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  1. #51
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    Quote Originally Posted by crunchie View Post
    Sorry for my not spelling MIDWIFERY correctly.....

    I must learn how to spell Midwifery.
    I must learn how to spell Midwifery.

    Actually i must learn how to spell.

    Thanks all for your input. Its definitely swaying me. As one poster said being a nurse and being a midwife are two very different careers.

    Keep the opinions coming.
    Lol it's an important word...
    IMO the difference between nursing and midwifery is the difference between physiotherapy and occupational therapy or speech pathology. Or Radiography or Radiation Therapy (that was a fun program to try to explain the difference between....) The gov will eventually recognise that they are two different professions and create jobs appropriately. It's supposed to be 100% continuity of care for rural areas by the end of 2013 and areas like Goondiwindi and Dalby already have MGP models, so I believe there will be a place for nurse midwives Australia wide. I think we should all move to WA, they offer publicly funded homebirth as options within their public hospitals!!!

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    they offer publicly funded homebirth as options within their public hospitals!!!
    Darwin and Alice Springs also have homebirth programs. Would love to see them everywhere!

  3. The Following User Says Thank You to flowerfae For This Useful Post:

    cupcake91  (22-01-2012)

  4. #53
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    Quote Originally Posted by cupcake91 View Post
    Wow you say you are all for midwives but you seem very against it.
    I take offense at that. I am all for midwives. I was invited by the midwife that did my prenatal care for all 3 of my children to present to the hospital board the reason for why it's important to have the stand alone clinic she ran for prenatal care continue. She asked me because I chose to go there for all 3 pregnancies. She knows I do a lot of research and know how to critically analyse what I am reading, as we had a lot of discussions on our shared interests over lunch and get togethers. That clinic, on the verge of being shut down, is now still open.

    I have two idols that are midwives- Barbara Herrera and Betsy Freeman. If I was single and childless, I would follow in the footsteps of Betsy Freeman. She is an amazing woman.


    Quote Originally Posted by cupcake91 View Post
    I hope you've been follow the current new media stories about lack of informed consent for caesareans and inductions at the moment, midwives and continuity of care needs support more than ever now, and people like you are not helping!!
    I sure have been following it- and I find the study on c/s pointless for a few reasons.
    -As they stated in those articles, most c/s aren't elective. This means that a labour turns high risk and the dr has minutes to inform the patient, get the team together and have the mother in the OR- he/she doesnt' have time to sit there for an hour to discuss it.

    -This means the woman is already in pain from labour, which lessens her comprehension, so even when something is explained, they can't take it all in. This also means that if the dr does have the hour to explain and answer questions, the mother just does not understand and is feeling too much terror and pain to be thinking clearly.

    -Teaching expectant mothers all about vaginal, but barely touching on c/s has an impact on what they consider 'informed consent' and how they approch birth.

    -There is no gun being held to their head. There is a baby/mother in dire circumstances, they understand that much at the time and sign away. Then they get home, and instead of 'congratulations' they get 'I'm so sorry about your birth', even though there is a happy, healthy baby in their arms. That does have an impact on reflective thinking. I have personally seen women who did decline a c/s, come home and announce that yes they had their baby die, but they got their vaginal birth and they would do it all again exactly the same- and women were EXCITED for them and happy. Not one observer voiced about the fact that by declining the c/s for their own wants, they killed their baby.

    -Hospitals and Dr's get sued when they don't perform a c/s and something bad happens. This makes them more cautious the longer they practise and subsequent births that are showing the same indicators are straight on the table to prevent them being sued and 'something bad' happening to the baby/mother, increasing the c/s rates.

    -'Informed consent' can mean different things for different mothers. For some, they feel it means being told weeks or months in advance so they can go home and research it. For others, it could mean while they are not in labour due to the not thinking clearly. The study does not define what is meant by informed consent and if the definition they used was explained to the women.

    - The rise in c/s also reflects the rise in diabeties, heart conditions, better understanding of the dangers and obesity, lowering of physical fitness, and more older women than ever before having babies thanks to the magic of IVF. The WHO recently came out and said they scrap their recommended c/s rate, as they were numbers plucked from thin air and that due to the rising numbers of high risk women getting pregnant, the numbers may get quite high.


