Wednesday, December 29, 2010

A year in reflection:

A reminder of the College Vision:
Our vision is to be the leading organisation shaping Australian maternity care for the benefit of women and their families
The Australian College of Midwives (ACM) is the peak professional body for Australian midwives, which strives to maximize the quality of midwifery and maternity care for Australian women and their families through:
• Providing a unified voice for the midwifery profession.
• Supporting midwives to reach their full potential.
• Ensuring all childbearing women have access to continuity of care by a known midwife.
• Setting professional practice and education standards

This has been an amazing year with many highs and lows.... everyone working hard for the College and the greater good ..... above all working to improve the choice for childbearing women and the midwives who work with women.

As I summarise the year from the blog entries I am in two minds as to how well we have done over the year....If I examine the word "well", skilfully, expertly, effectively, efficiently, adequately, admirably, conscientiously and proficiently - then I think as a Branch we have achieved this.... however as I read between the lines there has been some misfortune for me personally: as you can imagine writing a blog for the College I have to be mindful of confidentiality, defamation, ethics, conduct and my own professional standing....there is no such thing as freedom of speech.... however still offering news, honesty, general information etc.... therefore I have to be mindful of what is published.

I have to say that this rule has not been applied to myself and I am in the process of taking legal action against information wrongly published about me threatening my integrity and professional standing... this is a sad reflection of the times and soul destroying. Therefore this is a timely reminder to be mindful of what you publish on the Internet & email...... defamation is the fastest growing litigation....

The blog to date has had over 4500 hits...the blog posts have almost doubled and is up to date with current issues:

January was meeting the then Prime Minister & the Honorable Nicola Roxon, the Big Picture tour of the proposed changes for midwives; Februry.... new midwifery students and Homebirth rallies..... March... GoGirlAustralia... April.... ANMC here to stay as the "appointed accreditation body"... submissions for the "eligible midwife"... May... IMD celebrations...24hr Virtual IMD ..... and the farewell to Jill Banks....June... came the insurance debate, options and collaboration...July was D-Day for National Registration....and Collaborative arrangements... Determination 2010; concern for private practice, fear, stress, tears, it was a nightmare....

August...Australian Election....the nightmare continues; a hung Parliament... Homebirth...Collaborative arrangements...ACM National meeting & Breathing New life Conference Alice Springs....Sept... Determination still dominated the midwifery world... lobbying, emails...meetings with politicians...etc... GoGirlAustralia leaves Fremantle.....

October.. WA joins National Registration... APHRA comes alive for us.... Victorian conference and AGM also AGM for National.... November... History is made... Medicare Provider Numbers for eligible date there are approximately 15 eligible midwives throughout Australia...December... first Midwife to get collaborative agreement.... lets hope this continues....
Trail Blazers, the inaugural Bachelor of Midwifery for WA prepares to enter the workforce as Midwives (who are not nurses), Barb Vernon EO of the ACM resigns and change is in the air..... i have always said as a College we need to be united... "united we stand divided we fall" I am going to pinch a quote from Obama's State Union address " we face big and difficult challenges, we do not give up, we do not quit. We do not allow our fear or division to break our spirit".

Xmas dinner
Thank you to a wonderful executive team we have in WA.... the whole team has worked very hard and continue to work hard for the WA members and women of the State....wishing you all a happy and successful 2011.

My wish for the College & the year ahead:
"Teamwork is the ability to work together toward a common vision. The ability to direct individual accomplishments toward organizational objectives. It is the fuel that allows common people to attain uncommon results."~ Andrew Carnegie

"Coming together is a beginning. Keeping together is progress. Working together is success." Henry Ford

signing of for 2010, see you in the New Year, wishing you all a safe, happy, successful 2011. Pauline Costins

Tuesday, December 28, 2010

Guinea Pigs or Trail Blazers

When I was asked to write something for the ACM blog about the experience of being the first BMid students to get through their training in WA, I realised how difficult it was going to be to sum up the gamut of emotions, the roller coaster ride that my fellow BMidder’s and myself have been on the last 3 years.

We are a diverse bunch of women, some young, some not as young, we have children, husbands, careers, boyfriends, and jobs outside our training to be midwives. Yet I think it is safe to say that for three years we have lived, breathed, eaten, dreamed, hated, loved, and despaired over nothing else but midwifery. Midwifery has been centre stage.

