Fenwick Jennifer, Hammond Athena, Raymond Jane, Smith Rachel, Gray Joanne, Foureur Maralyn, Homer Caroline, Symon Andrew
Centre for Midwifery, Child and Family Health, Faculty of Nursing, Midwifery and Health, University of Technology Sydney, Sydney, NSW, Australia.
J Clin Nurs. 2012 Jul;21(13-14):2054-63. doi: 10.1111/j.1365-2702.2012.04090.x.
The study explored the experiences of newly qualified midwives and described the factors that facilitated or constrained their development during the transition from student to registered midwife.
Knowledge of the transition to midwifery practice remains limited.
A qualitative descriptive approach was used. Sixteen graduates from one Australian University participated in a tape-recorded interview. Thematic analysis was used to analyse the data set.
The metaphor of 'The Pond', an environment that consists of layers of life and can be both clear and peaceful or murky and infested, was used to describe new midwives perceptions of the context and culture of hospital-based maternity care. For some, 'The Pond' was a harsh environment that often became toxic. The 'Life-raft' metaphor was used to describe the importance of midwife-to-midwife relationships. The theme of 'Swimming' captured the consequence of positive interactions with colleagues and a supportive environment, whilst 'Sinking' described the consequence of poor relationships with midwives and a difficult working environment.
The study highlights the importance of positive midwife-to-midwife relationships on the transition from student to registered midwife. There was also evidence that continuity with women and midwifery colleagues enhanced confidence and restored faith in normal birth. At the same time, it was clear that the midwifery culture of some institutions remains highly contested with midwives struggling to provide woman-centred care and often challenged by the risk-averse nature of maternity care.
Whilst further work is required, the findings provide a deeper understanding of individual midwives' transition period. The importance of forming longitudinal relationships not only with women but with midwifery colleagues is highlighted. Developing continuity models that adequately support graduates and student's needs are likely to assist in addressing practices issues in both the academic and clinical setting.
本研究探讨了新获得资格的助产士的经历，并描述了在从学生助产士向注册助产士过渡期间促进或限制其发展的因素。
对于向助产实践过渡的了解仍然有限。
采用定性描述性方法。来自一所澳大利亚大学的16名毕业生参与了录音访谈。采用主题分析法对数据集进行分析。
“池塘”这一比喻被用来描述新助产士对医院产科护理环境和文化的认知，该环境由生活的不同层面构成，既可以清澈宁静，也可以浑浊且充满问题。对一些人来说，“池塘”是一个恶劣的环境，常常变得有害。“救生筏”这一比喻被用来描述助产士之间关系的重要性。“游泳”这一主题体现了与同事积极互动以及支持性环境所带来的结果，而“下沉”则描述了与助产士关系不佳以及工作环境困难所带来的后果。
本研究强调了积极的助产士之间关系在从学生助产士向注册助产士过渡过程中的重要性。还有证据表明，与产妇和助产同事保持连续性增强了信心，并恢复了对正常分娩的信念。与此同时，很明显，一些机构的助产文化仍然存在很大争议，助产士努力提供以产妇为中心的护理，却常常受到产科护理规避风险性质的挑战。
虽然还需要进一步开展工作，但研究结果为深入了解个体助产士的过渡期提供了帮助。强调了不仅要与产妇，还要与助产同事建立长期关系的重要性。开发能够充分支持毕业生和学生需求的连续性模式，可能有助于解决学术和临床环境中的实践问题。