    As for the woman that died due to septic shock, the article did not go into what type of infection she had, but did state that there was a whole floor of midwives who were sharing the care. It may have come down to simply being understaffed (although their records at the time showed they were adequately staffed) or that it's simply the way UK health is going- quite a few maternity hospitals are now under investigation due to the exteremly high numbers of maternal deaths. This also opens the questions of if taking 3 years to do nursing, then working in the industry, and after that coming back to do a further 2 years meant that only those really dedicated to being midwives got through, then what has the 3 year (NZ 4 year..which I like the idea of better) allowed to get into our maternity hospitals? There is a slide of care vaules in UK, does that mean that we will start to see grads not so dedicated because it's only a 3 year degree and they are in (Not all!! But the minority are the ones that cause the largest problems and make the most waves). When you have a 19/20 year old grad in charge of overseeing the birth of a baby, their values and feelings of responsibility may not quite be in the right place? Or the older ones who don't know what to do with their lives, so decide m/w is only 3 years, but they really don't care about the job or their mothers/babies.

    They are trying to weed out the less desirables who thought the same with the 3 year nursing degree, that are showing a lack of values and care and causing dangers to patients (see, I can also be realisitic about the career I want too). The only problem is that as soon as they identify one, more are graduating to entering the field. They are overviewing the current subjects, hoping to get some quite 'dry' core subjects in there that only those most dedicated will want to do, which will hopefully reduce the numbers of those that see it just as a way to get a job. And the 3 year nursing degree has been around for years! And it's still being reviewed and modified.

  5. #54
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    By the way lovely ladies- if you want to read some beautiful, tears rendering stories, I recommend you read this 3 part series (I think there will be more added)
    http://everymothercounts.org/news/20...s-field-part-1

  6. #55
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    Quote Originally Posted by monkey face View Post
    This also opens the questions of if taking 3 years to do nursing, then working in the industry, and after that coming back to do a further 2 years meant that only those really dedicated to being midwives got through, then what has the 3 year (NZ 4 year..which I like the idea of better) allowed to get into our maternity hospitals? There is a slide of care vaules in UK, does that mean that we will start to see grads not so dedicated because it's only a 3 year degree and they are in (Not all!! But the minority are the ones that cause the largest problems and make the most waves). When you have a 19/20 year old grad in charge of overseeing the birth of a baby, their values and feelings of responsibility may not quite be in the right place? Or the older ones who don't know what to do with their lives, so decide m/w is only 3 years, but they really don't care about the job or their mothers/babies.

    They are trying to weed out the less desirables who thought the same with the 3 year nursing degree, that are showing a lack of values and care and causing dangers to patients (see, I can also be realisitic about the career I want too). The only problem is that as soon as they identify one, more are graduating to entering the field. They are overviewing the current subjects, hoping to get some quite 'dry' core subjects in there that only those most dedicated will want to do, which will hopefully reduce the numbers of those that see it just as a way to get a job. And the 3 year nursing degree has been around for years! And it's still being reviewed and modified.
    I take offence to that as I will be a 20 year old graduate, and I feel quite confident/competent. I fail to see how being a 20 year old graduate is any different to being a 30 year old graduate as we have both completed the same degree and have both been deemed competent to practice by our university and by the Nursing and Midwifery Board of Australia. It's about the person not their age, and I can tell you I care a hell of a lot of more about the woman I care for then a lot of the older students in my class and the older midwives at the hospital. A lot more.

    You say you're in your first year? Take a look around at how many people are at your nursing orientation. Remember that number in 3 years time at your Graduation. On our first day of third year there was 55% of the original starting cohort left. That says to me that over the two years those who do not care, those who are not smart enough and those who can not cope have been weeded out. It is a tough program, and you have to want it to complete it. Its insulting for you to say that people are just doing it for a job. You seem to underestimate exactly how hard it is to complete a 3 year degree. Also the UK degree is a 4 year program with honours.

    As I mentioned above in the previous posts, I have been at 30+ births so far (20 of those my own deliveries), and will most likely have another 15-20 by the time I graduate. Post graduate midwives in their one year program often only have to do 10 births, and I have been kicked out of a labour in late October so a Postgrad could get her catches because she was running out of time. How does that make them a safer midwife than myself?

    The dual degree students only have half the clinical time in maternity. If they go onto work as a midwife, then they only have half the clinical experience that BMid students have. The comments from midwives at my current placement have reflected the fact that they don't think dual degree students or the current postgrad students are as clinically prepared as the b mid students.

    How is doing nursing first going to make you a better midwife for mothers and babies. If you cared that much you would go straight to the BMid. The best midwives I know (of those that we're non nurse midwives from the UK/NZ) have said if the B.Mid was around in their time there was no way in hell they would have done the nursing.
    Last edited by cupcake91; 22-01-2012 at 11:23.

  7. #56
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    Quote Originally Posted by flowerfae View Post
    Darwin and Alice Springs also have homebirth programs. Would love to see them everywhere!
    Ahh that's awesome!!! I think theres one or two running out of a couple of hospitals in Victoria as well?

