Monday, April 19, 2010

Have your say on what the 'Eligible Midwife' will be


Well here it is the Nursing and Midwifery Board of Australia has released a draft of what 'eligible midwife' may look like.....

The Key points are as follows;
1. Current general registration as a midwife in Australia with no restrictions on practice - having as it does all the requirements for eligibility for registration under the Act.

2. Practice for at least three years across the continuum of midwifery care (ante-natal care, intrapartum care and post-partum care of women and their infants), within the previous 5 years.

3. participation in an additional 20 hours per year of continuing professional development relevant to the continuum of midwifery care.

4. successful completion of a NMBA approved professional midwifery practice review program for midwives working across the continuum of midwifery care.

5. compliance with the collaboration requirements for eligible midwives- that is the requirements for midwives to work collaboratively with other health professionals as outlined in regulation and national health policy instruments.

6. successful completion of an accredited and approved program of study determined by the Board to develop midwives' knowledge and skills in prescribing, or a program that is substantially equivalent to such an approved program of study (at midwifery post graduate level and designed around the flour components of prescribing - information gathering, clinical decision making, generation of medication order and monitoring the review.

As the model of care for eligible midwives is across the continuum of maternity care, eligibility is contingent upon all requirements being met..... therefore once a midwife has been endorsed as an eligible midwife; and authorised and provided with the necessary provider number by Medicare Australia: READ the full document Guidelines & Assessment framework for the recognition & endorsement of eligible midwives

2 Endorsement to practice as an eligible midwife (to read the full document click the hyperlink)

To be entitled to endorsement under section 98 of the National Law an applicant wishing to be identified as an eligible midwife must be able to meet all the requirements including being a currently registered midwife in Australia; being able to demonstrate through professional review of practice at least 3 years experience across the continuum of midwifery care within the 5 year period preceding the application, comply with the collaboration requirements for eligible midwives; and have an approved qualification to administer, obtain, possess, prescribe and supply scheduled medicines required for practice across that
continuum of midwifery care.

Wording to appear on the register
Endorsed as an eligible midwife working across the continuum of midwifery care and qualified to provide the associated services, order diagnostic investigations and administer, obtain, possess, prescribe and supply schedule 2,3,4 & 8 medicines in
accordance with relevant State and Territory legislation, required for midwifery practice.

If you wish to provide comments on this paper, please lodge a written submission in electronic form by email to natboards@dhs.vic.gov.au by close of business on Wednesday 27 April 2010.

PLEASE FORWARD COMMENTS....if you wish please respond to the blog and I will collate the comments for a submission, but you need to add your name to the comments, otherwise they will not be included....... Now is the time to have your say..... get women, mothers, consumers....anyone who is interested in birthing in Australia needs to have a say....this is the future of Homebirth and Private Practice in Australia.....there is a short consulation period so please do it now!

Cheers Pauline



13 comments:

  1. Hi Pauline!

    Thanks for offering the oportunity to comment on the "eligible midwife" draft. Here is my thoughts:

    An eligible midwife should have 2 years experience across the full scope of midwifery practice AND recency of practice in the last five years (instead of 3 years in the last 5 years).

    I would also like to comment, that a direct entry midwife should only need 1 year of experience as the midwifery education is longer and broader.

    I would like to suggest the Midwifery Practice Review provided by the ACM as a approved professional review.

    Cheers, Sylvia

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  2. Thank you Sylvia for your comments, I would like to ask you on what evidence do you decide that a postgraduate midwife should be any different to a direct entry midwife.....as all midwives conduct the same number of births and continuum of care as students... once you are qualified, a midwife is a midwife..... You could argue that a postgraduate midwife has more experience in recognising and dealing with the more critical unwell client than a direct entry midwife otherwise known as Bachelor of Midwifery.... you have to be mindful of creating different categories of midwives.... again I reiterate a midwife is a midwife....and once qualified you should not need any more than 1 year to be able to work in the community.
    Once again thank you for starting the converstation well done.....

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  3. Hello midwives and midwifery students,

    I agree with the above comments that 3 years of post registration experience is excessive. One year of experience should be adequate. Can I ask where did 3 years come from?

    It is my understanding that in other countries, for instance NZ midwives can work independently as soon as they are registered.

    I also agree with the last comment that midwives are midwives however they train, however, direct entry midwives currently experience continuity of care with 30 women and what it is like to "be on call" during their training and this should count for something.

    In the current hospital system it would be very hard for midwives to gain experience with continuity of care.

    If required the student experience of continuity of care should be considered when deciding eligability, especially if unable to caseload once employed.

    Thanks
    Liza Kennedy
    Student midwife.

