The buck stops here: Midwives and maternity care in rural Scotland
Authors: Harris, F.M., van Teijlingen, E., Hundley, V., Farmer, J., Bryers, H., Caldow, J., Ireland, J., Kiger, A. and Tucker, J.
Journal: Midwifery
Volume: 27
Issue: 3
Pages: 301-307
ISSN: 0266-6138
DOI: 10.1016/j.midw.2010.10.007
Abstract:Objective: to explore and understand what it means to provide midwifery care in remote and rural Scotland. Design: qualitative interviews with 72 staff from 10 maternity units, analysed via a case study approach. Setting: remote and rural areas of Scotland. Participants: predominantly midwives, with some additional interviews with paramedics, general surgeons, anaesthetists and GPs. Findings: remote and rural maternity care includes a range of settings and models of care. However, the impact of rural geographies on decision-making and risk assessment is common to all settings. Making decisions and dealing with the implications of these decisions is, in many cases, done without onsite specialist support. This has implications for the skills and competencies that are needed to practice midwifery in remote and rural settings. Whereas most rural midwives reported that their skills in risk assessment and decisions to transfer were well developed and appropriate to practising in their particular settings, they perceived these decisions to be under scrutiny by urban-based colleagues and felt the need to stress their competence in the face of what they imagined to be stereotypes of rural incompetence. Conclusions: this study shows that skills in risk assessment and decision-making are central to high quality remote and rural midwifery care. However, linked to different perspectives on care, there is a risk that these skills can be undermined by contact with colleagues in large urban units, particularly when staff do not know each other well. There is a need to develop a professional understanding between midwives in different locations. Implications for practice: it is important for the good working relationships between urban and rural maternity units that all midwives understand the importance of contextual knowledge in both decisions to transfer from rural locations and the position of midwives in receiving units. Multiprofessional CPD courses have been effective in bringing together teams around obstetric emergencies; we suggest that a similar format may be required in considering issues of transfer. © 2010 Elsevier Ltd.
Source: Scopus
The buck stops here: midwives and maternity care in rural Scotland.
Authors: Harris, F.M., van Teijlingen, E., Hundley, V., Farmer, J., Bryers, H., Caldow, J., Ireland, J., Kiger, A. and Tucker, J.
Journal: Midwifery
Volume: 27
Issue: 3
Pages: 301-307
eISSN: 1532-3099
DOI: 10.1016/j.midw.2010.10.007
Abstract:OBJECTIVE: To explore and understand what it means to provide midwifery care in remote and rural Scotland. DESIGN: Qualitative interviews with 72 staff from 10 maternity units, analysed via a case study approach. SETTING: Remote and rural areas of Scotland. PARTICIPANTS: Predominantly midwives, with some additional interviews with paramedics, general surgeons, anaesthetists and GPs. FINDINGS: Remote and rural maternity care includes a range of settings and models of care. However, the impact of rural geographies on decision-making and risk assessment is common to all settings. Making decisions and dealing with the implications of these decisions is, in many cases, done without onsite specialist support. This has implications for the skills and competencies that are needed to practice midwifery in remote and rural settings. Whereas most rural midwives reported that their skills in risk assessment and decisions to transfer were well developed and appropriate to practising in their particular settings, they perceived these decisions to be under scrutiny by urban-based colleagues and felt the need to stress their competence in the face of what they imagined to be stereotypes of rural incompetence. CONCLUSIONS: This study shows that skills in risk assessment and decision-making are central to high quality remote and rural midwifery care. However, linked to different perspectives on care, there is a risk that these skills can be undermined by contact with colleagues in large urban units, particularly when staff do not know each other well. There is a need to develop a professional understanding between midwives in different locations. IMPLICATIONS FOR PRACTICE: It is important for the good working relationships between urban and rural maternity units that all midwives understand the importance of contextual knowledge in both decisions to transfer from rural locations and the position of midwives in receiving units. Multiprofessional CPD courses have been effective in bringing together teams around obstetric emergencies; we suggest that a similar format may be required in considering issues of transfer.
Source: PubMed
The buck stops here: Midwives and maternity care in rural Scotland
Authors: Harris, F.M., van Teijlingen, E., Hundley, V., Farmer, J., Bryers, H., Caldow, J., Ireland, J., Kiger, A. and Tucker, J.
