Supporting older nurses and midwives in the Australian healthcare workplace-A qualitative descriptive study.

AIM: To explore support strategies for older nurses and midwives in Australian healthcare workplaces. DESIGN: A qualitative descriptive study. METHOD: Participants were 50 older nurses and midwives and 20 healthcare managers recruited from a broad range of Australian healthcare settings. Data were collected using semi-structured interviews from November 2018 to April 2021. The interviews were recorded, transcribed and thematically analysed. RESULTS: The limited number of identified sedentary roles and inequitable distribution of workload responsibilities were identified as constraints that impact the provision of workplace support for older nurses and midwives in healthcare settings. Three major themes were identified: Workplace support, Personal support and Doing more. A small number of participants reported support was available at work, but most said there was not. Of the reported strategies some were offered exclusively to a cohort that met an age criterion, while others were open to all staff regardless of age. Personal support strategies were employed outside of the workplace while others used strategies during working hours. Doing more related to suggestions about how organizations could do more to support older nurses and midwives at work. CONCLUSION: Support mechanisms like adjustments in workload, employment fraction, practice location, upskilling and wellness programs in workplaces are limited. To facilitate retention and support older nurses and midwives in the workforce, health workplaces should consider implementing support mechanisms that can be tailored to the individual needs of the nurse or midwife over the life course of their career. IMPACT: The findings of this study highlight the lack of support for many older nurses and midwives in Australian healthcare workplaces, emphasizing the need for further research into innovative practices on how to better support healthcare staff as they age. REPORTING METHOD: This study adhered to the COREQ reporting method. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Recency of Practice and the Maintenance of Professional Competence for Nurses and Midwives: A Scoping Review Protocol.

Australian and international nursing regulators have specific requirements for continuing competence and the professional, safe practice of nurses and midwives. Requirements can dictate duration of practice, time away from/recency of practice, revalidation policies, and time between study program completion and practice commencement. Requirements vary between contexts and are periodically updated. To identify and examine Australian and international evidence for best regulatory practices relating to recency and the maintenance of professional competence among nurses and midwives, a scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews will be undertaken. This protocol details the scope, inclusion criteria, and methodology that will guide the scoping review, which will inform an update to the Nursing and Midwifery Board of Australia's Registration Standard: Recency of Practice.

Developing the Next Generation of Nursing Disciplinary Leaders in Higher Education: Protocol for a Sequential Mixed Methods Study.

BACKGROUND: Leading nurse education and research in the higher education (HE) sector has become increasingly challenging over the last decade with many universities in Australia and New Zealand having undergone academic restructuring. The future of HE faces many challenges including recruitment of suitably qualified staff to lead teaching and research and advance professional disciplines. Increasing cultural diversity of the Nursing workforce and the communities' nurses serve, and the identification of cultural attributes in the context of racial inequities exposed by the pandemic and the climate emergency suggest different forms of leadership may be required in the future by those leading nurse education in the HE sector. Currently, there is a dearth of research evidence that identifies the qualities, behaviors, and characteristics (collectively identified as core attributes) required by nurse academic leaders. OBJECTIVE: This research aims to identify an evidenced based set of core attributes that are required to lead the discipline of Nursing in the Australian and New Zealand HE sectors. METHODS: This research is using a 2-phase sequential mixed methods design incorporating a scoping review; and Delphi technique. In phase 1, a scoping review will be undertaken to identify the qualities, behaviors, and characteristics that can influence the evolution of the next generation of academic nurse leaders. A set of draft statements and questions will be prepared based on analysis of findings from the review. Phase 2 uses Delphi technique consisting of e-survey rounds with experts in leading nursing faculties in Australia and New Zealand. An Expert Advisory Group will consider the initial set of draft statements and questions from phase 1. Consistent with Delphi technique, a series of "rounds" will then occur using an e-survey method. Established leaders (Professors and Associate Professors who are members of the Council of Deans Australia and New Zealand) will rate their level of agreement to statements on the qualities, behaviors, and characteristics required to lead the discipline of nursing in the HE sector in Australia and New Zealand. RESULTS: The findings of the scoping review will identify what is currently known about the qualities, behaviors, and characteristics of academic nurse leaders. Quantitative and qualitative results from the Delphi study will initially be reported in separate manuscripts for publication. It is projected that a final paper will be prepared from aggregated research data and outline how the findings can inform the preparation of future academic nurse leaders. CONCLUSIONS: The generation of an evidenced-based set of core attributes will serve to inform the next generation of academic nurse leaders including informing recruitment processes and postgraduate nurse leadership programs. It is anticipated that the data sets and findings will be transferrable to other disciplines within HE to aid in future-proofing discipline-based expertise and leadership in the context of academic restructure. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/40677.