We are the guinea pigs. How often have we heard this girls? The initial reaction to us in some places was palpable. We were told we could not make good midwives (because we are not nurses), that we would not be employed (because we are not nurses), that we would not be able to give certain medications (because we are not nurses). We did wonder at times, if we would be able to do anything at midwives.

Despite these frustration’s, and thanks to the tenacity and support of amazing and wonderful women: Jenny Wood, Lesley Kuliukas, Janice Butt and our tutors, we marched on because we knew deep down inside that it is midwives we want to be, NOT nurses.

As a group we feel very lucky to have experienced many models of care. We were able to see home birth and family birth centre births. We watched women make informed choices about their care and become empowered in women centred models of care. We experienced continuity of care and developed an appreciation of how continuity of care is the gold standard in maternity care.

We were privileged to develop relationships with many women, and care for them during their pregnancy, labour, birth and beyond. We have been “with woman” for a diverse group of women: women with mental illness, women who are still teenagers, women from remote Aboriginal communities, refugee and migrant women, single and married women, women addicted to substances, diabetic and healthy, free and incarcerated, public and private. We are coloured by these experiences.

We have had three years to soak up the political environment. I am not sure any of us realised JUST how political midwifery and healthcare could be. We are now well informed of this fact and have consented to being a part of the debate. The same debate as always; how do we work together with other health professionals and how do we respect women’s choices.

There are 17 students in my graduating class, and through our trials and tribulations we have leaned on one another for support and friendship. We are grateful that we have had one another and will continue to support each another as we work as midwives. We are also grateful to the hospitals that have provided clinical placements and the midwives who have had the patience to take us under their wings.

So now that we are heading down the birth canal, there is a lot of stretching, and discomfort, a little bit of fear of what it means to be completely responsible for our actions as registered midwives. We have come a long way, and the learning is only just about to start. Most importantly, we have realised (and we hope everybody else does too) that, we are not guinea pigs, we are trail blazers and we are very proud to be moving the profession of midwifery forward.

Tuesday, December 21, 2010

Don't forget WA Midwives & Nurses need to renew your registration:

WA Registrations are now due: don't forget!

Amid the rush and excitement of Christmas, please do not forget to renew your registration with AHPRA - (on-line registration) due for most 31st December; it will cost you $48.00 to renew until May due to the change over dates of National Registration:

You need to renew both Midwifery and Nursing - or choose one or the other it is your choice as there are now two registers; remember what you are contracted to work before dropping off any of the registers:

The process is easy online or go into the AHPRA office in Hay St Subiaco WA:

Have a safe and Happy Festive Season:

Monday, December 20, 2010

A farewell tribute to Barb Vernon

Midwife means ‘with woman’. This meaning shapes midwifery’s philosophy, work and relationships........recognises every woman’s right to self-determination in attaining choice, control and continuity of care from one or more known caregivers...

The Australian College of Midwives (ACM) is the peak professional body for Australian midwives, which strives to maximize the quality of midwifery and maternity care for Australian women and their families through:
• Providing a unified voice for the midwifery profession.
• Supporting midwives to reach their full potential.
• Ensuring all childbearing women have access to continuity of care by a known midwife.
• Setting professional practice and education standards

I remember meeting Barb Vernon at the WA conference in 2003; this was around the time that Barb started off as the Executive Office for the College. I have always found Barb to be engaging, passionate and her focus was always to take the College to great heights; She has taught me the benefits of being politically savvy and most importantly being a quiet but forceful lobbyer; I regret having less than 10 months as a Board Director to learn from this phenomenal woman. I will not spend my time saying how amazing I thought Barb was, we all know that, and yes we all have our short comings, none of us are perfect, least of all me, however Barbs achievements speaks volumes.....and here creditability is without question.

It is remarkable what Barb has done for women, midwives and midwifery of Australia and where she has taken the College too in the last 7.5 years.... if you mention her name it is synonymous with the ACM: I can’t count the number of times I have heard people say “Barb Vernon, yes a very articulate and intelligent woman” “you’re lucky to have her” and they are correct.