Journal: MIDWIFERY
Volume: 27
Issue: 3
Pages: 301-307
ISSN: 0266-6138
DOI: 10.1016/j.midw.2010.10.007
Source: Web of Science (Lite)
The buck stops here: Midwives and maternity care in rural Scotland
Authors: Harris, F., van Teijlingen, E., Hundley, V., Farmer, J., Bryers, H., Caldow, J., Ireland, J., Kiger, A. and Tucker, J.S.
Journal: Midwifery
ISSN: 0266-6138
DOI: 10.1016/j.midw.2010.10.007
Abstract:Abstract Objective to explore and understand what it means to provide midwifery care in remote and rural Scotland.
Design qualitative interviews with 72 staff from 10 maternity units, analysed via a case study approach.
Setting remote and rural areas of Scotland.
Participants predominantly midwives, with some additional interviews with paramedics, general surgeons, anaesthetists and GPs.
Findings remote and rural maternity care includes a range of settings and models of care. However, the impact of rural geographies on decision-making and risk assessment is common to all settings. Making decisions and dealing with the implications of these decisions is, in many cases, done without onsite specialist support. This has implications for the skills and competencies that are needed to practice midwifery in remote and rural settings. Whereas most rural midwives reported that their skills in risk assessment and decisions to transfer were well developed and appropriate to practising in their particular settings, they perceived these decisions to be under scrutiny by urban-based colleagues and felt the need to stress their competence in the face of what they imagined to be stereotypes of rural incompetence.
Conclusions this study shows that skills in risk assessment and decision-making are central to high quality remote and rural midwifery care. However, linked to different perspectives on care, there is a risk that these skills can be undermined by contact with colleagues in large urban units, particularly when staff do not know each other well. There is a need to develop a professional understanding between midwives in different locations.
Implications for practice it is important for the good working relationships between urban and rural maternity units that all midwives understand the importance of contextual knowledge in both decisions to transfer from rural locations and the position of midwives in receiving units. Multiprofessional CPD courses have been effective in bringing together teams around obstetric emergencies; we suggest that a similar format may be required in considering issues of transfer.
Source: Manual
Preferred by: Edwin van Teijlingen and Vanora Hundley
The buck stops here: midwives and maternity care in rural Scotland.
Authors: Harris, F.M., van Teijlingen, E., Hundley, V., Farmer, J., Bryers, H., Caldow, J., Ireland, J., Kiger, A. and Tucker, J.
Journal: Midwifery
Volume: 27
Issue: 3
Pages: 301-307
eISSN: 1532-3099
ISSN: 0266-6138
DOI: 10.1016/j.midw.2010.10.007
Abstract:Objective
To explore and understand what it means to provide midwifery care in remote and rural Scotland.Design
Qualitative interviews with 72 staff from 10 maternity units, analysed via a case study approach.Setting
Remote and rural areas of Scotland.Participants
Predominantly midwives, with some additional interviews with paramedics, general surgeons, anaesthetists and GPs.Findings
Remote and rural maternity care includes a range of settings and models of care. However, the impact of rural geographies on decision-making and risk assessment is common to all settings. Making decisions and dealing with the implications of these decisions is, in many cases, done without onsite specialist support. This has implications for the skills and competencies that are needed to practice midwifery in remote and rural settings. Whereas most rural midwives reported that their skills in risk assessment and decisions to transfer were well developed and appropriate to practising in their particular settings, they perceived these decisions to be under scrutiny by urban-based colleagues and felt the need to stress their competence in the face of what they imagined to be stereotypes of rural incompetence.Conclusions
This study shows that skills in risk assessment and decision-making are central to high quality remote and rural midwifery care. However, linked to different perspectives on care, there is a risk that these skills can be undermined by contact with colleagues in large urban units, particularly when staff do not know each other well. There is a need to develop a professional understanding between midwives in different locations.Implications for practice
It is important for the good working relationships between urban and rural maternity units that all midwives understand the importance of contextual knowledge in both decisions to transfer from rural locations and the position of midwives in receiving units. Multiprofessional CPD courses have been effective in bringing together teams around obstetric emergencies; we suggest that a similar format may be required in considering issues of transfer.Source: Europe PubMed Central