References

Alnaqi H, McIntosh B, Lancaster A. Cultures of fear: perspectives on whistle-blowing. British Journal of Mental Health Nursing. 2017; 6:(3)134-137 https://doi.org/10.12968/bjmh.2017.6.3.134

Leadership at every level. 2018. https://www.rcm.org.uk/news-views/news/leadership-at-every-level/ (accessed 6 June 2019)

Astrup J. Cutting postnatal care. Midwives. 2015; 18:68-71

Barends E, Villanueva J, Rousseau DM Managerial attitudes and perceived barriers regarding evidence-based practice: an international survey. PLoS One. 2017; 12:(10) https://doi.org/10.1371/journal.pone.0184594

Barker K. Newly qualified midwives: be confident and competent. Br J Midwifery. 2014; 22:(9) https://doi.org/10.12968/bjom.2014.22.9.614

Barker K. Freedom to speak up—easier said than done. Br J Midwifery. 2015; 23:(3) https://doi.org/10.12968/bjom.2015.23.3.158

Battersby S. The role of the midwife in breastfeeding: dichotomies and dissonance. Br J Midwifery. 2014; 22:(8)551-556 https://doi.org/10.12968/bjom.2014.22.8.551

Beretta R. Reporting poor care. Nurs Stand. 2017; 31:(33)64-65 https://doi.org/10.7748/ns.31.33.64.s49

Bostock-Cox B. The Nursing and Midwifery Code: making it work for you and your patients. Practice Nurse. 2015; 45:(4)34-37

Bradfield Z, Duggan R, Hauck Y, Kelly M. Midwives being ‘with woman’: an integrative review. Women Birth. 2018; 31:(2)143-152 https://doi.org/10.1016/j.wombi.2017.07.011

Carolan M. ‘A good midwife stands out’: 3rd year midwifery students' views. Midwifery. 2013; 29:(2)115-121 https://doi.org/10.1016/j.midw.2011.11.005

Ciasullo MV, Cosimato S, Palumbo R. Improving health care quality: the implementation of whistle-blowing. TQM J. 2017; 29:(1)167-183 https://doi.org/10.1108/TQM-06-2016-0051

Dean E. Promoting professionalism. Nurs Stand. 2017; 31:(42) https://doi.org/10.7748/ns.31.42.15.s15

Debevec AD, Evanson TA. Improving breastfeeding support by understanding women's perspectives and emotional experiences of breastfeeding. Nurs Womens Health. 2016; 20:(5)464-474 https://doi.org/10.1016/j.nwh.2016.08.008

Deery R, Fisher P. Professionalism and person-centredness: developing a practice-based approach to leadership within NHS maternity services in the UK. Health Sociol Rev. 2017; 26:(2)143-159 https://doi.org/10.1080/14461242.2016.1159525

Edwards ME, Jepson RG, McInnes RJ. Breastfeeding initiation: an in-depth qualitative analysis of the perspectives of women and midwives using Social Cognitive Theory. Midwifery. 2018; 57:(1)8-17 https://doi.org/10.1016/j.midw.2017.10.013

Ekström AC, Thorstensson S. Nurses and midwives professional support increases with improved attitudes - design and effects of a longitudinal randomized controlled process-oriented intervention. BMC Pregnancy Childbirth. 2015; 15:(1) https://doi.org/10.1186/s12884-015-0712-z

Farokhzadian J, Khajouei R, Ahmadian L. Evaluating factors associated with implementing evidence-based practice in nursing. J Eval Clin Pract. 2015; 21:(6)1107-13 https://doi.org/10.1111/jep.12480

Foster S. Doing more to protect whistle-blowers. Br J Nurs. 2016; 25:(11) https://doi.org/10.12968/bjon.2016.25.11.641

Glasper A. Protecting whistle-blowers against discrimination in the NHS. Br J Nurs. 2017; 26:(9)522-523 https://doi.org/10.12968/bjon.2017.26.9.522

Groleau D, Pizarro KW, Molino L, Gray-Donald K, Semenic S. Empowering women to breastfeed: Does the Baby Friendly Initiative make a difference?. Matern Child Nutr. 2017; 13:(4) https://doi.org/10.1111/mcn.12370

Gustafsson I, Nyström M, Palmér L. Midwives' lived experience of caring for new mothers with initial breastfeeding difficulties: A phenomenological study. Sex Reprod Healthc. 2017; 12:9-15 https://doi.org/10.1016/j.srhc.2016.12.003

Hall JS, Mitchell M. Educating student midwives around dignity and respect. Women Birth. 2017; 30:(3)214-219 https://doi.org/10.1016/j.wombi.2017.04.007

Hunter B, Warren L. Midwives' experiences of workplace resilience. Midwifery. 2014; 30:(8)926-934 https://doi.org/10.1016/j.midw.2014.03.010

