profession combined with the increasing medicalisation of birth, and the underlying weakness in midwifery education and regulation.

Now, I don’t claim to be able to fix the world in a day..but there was one thing that I thought I may be able to do from behind my PC. I could get an article published in @ConversationUK about the midwifery profession…perhaps I could even debunk some myths and set the record straight!…

I had my article published…please share it widely via the link below:

Oh baby: seven things you probably didn’t know about midwives

Now I was limited in this article. Limited in words and in how many points I was able to make in one article…editors need to keep their publications engaging!..and so yes…I did not manage to publish everything in this article as I would have liked to…and yes there are many many more myths about midwives that need to be debunked. But I am hoping that this will the a start of a new conversation.

Midwifery is defined as “skilled, knowledgeable and compassionate care for childbearing women, newborn infants and families across the continuum from pre-pregnancy, pregnancy, birth, postpartum and the early weeks of life” and it should be celebrated at every opportunity.

Let’s keep the conversation going around the importance of the midwifery profession. Midwives are crucial to the delivery of high quality maternal and newborn care and subsequent reductions in maternal and newborn mortality around the world. Yet they must be celebrated, respected and supported.

The core characteristics of midwifery include “optimising normal biological, psychological, social and cultural processes of reproduction and early life, timely prevention and management of complications, consultation with and referral to other services, respecting women’s individual circumstances and views, and working in partnership with women to strengthen women’s own capabilities to care for themselves and their families” – Can we start to spread the word on this now please?

baby on back

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤

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A reflection on #internationaldayofthemidwife (#IDM2017)

International day of the midwife

Happy #internationaldayofthemidwife or () as it is indeed the 5th of May 2017. I wanted to do a quick reflection (and a little dance of happiness) about the fact that the focus of this year’s International Day of the Midwife is…

 “Midwives, Mothers and Families: Partners for Life!”

With messages coming from the International Confederation such as…”It is very important that midwives and mothers both acknowledge the reciprocity of their relationship” – Scarlett

Yes…..we work in PARTNERSHIP with women and their families!…mothers, families and midwives are all equal partners….this means that we can finally break the mold and state openly that we, as midwives can also be prioritised!…Fabulous!

I have often wondered whether terms such as ‘Patient comes first’ is really healthy…as it is terms like this which often infer that midwives come second at best. What do you think?

service and sacrifice

I have also been picking up on some other great messages, pictures and videos this ..such as…..

 

 

I have also been dipping in and out of the Virtual International Day of the Midwife conference sessions a FREE conference that happens online every year….I have presented my work at  () before, and it is such a great opportunity to get people together in one place from all over the world!

This year for  I have recorded a podcast ‘Made by midwives for midwives’. Hosted by London based midwives Anthonissa Moger and Kate Whatmough….  (The Midwifery Podcast: Os closed, go home.)..I will be sharing this in an upcoming blog post…but for now..I am off to enjoy the rest of …there is such positivity in the midwifery world today…Let’s keep the momentum going ❣🎓❣

 

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤

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Mindfulness and Self-Care in Midwifery

As my main research interests are firmly rooted within supporting a positive staff experience for healthcare workers, especially midwives in work-related psychological distress, I am always looking for new opportunities to share knowledge with others in this area. …The Global Alliance for Nursing and Midwifery (GANM) is a joint project sponsored by the Pan American Health Organization (PAHO) and the World Health Organization (WHO) Collaborating Center for Nursing Knowledge, Information Management & Sharing at the Johns Hopkins School of Nursing. This blog post provides an overview of a webinar session hosted by GANM entitled “Mindfulness and Self-Care in Midwifery:  Review of Current Evidence and Guided Mindfulness Practice.

For a preliminary introduction to this topic – check out an earlier blog post on this topic entitled “Midwife Burnout: A Brief Summary“.

downtimes

Erin Wright, DNP, CNM, APRN-BC, led the conversation…Participants were diverse, and originated from Canada, Peru, US (Baltimore, Urbana, Birmingham, Atlanta, Buffalo), Ireland, UK (Coventry University and School of Healthcare Sciences Cardiff), Brazil, Montserrat, and Trinidad.

