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Examining the lived experiences of newly qualified midwives during their preceptorship

02 July 2017
Volume 25 · Issue 7

Abstract

Background

Novice midwives at one NHS Trust undertook a 12-month preceptorship programme, designed to support them to consolidate their education and develop their competence. The study was commenced following concerns voiced by new midwives about levels of support during their transition, and also because of a high rate of attrition of newly qualified midwives at the Trust.

Aims

The aim of the study was to evaluate the experiences of newly qualified midwives during their preceptorship at the Trust.

Methods

A qualitative research design was applied. A sample of eight midwives provided data collected using a process of semi-structured interviews.

Findings

The findings of the research demonstrated that most of the midwives felt well-supported by their colleagues. However, although a preceptorship programme was in place at the Trust, barriers to implementing the programme included staffing levels, time for consolidation, not receiving protected time with preceptors and differences to allocated supernumerary time.

Conclusions

Recommendations were made for practice to include effective monitoring of the programme, and the provision of a specific Trust guideline for the preceptorship of newly qualified midwives. Providing individualised preceptorship pathways with supernumerary time in each clinical area was also recommended.

The transition to qualified professional has been reported extensively in the literature, with historic studies highlighting ‘reality shock’ and liking it to ‘flying without a parachute’ (Kramer, 1974; Godinez et al, 1999; Whitehead, 2001). The realisation of increased accountability and meeting the realities of contemporary midwifery practice can be described as a white-water raft ride with perhaps the only option being to ‘sink or swim’ (Hughes and Fraser, 2011).

Preceptorship is defined as ‘a period of structured transition for the newly registered practitioner, during which he or she will be supported to develop their confidence as an autonomous professional’ (Department of Health (DH), 2010a; 2010b:11).

Formal preceptorship programmes were first acknowledged by the UK Central Council (UKCC) (1996) and endorsed by the Nursing and Midwifery Council (NMC) (2006) to facilitate adaptation to new roles and responsibilities. Midwifery students undertake an educational programme to support their development, so that, upon qualification, they have gained the necessary skills to ensure that they are both fit for purpose and fit to practise (NMC, 2009b). To support this, the DH report, A High Quality Workforce (DH, 2008), advocated that a foundation year should be adopted post qualification to allow midwives to develop further skills, especially those relevant to complex midwifery care. This was further endorsed by the Preceptorship Framework for Newly Registered Nurses, Midwives and Allied Health Professionals (DH, 2010a), and Midwifery 2020 (DH, 2010b). However, new registrants often feel daunted by the responsibilities of their new role, and, upon qualification, lack confidence in their ability to provide effective care (Hobbs and Green, 2003).

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