Hyde P. A wicked problem? Whistle-blowing in healthcare organisations comment on “cultures of silence and cultures of voice: the role of whistle-blowing in healthcare organisations”. Int J Health Policy Manag. 2016; 5:(4)267-269 https://doi.org/10.15171/ijhpm.2016.01

Ingram J, Johnson D, Copeland M, Churchill C, Taylor H. The development of a new breast feeding assessment tool and the relationship with breast feeding self-efficacy. Midwifery. 2015; 31:(1)132-137 https://doi.org/10.1016/j.midw.2014.07.001

Jackson D, Hickman LD, Hutchinson M, Andrew S, Smith J, Potgieter I, Cleary M, Peters K. Whistle-blowing: an integrative literature review of data-based studies involving nurses. Contemp Nurse. 2014; 48:(2)240-252 https://doi.org/10.1080/10376178.2014.11081946

James L, Sweet L, Donnellan-Fernandez R. Breastfeeding initiation and support: A literature review of what women value and the impact of early discharge. Women Birth. 2017; 30:(2)87-99 https://doi.org/10.1016/j.wombi.2016.09.013

Jones A, Kelly D. Deafening silence? Time to reconsider whether organisations are silent or deaf when things go wrong. BMJ Qual Saf. 2014; 23:(9)709-713 https://doi.org/10.1136/bmjqs-2013-002718

Kumar M, Santoro D. A justification of whistle-blowing. Philos Soc Criticism. 2017; 43:(7)669-684 https://doi.org/10.1177/0191453717708469

Lawton K, Robinson A. Midwives' experiences of helping women struggling to breastfeed. Br J Midwifery. 2016; 24:(4)248-253 https://doi.org/10.12968/bjom.2016.24.4.248

Lundeen S, Sorensen S, Bland M, George S, Snyder B. Nurses' perspectives on the process of attaining Baby-Friendly designation. Nurs Womens Health. 2016; 20:(3)277-287 https://doi.org/10.1016/j.nwh.2016.03.004

Mackey A, Bassendowski S. The history of evidence-based practice in nursing education and practice. J Prof Nurs. 2017; 33:(1)51-55 https://doi.org/10.1016/j.profnurs.2016.05.009

McFadden A, Mason F, Baker J Spotlight on infant formula: coordinated global action needed. Lancet. 2016; 387:(10017)413-415 https://doi.org/10.1016/S0140-6736(16)00103-3

Milligan F, Wareing M, Preston-Shoot M, Pappas Y, Randhawa G, Bhandol J. “Supporting nursing, midwifery and allied health professional students to raise concerns with the quality of care: A review of the research literature”. Nurse Educ Today. 2017; 57:(1)29-39 https://doi.org/10.1016/j.nedt.2017.06.006

Molina RL, Patel SJ, Scott J, Schantz-Dunn J, Nour NM. Striving for respectful maternity care everywhere. Matern Child Health J. 2016; 20:(9)1769-1773 https://doi.org/10.1007/s10995-016-2004-2

Morrow J, McLachlan H, Forster D, Davey MA, Newton M. Redesigning postnatal care: exploring the views and experiences of midwives. Midwifery. 2013; 29:(2)159-166 https://doi.org/10.1016/j.midw.2011.11.006

Postnatal care up to 8 weeks after birth [CG37].London: NICE; 2015

Newdick C, Danbury C. Culture, compassion and clinical neglect: probity in the NHS after Mid Staffordshire. J Med Ethics. 2015; 41:(12)956-962 https://doi.org/10.1136/medethics-2012-101048

A-EQUIP: A model of clinical midwifery supervision.London: NHS England; 2017

Nilsen P, Neher M, Ellström PE, Gardner B. Implementation of evidence-based practice from a learning perspective. Worldviews Evid Based Nurs. 2017; 14:(3)192-199 https://doi.org/10.1111/wvn.12212

The Code: Professional standards of practice and behaviour for nurses and midwives.London: NMC; 2018a

Raising concerns: Guidance for nurses and midwives.London: NMC; 2018b

Pérez-Escamilla R, Martinez JL, Segura-Pérez S. Impact of the Baby-friendly Hospital Initiative on breastfeeding and child health outcomes: a systematic review. Matern Child Nutr. 2016; 12:(3)402-417 https://doi.org/10.1111/mcn.12294

Phelan A, O Connell R, Murphy M, McLoughlin G, Long O. A contextual clinical assessment for student midwives in Ireland. Nurse Educ Today. 2014; 34:(3)292-294 https://doi.org/10.1016/j.nedt.2013.10.016

