Dear Sue,
I hope the trial goes well for you all at Swans. My heart is always with
the unit.
I know that I could not work a shift and caseload as well. As you know, in
private practice at the Midwifery & Natural Childbirth Centre (not a birth
centre) we caseload as the primary midwife and very rarely need to send for
a colleague to take over. A caseload of 40 births per annum is quite enough
for me and allows me to give clients my full attention as well as giving me
plenty of time to wear my numerous other "hats". I also don't take rostered
days off nor do I have rostered holidays except for 3 months every 10 years
when my husband has long service leave and we go overseas. The births have
their own rythm and I get quite a few days off to do my own thing and wear
those other hats.
I agree that being "on call" has it's disadvantages, especially when my
five children were small. Now they are grown up it is easier of course,
except that now my daughter says that I am an unreliable babysitter,
although I have only missed once in 2 years. I guess that per midwife you
would have a lot more clients than I do, so that is probably the difference.
There must be a way to make it work in the hospital birth centre setting!
Someone out there must have the formula!. The Freestanding Birth Centre
midwives in the States may be able to give us a few clues. Maybe we should
contact Kitty Ernst or Ruth Lubic ? Even if they are retired i know that
Kitty's daughter was still running things in 1997. Random thoughts.
regards, Mary Murphy
----- Original Message -----
From: Sue Cudlipp <[EMAIL PROTECTED]>
To: midwifery list <[EMAIL PROTECTED]>
Sent: Saturday, August 14, 1999 11:42 AM
Subject: Fw: Negative Effects of Being a Caseload Midwife
>
> -----Original Message-----
> From: Sue Cudlipp <[EMAIL PROTECTED]>
> To: Kathleen Fahy <[EMAIL PROTECTED]>
> Date: Saturday, 14 August 1999 11:24
> Subject: Re: Negative Effects of Being a Caseload Midwife
>
>
> >Dear Kathleen
> >I am reposting a reply I made to Trish Davis' enquiry about on-calls as
it
> >seems relevant to your question too.
> >As a footnote (if a footnote can come at the start!?)
> >I have just had my first on-call with the new trial method and it worked
> >thus:
> >I worked a rostered shift yesterday from 7-14.30, the oncoming midwife
for
> >the team received a call from a primip in labour just before I left, she
> was
> >admitted and was in early labour with an OP position.
> >My colleague rang me at 6pm to say I would be needed to relieve her at
> 9.30.
> >I managed a short rest on the settee and returned. The client birthed at
> >0250
> >I was able to leave at 0600. My rostered shift for today is 1400-2130
but
> >according to the conditions of on-call, I have to have 10 hours break, so
> >will not return till 1600, without loss of pay.
> >You may well wonder why I am not asleep now! - My husband had a prior
> >commitment this morning and we have three children, so I have had a
couple
> >of hours and plan to have a few more when he returns.
> >Financially it was a profitable night for me, physically I dont feel too
> bad
> >at the moment, as I only work part-time I do at least get the chance to
> >catch up on Monday!
> >We are committed to making this 'compromise' work and the team are all
> quite
> >positive - I know from past experience there will be unforeseen problems
> but
> >we hope that we will at least be able to keep our birth centre running
this
> >way. Bottom line is that all our clients will receive good, safe,
midwife
> >care and medical care when appropriate. As we are such a small BC there
> has
> >always been the possibility that the room may be occupied when women come
> in
> >so the clients have always been made aware of this - in fact this
happened
> >last night- there was another BC lady in at the same time, both birthed
> >within a couple of hours, but the second one to arrive was cared for by
> >midwives rostered to delivery ward that night - her birth and care were
as
> >she wished, and she had no interference with her labour.
> >
> >Anyway - here is the rest of the post - hope it is helpful, the problems
of
> >this sort of system are very real to those working the long hours. In
the
> >original BC format I have spent up to 22 hours with one labouring woman -
> >one has to question the safety of this! Not least of which is the issue
of
> >driving home in such a tired state!
> >Regards, Sue
> >
> >>Dear Trish
> >I don't know about research but our Family Birth Centre at Swan District
> >Hospital is threatening to close ( again!) This time due mainly to
'midwife
> >burn-out'.
> >We are trialing a three month compromise which is more midwife friendly,
> but
> >less client friendly. It means that the women will not get to know their
> >midwife in the same way that was previously managed, and stand a higher
> >chance of transferring into the unit for staffing acuity reasons rather
> than
> >medical ones.
> >I worked for 15 months in the FBC when it first opened, without a
holiday,
> >and only part-time but I know how tough it was for me on a personal level
> to
> >cope with the on-calls and have a life too!
> >I am one of the new team for this trial period and hope that it is
> >successful - but there are many doubts!
> >Regards, Sue
> >-----Original Message-----
> >From: Trish David <[EMAIL PROTECTED]>
> >To: [EMAIL PROTECTED] <[EMAIL PROTECTED]>
> >Date: Thursday, 12 August 1999 9:32
> >Subject: on call
> >
> >
> >>Dear Listners
> >>Does anyone have any information on research whcih has been conducted
into
> >>the effects of being 'on-call' on midwives or nurses? I have a friend
> >>doing a masters project looking at these effects on NNICU nurses doing
> NETS
> >>transports. Your help would be of enormous benefit. Ta. Trish
> >>--
> >
> >-----Original Message-----
> >From: Kathleen Fahy <[EMAIL PROTECTED]>
> >To: Ozmidwifery <[EMAIL PROTECTED]>
> >Date: Thursday, 12 August 1999 13:10
> >Subject: Negative Effects of Being a Caseload Midwife
> >
> >
> >>Here in Toowoomba we are working towards a submission for caseload
> >midwifery
> >>within the mainstream health services.
> >>
> >>We expect about 10% of women to take up the offer of MMC (I know, we are
> >>still going to move ahead in spite of what has happened at John Hunter).
> >>
> >>The midwives on the unit have asked me to ask midwives who have made the
> >>switch from traditional shift work to caseload to describe what the
> >>transition was like and particularly focus on the perceived negatives of
> >>being on-call and maybe spending long hours at some labours.
> >>
> >>I would appreciate your responses which I will then share with
interested
> >>midwives.
> >>
> >>Thanks,
> >>
> >>Kathleen
> >>
> >>Dr. Kathleen Fahy
> >>Associate Professor
> >>Midwifery Co-ordinator
> >>University Southern Queensland
> >>07 46312377
> >>[EMAIL PROTECTED]
> >>
> >>--
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> >>
> >
>
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