  8. #57
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    As an EN (currently doing my RN) and as a mum, my option between an RNM and a direct entry Mid, I feel I would be getting better care from an RNM honestly. JMO.

    While I understand DEM's have a hell of a lot of clinical knowledge and skills in their field (i honestly applaud them for this), while they do a portion of nursing based subjects and clinicals on general wards/A&E - I have personally seen DEM's take no interest in their nursing pracs as it isn't what they want to do...

    Yeah bed pans, fighting other nurses for the showers are no fun. Nor is cleaning up a demented patient who has been poo painting.

    I would honestly prefer to have a midwife who has an all-round knowledge base who would be able to pick up on a tiniest clue (that a dem may or may not pick up on - some DEM's that I know are very cluey and switched on) and act upon it straight away. RNM's are able to understand the pathophysiology of most conditions and how it all links in to another and how everything combined effects the baby...

    I feel that healthy pregnancies with no complications or anything will be adequately cared for by both DEM's and RNM's. However, when it comes to women with underlying conditions or any kind of complications at all, I think an RNM is better qualified in managing that woman's care.

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    Quote Originally Posted by OneNowOneLater View Post
    I would honestly prefer to have a midwife who has an all-round knowledge base who would be able to pick up on a tiniest clue (that a dem may or may not pick up on - some DEM's that I know are very cluey and switched on) and act upon it straight away. RNM's are able to understand the pathophysiology of most conditions and how it all links in to another and how everything combined effects the baby...
    .
    We learn about the pathophysiology of most conditions (diabetes, cardio, respiratory, endocrine, mental illness etc) and how it affects pregnancy and how pregnancy affects the disease and the medications involved in our BMid degree. We don't spend half the degree learning about high risk women for nothing.....

    So basically you're saying at Midwife wouldn't be qualified in caring for a women with pre-eclampsia (a high risk condition) because she's not a nurse, even though pre-eclampsia is a pregnancy only disease and I doubt that this would have been covered in a nursing degree??

    Oh god forbid I check a woman with diabetes BSL in labour. How could I possibly know what the result would mean, because I'm not a nurse and don't have any knowledge about diabetes, despite having done an entire subject dedicated to women with diabetes.

    Might as well just give up on checking blood pressures, pulses, urine tests, ordering blood tests as well seeing as they could all show that they have a medical condition that I wouldn't know how to care for. You do know that test and observational results (blood pressure, iron levels etc) are different in pregnant women and different between trimesters compared to non pregnant women, so using your nursing knowledge to check these results is going to result in using incorrect reference ranges?
    Last edited by cupcake91; 22-01-2012 at 11:53.

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    I will not pretend to know exactly what a bmid learns during their degree. Nor do I intend any belittling of your degree over those of an RNM. I apologise if I came across that way at all.

    All I meant was that while you are specialists in your field (once again, I applaud you all for this - preeclampsia I would categorise as a complication that DEM's would have amazing knowledge of) I would feel safer under the care of an RNM (especially one whom I work with in A&E).

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    Quote Originally Posted by monkey face View Post

    I sure have been following it- and I find the study on c/s pointless for a few reasons.
    -As they stated in those articles, most c/s aren't elective. This means that a labour turns high risk and the dr has minutes to inform the patient, get the team together and have the mother in the OR- he/she doesnt' have time to sit there for an hour to discuss it.

    -This means the woman is already in pain from labour, which lessens her comprehension, so even when something is explained, they can't take it all in. This also means that if the dr does have the hour to explain and answer questions, the mother just does not understand and is feeling too much terror and pain to be thinking clearly.

    -Teaching expectant mothers all about vaginal, but barely touching on c/s has an impact on what they consider 'informed consent' and how they approch birth.

    -There is no gun being held to their head. There is a baby/mother in dire circumstances, they understand that much at the time and sign away. Then they get home, and instead of 'congratulations' they get 'I'm so sorry about your birth', even though there is a happy, healthy baby in their arms. That does have an impact on reflective thinking. I have personally seen women who did decline a c/s, come home and announce that yes they had their baby die, but they got their vaginal birth and they would do it all again exactly the same- and women were EXCITED for them and happy. Not one observer voiced about the fact that by declining the c/s for their own wants, they killed their baby.

    -Hospitals and Dr's get sued when they don't perform a c/s and something bad happens. This makes them more cautious the longer they practise and subsequent births that are showing the same indicators are straight on the table to prevent them being sued and 'something bad' happening to the baby/mother, increasing the c/s rates.