Renolen Å, Høye S, Hjälmhult E, Danbolt LJ, Kirkevold M. “Keeping on track”—Hospital nurses' struggles with maintaining workflow while seeking to integrate evidence-based practice into their daily work: A grounded theory study. Int J Nurs Stud. 2018; 77:(1)179-188 https://doi.org/10.1016/j.ijnurstu.2017.09.006

Reynolds EK, Cluett E, Le-May A. Fairy tale midwifery—fact or fiction: the lived experiences of newly qualified midwives. Br J Midwifery. 2014; 22:(9)660-668 https://doi.org/10.12968/bjom.2014.22.9.660

Standing up for high standards.London: RCM; 2015

Ruyak SL, Migliaccio L, Levi A, Patel S, Patel S. Role development in midwifery education: A place for simulation. Midwifery. 2018; 59:141-143 https://doi.org/10.1016/j.midw.2018.01.021

Schmied V, Bick D. Postnatal care – Current issues and future challenges. Midwifery. 2014; 30:(6)571-574 https://doi.org/10.1016/j.midw.2014.05.001

Sidebotham M, Jomeen J, Gamble J. Teaching evidence-based practice and research through blended learning to undergraduate midwifery students from a practice based perspective. Nurse Educ Pract. 2014; 14:(2)220-224 https://doi.org/10.1016/j.nepr.2013.10.001

Simpson PD, Morris EP. The implications of the Francis report. Obstetrics, Gynaecol Reprod Med. 2014; 24:(6)186-188 https://doi.org/10.1016/j.ogrm.2014.04.008

Spiro A. The public health benefits of breastfeeding. Perspect Public Health. 2017; 137:(6)307-308 https://doi.org/10.1177/1757913917734139

Stalberg P. Learning by listening to women: A supervisor of midwives' initiative. Br J Midwifery. 2017; 25:(7)465-469 https://doi.org/10.12968/bjom.2017.25.7.465

Swerts M, Westhof E, Bogaerts A, Lemiengre J. Supporting breast-feeding women from the perspective of the midwife: A systematic review of the literature. Midwifery. 2016; 37:(1)32-40 https://doi.org/10.1016/j.midw.2016.02.016

Symon A. Being sued for being rude. Br J Midwifery. 2015; 23:(9)676-677 https://doi.org/10.12968/bjom.2015.23.9.676

Unicef. Guide to the Unicef UK Baby Friendly Initiative standards. 2017. https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2014/02/Guide-to-the-Unicef-UK-Baby-Friendly-Initiative-Standards.pdf (accessed 6 June 2019)

Veeramah V. The use of evidenced-based information by nurses and midwives to inform practice. J Clin Nurs. 2016; 25:(3-4)340-350 https://doi.org/10.1111/jocn.13054

Wain A. Examining the lived experiences of newly qualified midwives during their preceptorship. Br J Midwifery. 2017; 25:(7)451-457 https://doi.org/10.12968/bjom.2017.25.7.451

Warren E. Evidence-based practice. Practice Nurse. 2015; 45:(12)

Promoting evidence-based practice and raising concerns: considerations for the newly-qualified midwife

02 July 2019
Professional
02 July 2019
Volume 27 · Issue 7

Abstract

Although newly-qualified midwives have achieved the professional standards required to become autonomous practitioners, many doubt their capabilities and decision-making skills, often comparing their limited clinical experience to that of senior midwives. As a result, it may prove challenging to ensure that evidence-based practice and the professional standards are upheld when confronted with resistance to change in practice. This article will discuss these challenges for the newly-qualified midwife, exploring the promotion of evidence-based practice in relation to providing breastfeeding support and advice; dealing with poor professional practice in relation to supporting mothers to breastfeed; and the stigmatised issue of whistle-blowing.

Newly-qualified midwives are expected to be safe, competent practitioners and are responsible for providing high standards of care for women and babies (Phelan et al, 2014); however, for many midwives it can be a particularly vulnerable point in their career. Although newly-qualified midwives have achieved the professional standards required to become autonomous practitioners (Reynolds et al, 2014), many doubt their capabilities and decision-making skills, often comparing their limited clinical experience to that of senior midwives (Wain, 2017). As a result, it may prove challenging to ensure that evidence-based practice and the professional standards promoted by the Nursing and Midwifery Council (NMC) (2018a) are upheld when confronted with attitudes resistant to change in practice.

This article will discuss these challenges for the newly-qualified midwife. This was motivated by an experience in clinical practice that caused one midwife, Ruth*, who at the time was on the verge of qualification, to consider the challenges of transitioning to registrant status. The article will explore the promotion of evidence-based practice when providing breastfeeding support and advice; dealing with poor professional practice; and the stigmatised issue of whistle-blowing.

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New midwifery registrant
Breastfeeding
Whistle-blowing
Professional support
Evidence-based midwifery practice
Raising concerns