Single registered midwives contributing care for general patients: a scoping study

Abstract

Background: Midwifery vacancies persist in small maternity units in Australian rural and private settings where midwives are expected to also care for general (non-maternity) patients when midwifery activity is low. Recruiting dual registered nurse/midwives over single registered midwives is preferred, as single registered midwives are seen as inflexible to assist with nursing work. Little is known about single registered midwives’ contribution to care of general patients in small maternity units. Objective: This scoping study aimed to consult single registered midwives and managers of single registered midwives to determine perspectives on single registered midwives’ contribution in small maternity units where the workload encompasses both midwifery and care of general patients, to inform further research. Study design and methods: This study used a qualitative description design. Two online focus groups were held, one containing three single registered midwives, the other three managers of single registered midwives. Similar questions were posed to each group about single registered midwives’ contribution to care in small maternity units. Data analysis was conducted collaboratively through coding and thematic categorisation processes. Results: Four major categories were found. Single registered midwives’ scope of practice concerning general patients is undefined; single registered midwives possess transferrable clinical skills applicable to general patients; practical, professional, and emotional barriers exist for single-registered midwives in small maternity units; and future research recommendations include scope of practice and workplace experiences. Discussion: Persistent midwifery vacancies are implicated in the closure of small maternity units to the detriment of childbearing families. Understanding the contribution of single registered midwives in small maternity units will inform future research and midwifery recruitment strategies to improve access to services. Conclusion: The experiences of single registered midwives working in small maternity units warrants further investigation. This scoping study contributes to the literature about single registered midwives’ experiences in small maternity units and suggests considerations for future research. Implications for research, policy and practice: Findings from this study provide information about the contribution of single registered midwives to small maternity units where there is an expectation to contribute to care of general patients in addition to midwifery. Future research into the experiences of single registered midwives working in these settings will generate information to inform recruitment strategies, potentially improving access to maternity care in small maternity units and may be used in the review of midwifery regulation and educational standards.

Keywords

Midwife, Direct-entry, Dual-registered, Scope, Workforce, Rural

Link to Publisher Version (URL)

10.37464/2023.402.725

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