Barb has always put her heart and soul into everything she has done for the College... her major achievements is as follows: (and I have not listed them all).
Medicare funding, provision of PBS and prescribing rights for midwives, national standards for entry to midwifery, establishment of separate, national professional standards for midwifery, separate register for midwives in the new national registration recognising midwifery in its own right, the development of the Midwifery Practice Review, MidPLUS, online CPD and portfolios, the development of an internationally recognised peer review journal for midwives, the list is endless;

For me what Barb has done most is establish mutually respectful and collaborative relationships with key national health organisations, such as, Australian Nursing Federation, the Australian Nursing and Midwifery Council, the Nursing and Midwifery Board of Australia, the National Rural Health Alliance and many others...... She has forged a way forward politically, established good working relationships..... with Health Ministers etc. The college has had phenomenal growth to date; excellent collegial relationships with major stake holders expanded the College activities and services to members for the future and good political ties, the College is at the table for discussions and this is due to Barbs excellent political and lobbying skills.

There does come a time to say goodbye, when you have done all you can and for someone else to come along and take the college the next step, sadly that time has come for us. I bid Barb Vernon a fond good bye and wish her every success in life; and say the ACM & women owe her a multitude of thanks – we went part of the way in thanking her when we celebrated Barb’s achievements at a farewell in Canberra last week.

I am going to leave you with one of my favourite sayings Barb; an Irish Blessing (A Blessing from St. Patrick)
May the road rise to meet you,
May the wind be always at your back,
May the sun shine warm upon your face,
May the rains fall soft upon your fields,
And, until we meet again,
May God hold you in the hollow of His hand.

(Traditional Irish Blessing; origin unknown,
although some attribute it to St. Patrick.)


Thursday, December 16, 2010

A Directors responsibility under the Corporations Act 2001 (Cth) (the Act)

The Australian College of Midwives is an incorporation therefore falls under the rules and regulations of the Corporations Act (Cth) and the statue of limitation is 6 years, therefore a responsible position.
By law a Board Director is responsible for: The following information comes from Directors Duties under the Corporations Act 2001

Duty to act with care and diligence - s180(1)
A director or other officer must exercise their duties with a degree of care and diligence that a reasonable person would exercise in their position. The standard of care and diligence required as determined by a court would take into consideration the company's circumstances and the director or officers position within the company. The skill required by an executive director is measured objectively in regard to that directors' special calling. So, in considering whether a director is so negligent as to be in breach of the statutory duty, the conduct is measured in two ways: against the (objective) standard of care; and against the standard of skill held by the particular director or officer.

Duty to exercise powers in good faith – s181(1) (Conflict of duties)
A director or other officer of a corporation must exercise their powers and discharge their duties: in good faith in the best interests of the corporation; and for a proper purpose.

Duty not to improperly use position - s182 (Duty not to profit from position)
A director, secretary, other officer or employee of a corporation must not improperly use their position to: gain an advantage for themselves or someone else; or cause detriment to the corporation.

Duty not to fetter discretion's Directors have certain discretion's conferred on them by law and the company's constitution. When exercising such discretion's the directors are subject to two duties, namely: a duty to retain discretion; and duty to give adequate consideration.

Directors must exercise active discretion, they cannot ignore issues or blindly rely on another person. They must give adequate consideration when purporting to exercise a particular discretion.

Material personal interest - director's duty to disclose - Section 191
s191 requires a director who has material personal interest in a matter that relates to the affairs of the company to give the other directors notice of this interest. s191(2) outlines the exceptions to this requirement to provide notice.

The notice must give details of the nature and extent of the interest and the relation of the interest to the affairs of the company and be provided at a directors' meeting as soon as practicable after the director becomes aware of their interest. The details must be recorded in the minutes of the meeting.

Failure to disclose a material personal interest according to s191(4) does not invalidate a resolution by the directors at first instance. It has been held that the threshold for determining whether an interest is material is quite low however this contrasts with Magellan v Mount King Mining NL where the Western Australian Supreme Court stated that the nature of the interest ``should have the capacity to influence the vote of the particular director upon the decision to be made, bearing in mind that the conflict of interest must be of a real or substantial kind''.

Therefore it is considered appropriate to declare even minor conflicts of interest where there is a potential for conflict so as to err on the side of caution.

s192 of the Act provides that a director may give other directors standing notice about an interest. The notice may be given at any time and whether or not the matter relates to the affairs of the Company at the time the notice is given.