Midwifery students' knowledge, understanding and experiences of workplace bullying, and violence: An integrative review.

Background: Workplace bullying, and violence within the midwifery profession, has been a well-documented concern in health literature since the early 1990's. However, contemporary research highlights that workplace bullying, and violence is often inflicted upon midwifery students. Workplace bullying, and violence has both short- and long-term effects on the student, including psychological trauma and poor mental health, loss of passion for the midwifery profession and absenteeism. To consider a solution to this phenomenon, current literature regarding midwifery students' knowledge, understanding and experiences of workplace bullying, and violence has been reviewed. Objective: To explore and critique current literature on midwifery students' knowledge, understanding and experiences of workplace bullying, and violence. Design: An integrative review. Review methods: Toronto & Remington's six-stage systematic framework was used to conduct the review, with rigour and validity for the research process. Results: Following critical appraisal, 12 articles met the inclusion criteria. Four themes emerged: (1) Prevalence and types of workplace bullying, and violence towards midwifery students. (2) Impact of workplace bullying, and violence on midwifery students' experiences during the degree. (3) Impact of negative workplace culture on the midwifery profession. (4) The requirement to develop strategies for midwifery students to address workplace bullying, and violence. Conclusions: Workplace bullying, and violence is a global health concern within the midwifery profession with evidenced impact on midwifery students' professional and personal lives. Organisational systems and approaches were identified as causes of a toxic clinical environment and workplace bullying, and violence, which impacted midwifery students' experiences. Suggestions supported universities incorporating conflict resolution strategies into midwifery degree programs, to prepare midwifery students to manage workplace bullying, and violence. Tweetable abstract: Workplace bullying, and violence is a global health concern entrenched within the midwifery profession, impacting midwifery students' professional and personal lives. Incorporating conflict resolution strategies into Bachelor of midwifery degree programs, may help prepare midwifery students to manage workplace bullying, and violence.

Developing Conflict Resolution Strategies and Building Resilient Midwifery Students: Protocol for a Mixed Methods Research Study.

BACKGROUND: Workplace bullying and violence (WBV) are well-documented issues in the midwifery profession. Negative workplace culture, conflict, and bullying are the most common forms of workplace violence experienced by midwives. Workplace violence increases the risk of midwives experiencing burnout, compassion fatigue, psychological trauma, poor mental health, absenteeism, loss of passion for the midwifery profession, job dissatisfaction, and poor job retention. Midwifery students describe workplace violence in the form of physical, emotional, or verbal abuse, and bullying. Therefore, there is a justification to develop conflict resolution strategies and resilience in midwifery students prior to graduation. OBJECTIVE: Our aim is to develop and facilitate a bespoke education program for South Australian midwifery students to enable them to develop skills in conflict resolution, build resilience, and identify self-care strategies. METHODS: This study will undertake a preparatory phase summarizing the body of literature on midwifery students' knowledge, understanding, and experiences of WBV. Following this, a 3-phase sequential mixed methods research design study will be undertaken. In Phase 1, quantitative data will be collected via a semistructured questionnaire and a validated conflict measurement tool, before and after attending an education workshop, and will be analyzed using descriptive and inferential statistics. Results from Phase 1 will inform and guide the development of an interview schedule for Phase 2. In Phase 2, qualitative data will be gathered by facilitating one-to-one interviews and a thematic analysis will be undertaken to gain a deeper understanding of midwifery students' experiences of WBV. In Phase 3, data integration using triangulation will be undertaken and meta-inferences will be developed via the integration of results and findings from Phases 1 and 2. RESULTS: The preparatory phase will commence in October 2021. Phase 1 will commence in 2022 with analysis of pre- and posteducation results anticipated to be completed by December 2022. Phase 2 will be developed from findings of the preparatory phase and results of Phase 1. An interpretation of verbatim interview transcripts is estimated to be undertaken by April 2023. Phase 3 of the study is expected to commence in May 2023, and this will involve the analysis of collective evidence gathered from Phases 1 and 2. The anticipated completion date for the study is December 2023. CONCLUSIONS: The outcomes of this research will provide insights into the prevalence and impact of WBV experienced by midwifery students. The findings of the research will report on levels of knowledge, skills, and confidence, and will assess the impact of a bespoke conflict resolution and resilience education workshop for midwifery students in managing WBV. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/35558.