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  4. Dear Lisa,
    Thanks for your opinion it is most valued, it is really good to see our future midwives taking such interest and being motivated to comment on such important issues. Now to respond to your comment, yes I do think that the Bachelor of Midwifery students are in an ideal situation to move more easily into caseload when they have competed their course because of the continuity of care experiences they have gained..…however I also feel that the postgraduate students are disadvantaged by not being able to experience the continuity of care at this stage, but we are working towards that so that there is equity in both courses, this is a plan for the future. You also have to remember that nurses moving into midwifery bring an enormous wealth of skills from working in the health care setting. Some of them have worked in rural and remote settings where they are ‘on call’ and experience a type of continuity of care, they are well equipped to deal with much different health care issues… also there are nurses who have worked in critical care and theatre which also expose them to ‘on call’ . I guess the bottom line is Lisa; at this stage we will be arguing for 1 year post course experience (a graduate year) rather than 3yrs before you can be an eligible midwife….As for your question where did the three years come from…. That is a question for the NMBA as they recommended it….there is no evidence for it that I can find. All midwives even current students will have to do the bridging or updating course whatever you want to call the extra courses required for eligibility…. As this is not incorporated in the current courses in Australia (MBS & PBS) as it is all new to us….but will be included for future courses and continuity of care will be included for postgraduate midwives…. It is important to remember that we are all midwives whether a Bachelor of Midwifery of a Postgraduate Midwife….we need to all work together to achieve the end goal, which is that every woman needs a midwife….. it is team work we want….we want to stand together no matter what course we did, we do not want divisions within Midwifery. A Midwife is a Midwife is a Midwife.......

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  5. opps forgot to add we have many many UK midwives that have done the 18mths Bachelor of Midwifery shortened course (nurses now midwives) who by definition are already eligibile midwives, because this is how they work in the UK.....just for example I have worked in caseload in the UK....what about the NZ midwives?? it is going to be hard to start adding exceptions to the rule....lets just all work together....All women need a midwife.

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  6. Absolutley- midwives united is the only way to go!

    It would be a great opportunity for all midwives in their training to experience working in the community and continuity of care, as this is the future of care in this country.

    All women need continuity of care, and yes, all women need a midwife.

    Liza Kennedy

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  7. thanks Liza lets make some waves......

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  8. I cannot help but feel dissappointed in the requirements for "Endorsement to practice as an eligible midwife."
    There is no evidence that says 3 years preparation is what is required, most other countries do not have this requirement - as once you graduate from an accredited course you are registered to practice.
    Also I would like to know what is meant by "accredited and approved program of study determined by the Board" - what availabily/cost is associated with this. Also there seems to be an assumption that this is not already addressed in current courses.
    RWe need to remember that within a few months the NMBA will be looking to endorse national accreditation standards for midwifery courses - these may involve the UG course continuing at 3 years and the course's for nurses wanting to become midwives being a minimum of 18 months. So when looking at the criteria we need to remember that the future graduate may look a little different, have different opportunities and clinical experiences as a student. Including the Continuity of Care Experiences.

    I teach in both undergraduate and postgraduate midwifery courses - and prepare midwives for practice as midwives. I think it is very dangerous for the profession to suggest that one course or the other prepares a different sort of midwife. Registration as a midwife should mean you can practice as a midwife, irrespective of your route to that qualification. In fact - the diversity, life experiences .... of our graduates is what makes the midwifery profession as "rich" as it is.
    Jennie

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  9. NZ midwives are able to work in the community as self-employed, independent midwives from day 1 after registration. We have a mentoring program in place to support these midwives:

    http://www.midwife.org.nz/index.cfm/1,171,html

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  10. I have read the comments and I have to say I am a little disappointed in the "them and us” attitude. At the end of the day once you get your registration you are a midwife and that is all that matters. We all have different journeys that lead us to becoming a midwife and we bring these and the life experiences, as well as the "training experiences" with us.
    But back to the point,
    3 years is basically ridiculous. At the end of the day if you are registered as a midwife you should be able to practise as a midwife from day 1, 1 years experience should be the maximum required. As for the other stuff. 20 extra hours of what, don't we do this already?
    Successful completion of an accredited and approved program of study determined by the Board to develop midwives' knowledge and skills in prescribing, where do we access this and who is going to pay for it??
    I think they are making it so much harder than it needs to be and what worries me is this is only for antenatal and post partum care. what will the requirements be for community intrapartum care??
    Clare Davison

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  11. very true Clare, thank you for taking the time to comment....we have to wait and see what the outcome will be....

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  12. Hello!
    I understand and believe that we do not want to create different classes of midwives as we need to be united to form the midwifery future in Australia. From my observations the direct entry midwives trained in this country are getting very well prepared to work as independent midwives because of their exposure to continuity of care, being on call and work within different hospital systems and CMWA. Therefore I was inclined to give them “credit” towards quicker eligibility. On the other side I do acknowledge the experience a postgraduate midwives brings along and would support your idea of using the additional 1 year experience requirement to ensure all eligible midwives meet the same professional standard to act as an independent midwife endorsed by ACMWA.
    Regards, Sylvia

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  13. thanks Sylvia, we need to stop differentiating between midwives...by the course a midwife has completed....at the end of the day a midwife is a midwife..... a small percentage of midwives will end up practising as an independent or (private practising) midwife. Also the ACM WA does not endorse midwives... whatever decision is made by the NMBA it will apply to all midwives across the board and the 'eligible midwive' will have to do further study regardless of which course they have completed for the short term anyway...
    lets work together....

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