The University of Queensland, School of Nursing, Midwifery and Social Work Level 3, Chamberlain Building (35), St Lucia, Qld 4072, Australia.
The University of Queensland, School of Nursing, Midwifery and Social Work Level 3, Chamberlain Building (35), St Lucia, Qld 4072, Australia; University of the Sunshine Coast, Sippy Downs, Qld 4558, Australia.
Women Birth. 2021 Feb;34(1):38-47. doi: 10.1016/j.wombi.2020.09.002. Epub 2020 Sep 15.
The purpose of regulation of health professionals is public protection. Concerns regarding professional conduct or midwifery care can lead to clinical investigation. Midwifery literature reveals midwives feel ill-equipped and unprepared for clinical investigation and experience stress and abreaction.
To explore the lived experience of clinical investigation and identify the personal and professional impact on Australian midwives.
Semi-structured interviews of a purposive sample of Australian midwives. Data analysis was informed by a phenomenological conceptual framework derived from Husserl, Heidegger and Merleau-Ponty.
Twelve midwives were interviewed, with seven under current investigation. Discussion involved personal and professional experiences of three or more investigations each, over a period of three to five years. Most investigations were instigated by hospitals with two complaints from women. Seven participants were alleged negligent following adverse neonatal outcomes and five had misconduct allegations. Midwives were employed or in private practice and half provided homebirth services. Themes included being safe, being connected, time and being, perception and well-being.
The investigative process involves different health services, state and national bodies using varying powers and processes over protracted time periods. Participants discussed aspects such as disrespect, inequity, powerlessness, silence and ostracization. Midwives who successfully navigated clinical investigation developed resilience through reflection on clinical practice in a culture of safety.
The process of regulating midwives, designed to protect the Australian public, may be harming investigated midwives. Understanding the personal and professional impact of clinical investigation needs to underpin midwifery education, clinical practice, inform policy and regulatory reform.
规范卫生专业人员的目的是为了保护公众。对专业行为或助产护理的关注可能会导致临床调查。助产文献表明，助产士感到自己在临床调查方面准备不足，感到压力和情绪反应。
探索临床调查的真实体验，并确定其对澳大利亚助产士的个人和职业影响。
对澳大利亚助产士进行目的抽样的半结构式访谈。数据分析的信息来源于 Husserl、Heidegger 和 Merleau-Ponty 的现象学概念框架。
共采访了 12 名助产士，其中 7 名正在接受调查。讨论涉及每人至少三次、每次持续三到五年的个人和职业调查经验。大多数调查都是由医院发起的，有两起投诉来自妇女。有 7 名参与者被指控在新生儿不良结局后疏忽大意，有 5 名被指控行为不当。助产士受雇或从事私人执业，其中一半提供家庭分娩服务。主题包括安全、联系、时间和存在、感知和幸福感。
调查过程涉及不同的卫生服务、州和国家机构，使用不同的权力和程序，时间跨度长。参与者讨论了不尊重、不平等、无力感、沉默和排斥等方面。成功通过临床调查的助产士通过在安全文化中反思临床实践发展出了韧性。
规范助产士的目的是为了保护澳大利亚公众，但可能会对接受调查的助产士造成伤害。了解临床调查的个人和职业影响需要成为助产教育、临床实践、政策和监管改革的基础。