The full webinar can be accessed here.

Much of the research covered, has also been captured within my earlier narrative review: Pezaro, Sally, et al. “‘Midwives Overboard!’Inside their hearts are breaking, their makeup may be flaking but their smile still stays on.” Women and Birth 29.3 (2016): e59-e66.

However, there were some new and interesting comparisons made with more recent research here…

“Four common themes have been identified that traverse the different models of care. The NZ study provides insight into how case load midwifery can be sustainable enabling long term sustainability. The UK study highlights healthy resilient practices that enable practice. What remains uncertain is how models of care enable or disable sustainable long term practice and nurture healthy resilient behaviours within the different models of care”.

comparisons

“The notion of resilience in midwifery as the panacea to resolve current concerns may need rethinking as the notion may be interpreted as expecting midwives ‘to toughen up’ in a working setting that is socially, economically and culturally challenging.”

Sources (Crowther, Susan, et al. “Sustainability and resilience in midwifery: A discussion paper.” Midwifery 40 (2016): 40-48.)

So we are now much enlightened as to how and why midwives are experiencing distress, we also have some insights into how they try to cope (or not)…and where this distress may affect maternity services…but what we are yet to learn, is what may be most effective in supporting midwives in work-related psychological distress…although a few clues are emerging….

Mindfulness is coming forward as a potential tool of support..stress management, education and clinical supervision may also be of benefit to midwives in distress…But how, why and how much is not yet clear.

After exploring the literature in relation to psychological distress in midwifery populations, we were all invited to join in some mindfulness practice..What is mindfulness?

Image result for mindfulness

 

Feeling overwhelmed?…TRY….R.A.I.N

RRecognize What’s Going On

AAllowing: Taking a Life-Giving Pause

I—Investigating with Kindness

NNatural Loving Awareness

Source: Mindful.org

relation-ships

Recommended further reading

Youtube presenters:

  • Jon Kabat Zinn
  • Elisha Goldstein
  • Tara Brach
  • Sharon Salzberg

Websites/Audio Links:

Books: 

  • A Mindfulness Based Stress Reduction Workbook (Goldstein and Stahl)
  • Everyday Catastrophe Living (Jon Kabat Zinn)
  • Wherever you go there you are (Jon Kabat Zinn)
  • Mindfulness for Beginners (Jon Kabat Zinn)
  • Real Happiness (Sharon Salzberg)
  • The Mindful Nurse (Carmel Sheridan)

For more mindfulness exercises, visit the UCLA Mindfulness Awareness Research Center.

book-mark

Thanks for a very insightful and informative session!

Until next time…Look after yourselves & each other 🦄💫🎓

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The 5 stages of academic rejection grief

Image result for temper

An academic career has been described as a journey filled with brutal, unrelenting rejection. I frequently find myself having to pick myself up from rejection. It is hard.

In academia..your peers will be some of the most intelligent, creative and driven people in the world. – I have found this to be very true. I am in awe of them all.

Additionally, from the inside, all you ever see is tweets and Facebook posts about how everyone else is winning awards, being featured by the press, or getting cited a thousand times.….Yes. I am constantly celebrating the achievements of my peers…. this is wonderful!…but yes… this does make my own rejections even harder.

Whether it is a paper in a journal, a grant application, your viva or an idea that you have lovingly nurtured and come to love and cherish, there are 5 stages of rejection grief that are more or less inevitable (for me anyway).

Having your work rejected can feel like you have just spent a lifetime nurturing and rearing a beloved child, only to find out that it has grown into an evil and murderous human being in need of ‘Major revisions’!

Image result for chucky

1. Denial and isolation

This is wrong. It cannot be. I was so certain that my work was beautiful!…I don’t want to talk about it 😦

2. Anger

How dare the reviewer pull apart my work in this way…do they know nothing???!!