Self-compassion Education for Health Professionals (Nurses and Midwives): Protocol for a Sequential Explanatory Mixed Methods Study.

BACKGROUND: A few recent studies have reported that having the ability to provide self-compassion can reduce health professionals' levels of anxiety and stress, the risk of compassion fatigue, and burnout, and it can generally improve their well-being. Therefore, there is evidence to support further research into the investigation and exploration of self-compassion education and training for health professionals. OBJECTIVE: This study aims to increase the knowledge and understanding of self-compassion and how this may enhance the health and well-being of health professionals. METHODS: The proposed research study will adopt a sequential explanatory mixed methods design. This study will be conducted in 3 phases. Phase 1 will use a pre-educational self-compassion questionnaire (web-based survey) to collect data from participants at 3 time points (before, immediately after, and after follow-up at 6-8 weeks) after they have attended a self-compassion education and training program. Phase 2 will use an interview schedule to explore the participants' views and experiences through a follow-up focus group or individual interview. Finally, phase 3 will include data integration and dissemination of key findings and recommendations. RESULTS: This study was approved by the Women's and Children's Health Network Human Research Ethics Committee and the Human Research Ethics Committee at the University of South Australia on June 26, 2021 (ID: 204,074). A scoping review was conducted to inform this research study (focusing on nurses and midwives). The preparatory phase was completed in April 2021. Phase 1 is expected to be completed by June 2022 and phase 2 will commence in July 2022. CONCLUSIONS: The key findings from the data integration for this research project will provide in-depth details and insights to broaden the discussion about self-compassion and its influence on health professionals' health and well-being. Health professionals (nurses and midwives) may benefit from self-compassion education and training programs to improve their health and well-being. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/34372.

Influence of Self-Compassion on the Health of Midwives and Nurses: Protocol for a Scoping Review.

BACKGROUND: Self-compassion is recognized to have a positive effect upon a person's health. However, the influence of self-compassion on the health of midwives and nurses is less well understood. Midwives and nurses often work in highly demanding environments and situations, and are exposed to multiple work-based stressors simultaneously. Stressors such as a demanding clinical workload, high acuity, missing breaks, working more than their contracted hours, insufficient resources and staff, and poor patient outcomes can lead to midwives and nurses feeling physically exhausted and at increased risk of poor mental health. Self-compassion may act as a protective factor, assisting midwives and nurses to remain healthy. OBJECTIVE: This scoping review will provide an overview of the evidence base relating to the influence of self-compassion on the health of midwives and nurses. METHODS: The purpose of a scoping review is to comprehensively and systematically review the literature and identify key evidence or gaps. The search strategy for this protocol includes electronic databases such as Medline, Embase, Emcare, PsycInfo, Joanna Briggs Institute, Cochrane Library, and Scopus. Grey literature sources will be also searched, including ProQuest Central, internet search engines (Google Scholar), and manually searched key journals and reference lists of relevant articles. This scoping review will be undertaken in seven stages, guided by established scoping review methods and reporting guidelines: (1) identifying the research questions; (2) identifying relevant studies; (3) selecting the studies; (4) charting the data; (5) collating, summarizing, and reporting the results; (6) consulting; and (7) dissemination of knowledge. Data will be abstracted and presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and explanation by three independent researchers. RESULTS: A preliminary search conducted in Medline (OVID) retrieved 194 results. Completion of the review is expected in December 2020 and will be published in early 2021. CONCLUSIONS: To our knowledge, this will be the first scoping review of evidence-based literature relating to the influence of self-compassion on the health of midwives and nurses. It is anticipated that this analysis of the literature will contribute to understanding how midwives and nurses may use self-compassion in a proactive way to reduce work-based stressors such as burnout, stress, and compassion fatigue. Furthermore, the findings may inform educational needs with implications for clinical practice. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/21917.

Transition experiences of internationally qualified midwives practising midwifery in Australia.