    -'Informed consent' can mean different things for different mothers. For some, they feel it means being told weeks or months in advance so they can go home and research it. For others, it could mean while they are not in labour due to the not thinking clearly. The study does not define what is meant by informed consent and if the definition they used was explained to the women.

    - The rise in c/s also reflects the rise in diabeties, heart conditions, better understanding of the dangers and obesity, lowering of physical fitness, and more older women than ever before having babies thanks to the magic of IVF. The WHO recently came out and said they scrap their recommended c/s rate, as they were numbers plucked from thin air and that due to the rising numbers of high risk women getting pregnant, the numbers may get quite high.


    As for the woman that died due to septic shock, the article did not go into what type of infection she had, but did state that there was a whole floor of midwives who were sharing the care. It may have come down to simply being understaffed (although their records at the time showed they were adequately staffed) or that it's simply the way UK health is going- quite a few maternity hospitals are now under investigation due to the exteremly high numbers of maternal deaths. This also opens the questions of if taking 3 years to do nursing, then working in the industry, and after that coming back to do a further 2 years meant that only those really dedicated to being midwives got through, then what has the 3 year (NZ 4 year..which I like the idea of better) allowed to get into our maternity hospitals? There is a slide of care vaules in UK, does that mean that we will start to see grads not so dedicated because it's only a 3 year degree and they are in (Not all!! But the minority are the ones that cause the largest problems and make the most waves). When you have a 19/20 year old grad in charge of overseeing the birth of a baby, their values and feelings of responsibility may not quite be in the right place? Or the older ones who don't know what to do with their lives, so decide m/w is only 3 years, but they really don't care about the job or their mothers/babies.

    They are trying to weed out the less desirables who thought the same with the 3 year nursing degree, that are showing a lack of values and care and causing dangers to patients (see, I can also be realisitic about the career I want too). The only problem is that as soon as they identify one, more are graduating to entering the field. They are overviewing the current subjects, hoping to get some quite 'dry' core subjects in there that only those most dedicated will want to do, which will hopefully reduce the numbers of those that see it just as a way to get a job. And the 3 year nursing degree has been around for years! And it's still being reviewed and modified.
    Interesting. I agree with a lot of what you've said. Difficulty getting informed consent in an emergency c/s like you can in an elective, older first time mothers, more mums with chronic health conditions, etc are all going to help our c/s rate go up.

    I also agree with the high c/s rates coming about possibly through ob's not wanting to get sued. I was talking about that with someone the other day actually - and I have to say that with the current climate of suing whenever something goes wrong, I completely understand where they're coming from.

    About the degree-I'm not sure why we are talking about 'the most dedicated only getting through'

    There are more prospective nursing/ middy students than there are uni placements. Why? Simple case of $$. It's an expensive degree for the university to run- labs, clinical placements, etc to pay for as well as the lecturers and tutors you have with any other degree. To top that off, students pay the lowest fees out of all degrees apart from teaching. Not much money in it for the university- better off taking law students who don't need labs and clinical placements and pay top dollar fees!

    Nursing is actually quite fortunate in a way, in that you do prac fairly soon after starting and so get a taste of what it's actually like working in a hospital. We lost quite a number after the first prac who just knew it wasn't for them and transferred - and fair enough. Although you might like the idea or nursing or middy, it's hard to know before you start the course and actually give it a go whether you like it or whether you just like the idea of it. Then after you finish you join the workforce and that's different again. I would hope however that with both degrees any students who are downright dangerous and show a lack of values but continue to do the course anyway would not be passed during pracs. I remember a couple of students that went through with me failed pracs for that reason.

    Then, once you graduate, the workforce is extremely good at weeding people out. I've heard (don't know where they got the information from, but I can well believe it) that the average nurse lasts 2 yrs on the job.
    Not surprising- shift work, unsociable hours, being on your feet all day, no breaks, heavy workload, *****y shift coordinators that think they own the place etc does take its toll fairly quickly. You have to really like the work to last- the working conditions certainly don't do much to retain staff.
    I don't blame people for not wanting to stay in the job- although I love nursing, the work conditions REALLY get to you after a while.

    I'm not sure about why they would want to get really dry subjects in there. Sure, some are dry. But they have to be included- evidence based practice is one that springs to mind. I however wouldn't like to see a university course where they didn't have some sort of education on EBP!

    In short- I don't think the degree is the problem. It's nice that you can do prac and get an idea of what the workplace is like, but I don't think you can call yourself dedicated because you managed to finish a 3 year degree. I think if you've graduated, worked for a good few years and plan to keep going- that's more like it.


 

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