3. Bargaining

OK, I will take a look at the revisions. I will accept comment 4 and 5, but I’m not doing what reviewer 3 wants!

4. Depression

Gah!….these revisions are so laborious and depressing.

5. Acceptance

Oh…OK…phew… it is done. I am happy with it. I am at peace and ready to resubmit!

Image result for who said everything will be alright in the end and if

Feedback is golden…but it can be challenging to accept…it feels like rejection….but we are all actually moving forward ..all of the time. See here about the importance of feedback. I don’t believe that managers, reviewers or examiners are out to get us (not all of them anyway)….and so we must remember that none of this is personal. It is not a rejection of you as an entity, it is a very subjective point of view which may actually improve the work you do.

Try to portray humility and gratitude…Rather than any knee jerk feelings…

Image may contain: 1 person, meme and text

“I’m sorry… you’ve got major revisions to do”

Work that needs major revisions? How will people judge that? How will I be judged? is everything I thought I knew a lie?..what would another reviewer have said? (Most of the time the reviewers all want different things in any case)!

Self doubt, career doubt, black and white thinking and a feeling of doom sets in. ‘I am not good enough’…I begin to catastrophise. But then I reflect…what is really behind success?

Image result for iceberg of success

I think that my approach to revisions needs major revisions. I continue to work on these revisions daily….

Every piece of work that I have ever revised following feedback or rejection has improved. Yet every time…I have to put all of my toys back into my pram before I begin the process of making any changes. I go back and forward around the 5 stages of academic grief..round and around…but it always ends up fine in the end….mostly it ends up better.

I live in constant fear of rejection, failure and disappointing those who I respect most… But we must try to get over our fear of failure and rejection, or we loose the opportunities we have to learn and grow.

Remember…things always feel better in the morning…you will not always feel this way. The cure for academic rejection grief is not always instant success…it is compassion for both yourself and others.

Until next time, take care of yourselves and eachother ⭐🎓⭐

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💚💜❤Preventing Birth Trauma at #artofbirth16💚💜❤

Recently, I was asked by Dr. Gloria Esegbona from the @art_of_birth to share some of my thoughts on birth trauma at the latest  summit at Kings College London. My first thought, as always was…. do you mean physical? or psychological?… I was assured that her latest event would be addressing both. Time to learn & grow 💚💜❤

art-of-birth-event-with-sally-pezaro-2016

And so how can we as midwives prevent physical birth trauma?

“we can reduce ventouse to and with left lateral & slow head delivery

“Preventable physical to & caused by poor positions and outdated pushing practices

Quiz – Which methods of pushing during vaginal delivery and pelvic floor relate to which perineal outcomes?

(No peeking at the link to get the answers first!)

#Discuss #GetYourGeekOn

Methods:
-open-glottis technique?
-Valsalva pushing?
———————-
Outcomes:
-incidence of instrumental and cesarean delivery?
-incidence of postpartum hemorrhage?
-urinary incontinence
-Episiotomy rates?
-maternal satisfaction?
-fetal heart rate (FHR) abnormalities?
-Apgar score?

No peeking at the answers link before you comment/answer below!

(We are still awaiting more evidence in any case)!

The Art of Birth is promoting art in the science of to prevent #birthtrauma 

And so what about the psychological trauma and the 2nd victim…the midwife?

Can we begin to understand women’s experiences in relation to psychological birth trauma? How do we revisit the language we use during birth? Can we all be more compassionate in our practice?

I was quoted on this day when talking about “superhero midwives” – healthy, well-supported lead to healthy, well-supported mums. …It is true…so many people wanting to do good….some burning out. Some traumatised.

I thank you all for hearing about my work on the wellbeing of midwives in the workplace.

I had some really great panel questions too…What I loved most about this conference was that I managed to receive lots of  and create  with so many inspiring midwives, doulas, students and others wanting to support each other, share and learn  💚💜❤.. I can’t wait to see some of you in the near future and learn more about how you have turned these lessons into practice. 💚💜❤

Until next time – look after yourselves and each other #GetYourGeekOn 💚💜❤