This is worth reading and taking note if you are a Board Director........

Wednesday, December 15, 2010

In the best interest

This blog is not meant to reflect any one person or persons: it is pondering on the phrase “In the best interest”: what does this really mean? when it comes to law and ethics there are two very different meanings, traditionally when we refer to children you might consider that parents and doctors talk about “in the best interest” it means what is considered to be best for the child...not what is best for the adult, there are times when both the doctor and the parents do not agree as to what is in the child’s best interest. “Best interests” is the doctrine used by most courts to determine a wide range of issues relating to the well-being of children.

My discussion today is about “in the best interest for the College” – now we are looking at “best interest” from a different perspective: you are looking at a philosophy, an organisation and the people within that organisation: 8 people on a Board an EO, office support staff and the membership & stakeholders: Without the membership nothing else exists:

Defintion of “Best Interest” Authority delegated for taking any action or step the delegatee thinks to be the most advantageous to the organization, under the circumstances. This power is conferred usually where it is impossible to anticipate every eventuality, or where the need for rapid decisions or quick response is critical. It is normally given for a short period, or until the time adequate information is available to formulate specific directions or guidelines.

Just to explain some general governance processes of a board for those who may not be familiar with this process: Usually an organisation will have a Constitution Governance Charter (which sets out the ground rules and job descriptions)and several other polices: The board directors are the strategic thinkers they set future goals and represent the college on the National & political front; The directors are selected by the State Membership, this does not mean that the State Board director is responsible to the state they are the National Board director from each state and territory looking after the best interest of the National College: the board director may choose to report back to the State branch to keep them informed about National issues: Therefore the National College has 8 board directors: from this the office bearers are elected the; College President, Vice President and Treasurer; All the directors are volunteers, this is an unpaid position, done as a professional duty to further the profession.

The executive officer is a salaried position; appointed via advertisement and a panel interview: The EO is responsible for carrying out the strategic plans that the board develops: and managing the office staff to carry out the work required in assisting the membership etc the day to day minutia that is required of an organisation of a 5500 membership; The board directors do not venture into the realm of the EO, that is the day to day running of the college.

In order for an organisation to function well you have to have a president and an EO that can work together and a board that is united in philosophy – they do not have to necessarily see eye to eye but they have to know how to agree to disagree and come to reasoned decisions, the ability to argue respectfully, have insight to their behaviour and most importantly have integrity. You have to leave your own agenda at the door, because the focus is “in the best interest of the College” that is for all 5500 members not just certain sectors of the membership. Confidentiality is a vital component to any board, mutual respect and good governance. Once on the board it is a National board, no state or territory exists, however this does not stop factions, such as state biases, homebirth etc

If directors come to the table with different agendas and ego’s the ability to have insight is difficult and decisions are clouded by the comment “in the best interest” my question is whose “best interest” are they truly serving? When you have powerful people in the room you are bound to get explosions, what is required is reasoned arguments, powers of persuasion without bullying and mutual respect.... once respect is gone there is a breakdown in communication because there is a tug of war about “the best interest” this is blatantly clear because there is a breakdown of respect and the factions then take over or the personal loyalties to people rather than “the best interest of the College” and then the battle begins.

The other over powering conflict that may influence how boards behave is outside influence – everyone else knows how to run the board – everyone looking into the fish bowl thinks they know best and want their two cents worth – this can be detrimental – again this comes down to a breakdown of trust and the issue of “the best interest” again I ask “whose best interest” or “whose agenda”? Once you as a board member breach confidentiality and let the outside world in...... it opens the board to criticism.... there is a fine line between being transparent and breaching confidences that lead to untenable situations.

If you do not have good governance you will not be able to function as expected and when things go pear shaped you have nothing to fall back on, it is imperative to ensure there are appropriate governance structures in place to protect your board and organisation.

I am truly saddened that great women have been wounded –in my experience 95% of people are good....but sure as hell that 5% can cause havoc, there is always a minority that cause you to have to reconsider your point of view:

I am disappointed that I have not been able to achieve the things I wanted and have a heavy heart however I am confident I have followed my heart and acted “in the best interest of the College”.