BACKGROUND: Internationally qualified midwives comprise approximately 13% of the Australian midwifery workforce. Despite their central role in the Australian midwifery system, understanding of their transitional experiences is limited. AIM: To explore the transitional experiences of internationally qualified midwives practising in Australia. METHOD: A descriptive qualitative study was undertaken, as the second phase of a larger mixed methods study. In this paper we present in-depth insights from 11 internationally qualified midwives practising in Australia. Individual semi-structured interviews were conducted between May-August 2018, digitally recorded and then transcribed. Transcriptions were analysed using a thematic analysis approach. FINDINGS: Participants in this study identified that the different culture of the work environment, differences in midwifery practice, lack of autonomy in their practice and perceived discrimination influenced their transition into Australian midwifery practice. Four themes were identified: 'Differences in midwifery practice', 'Cultural incongruence', 'Discrimination' and 'Mixed emotions'. DISCUSSION: Success during the complex transition process depends on the migrant midwives' ability to build a sense of belonging, and to develop and adopt strategies that assist in dealing with new workplaces and an unfamiliar workforce. CONCLUSION: A structured transition program prior to commencing practice, as well as an evidence-based workplace mentorship program with a focus on Australian midwifery care and culture, may be effective strategies to facilitate their transition. To promote awareness of multiculturalism within the work environment, this study recommends actively encouraging host staff to further develop perspectives that enable them to create positive relationships with staff from other cultures.

Transitional Experiences of Internationally Qualified Midwives Practicing in Australia: Protocol for a Mixed Methods Study.

BACKGROUND: Approximately 13% of the total Australian midwifery workforce is internationally qualified. Although the internationally qualified midwives (IQMs) play a significant role in the Australian midwifery system, there is limited understanding of their transitional experiences. OBJECTIVE: The objective of this study protocol is to explore the transitional experiences and views of IQMs practicing in Australia, through the investigation of demographic profiles and key challenges that influence a smooth transition. METHODS: This paper presents an explanatory sequential mixed methods study protocol. This protocol incorporates an e-survey and individual interviews. The e-survey in the first phase will be distributed to IQMs in Australia via the website e-bulletins of the Australian Nursing and Midwifery Federation and the Australian College of Midwives. Additionally, potential respondents will be recruited via social media (ie, Twitter and Facebook) and associated snowball sampling. Data from the e-survey will be statistically analyzed. At the end of the e-survey, respondents will be asked whether they are willing to take part in an interview. The results of the e-survey and relevant literature review will help to develop a guideline for interview questions for the second phase. In phase two, a purposeful sample of participants will be recruited using the same selection criteria as for the e-survey. Semistructured interviews will provide a deeper insight into the transitional experiences of IQMs. Data from the interviews will then be thematically analyzed. RESULTS: An integration of the e-survey results (phase one) and interview findings (phase two) will be synthesized to explore and better understand the transitional experiences of this group of midwives. It is anticipated that data collection and analysis will be completed by June 2019 and results will be disseminated through peer-reviewed publications in late 2019. CONCLUSIONS: This research protocol may generate new knowledge about the transition of IQMs in Australia. These findings could be used to formulate recommendations to inform the transition of future IQMs in Australia. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/13406.

Comparison of three clinical facilitation models for midwifery students undertaking clinical placement in south Australia.

Clinical placement is a core feature of Australian midwifery education programs, with clinical supervision acknowledged as a key component for student success. The aim of this study was to evaluate the clinical facilitation models in South Australia, specifically the quality of clinical supervision to facilitate learning, and key stakeholder satisfaction. A mixed method evaluation research design was used to compare three models of clinical facilitation for midwifery students undertaking clinical placement across five venues. Midwifery students (n = 174), across two universities completed an anonymous e-survey utilising the validated Clinical Placement Experience Questionnaire. Midwives (n = 149) across five venues completed an anonymous purpose-designed questionnaire on their experience providing clinical supervision to midwifery students and Clinical Facilitators (n = 8) representing three facilitation models completed a self-report e-diary for two weeks and engaged in a focus group. Few differences were identified between the quality of student support and learning opportunities. Students in all models were well orientated and prepared for the clinical environment. Clinical Facilitators were supportive, educative and valuable for the students to achieve their learning objectives. One significant difference was that facilitators employed in the 'Shared' model were more able to provide support to midwives supervising students and maintain good liaison with the universities.