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Fairy tale midwifery 10 years on: re-evaluating the lived experiences of newly qualified midwives

02 October 2019
12 min read
Volume 27 · Issue 10

Abstract

Newly qualified midwives (NQM) experience a reality shock upon initiation of first post. Despite efforts to smooth the transition to NQM status, there remains an incongruence between the expectations (‘fairy tale’) and the realities of practice. Transition and preceptorship programmes aim to increase competence and confidence, and improve the lived experiences of NQMs. Preceptorship, however, is unstandardised and supernumerary shifts and rotations to clinical areas may be affected by service demands. Sources of support in practice include peers, preceptors and midwives on shift. No new themes emerged when comparing contemporary and original research, suggesting data saturation has been reached, although it may still be pertinent to consider the experiences of NQMs in order to reduce attrition rates and increase job satisfaction.

At the point of registration, the newly qualified midwife (NQM) is a competent novice practitioner in low-risk midwifery care, and is expected to refine and develop skills and confidence in caring for women with more complex clinical needs (Nursing and Midwifery Council, 2009; Department of Health [DH], 2010). Seminal work by Kramer (1974) suggested that newly qualified healthcare practitioners at the start of their first clinical role post-qualification experienced ‘reality shock’, which was supported by subsequent research (Maben and Clark, 1996; Godinez et al, 1999; Gerrish, 2000; Montgomery et al, 2004; van der Putten, 2008).

The DH advises that all NQMs undertake a preceptorship period to smooth the transition from student to qualified midwife and to enhance clinical skills and confidence, (DH, 2010). Preceptorship remains unstandardised and is determined at a local level, thus length and content of programmes is at the discretion of individual NHS Trusts (Bannister, 2012; Mason and Davies, 2013). The local Trust adopts a 12-month programme to support NQMs, incorporating rotations to each area of practice that include obstetric and midwifery-led care pathways. Time spent on each rotation varies each year as the service requires.

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