Re: [ozmidwifery] Bullying - doing something about it

[Marilyn Kleidon]

Dear Carolyn:   I endorse everything you have written with the addition of reduction in the mother/baby pair to midiwfe ratio IF a mother/baby pair is recovering from a caesarean birth. As you all know it is not just the increased obs in the first 24 hrs it is the increased breastfeeding difficulties that demand a midwife's care during this period, but this means the other women in our care get minimal care.   To off set this, I wonder if we could have rooming in rooms for mothers and babies who are basically well enough to go home 6hrs after the birth but just don't feel they want to (for a variety of reasons that would be solved by NMAP). At the moment I see many women in this situation who would like to stay maybe 48 hrs in the hospital but are sent home in between the shifts I work because we need the bed. To be honest, I don't know why they want to stay, and I do think they'd be better off at home, but for some reason (expectation??) they want to stay, usually they say to get breastfeeding established. Home visits by extended midwifery service is not really going to solve the lack of support systems that many women have at home.  It does worry me. Insurance companies went through this about 10 yrs ago in the USA, where they were basically expecting women who had normal vaginal births to do a drive by birthing. What they did end up with was a lot of sick and neglected babies: failure to thrive babies: I don't know the exact stats but enough to get a federal law passed forbidding hospitals from forcing women out inside of 48hours after the birth. Of course women who want to leave early can. The key words are WOMEN WANT. We do know from homebirthing that mothers and babies do need a support system in that postnatal period and you just don't put it together moments before discharge.   In solidarity   marilyn ----- Original Message ----- From: Heartlogic To: [EMAIL PROTECTED] Sent: Saturday, April 05, 2003 4:49 AM Subject: RE: [ozmidwifery] Bullying - doing something about it Judy wrote: With regard to the workload, I have just found out that the position I left last december has not been filled and more FTE have been cut from the staffing. Antenatal education is suffering and the workload is the same. I really don't know how the management (not midwife friendly) expects quality care. These hospital philosophies mean nothing when they keep doing this. Forcing such workloads is bullying in itself but I am sure they would not recognise this. Judy Yes, it is bullying Judy and no, they don't recognise it for what it is - because 'they' are so divorced from being 'with people' (aka with woman)  -  'they' haven't got a clue as to the reality of our work - and so we have to tell them that the way 'they' construct our work environment is abusive.    The CEO of our place is a doctor whose background is pathology. The general manager is a financial whizz who is also a doctor and one who has never, from what I understand, practised  bedside or even office chair side medicine.  These people have absolutely no idea of what either midwifery or nursing is about.  They do not understand the practice of either discipline at all.  It is impossible for them. People can't do what they don't know.  I personally find it simply amazing that these people have the right to dictate how nursing and midwifery budgets are spent.  Where are all the tough characters that ruled the budgets for our professions and had a say in the executives of the Health Services?  The current trend towards clinical streaming is leading more and more away from the notion of self determination with financial matters. This is a huge issue for the union(s) to take up.    Great opportunity here for all of us to unite and give the same message in a format 'they' understand.  Time to stand up and be counted - we have the numbers and the power.  I have been thinking - what would happen if we said by such a such a day at such and such a time, all over Australia, midwives and nurses would walk out and everyone did.   We could give them two weeks notice, get doctors and adminstrators to organise themselves into rosters to provide care and then every single one of us, walk out.    We have been 'nice' and compliant for too long. It is like being in a domestic violence situation - everyone wonders why women don't leave abusive men, but we know don't we?  We care too much.   Imagine if we asked for:   midwifery models of care one to one care for labouring women well babies to be counted in workloads one midwife to four motherbaby pair ratios in prenatal/postnatal wards (that is whether the baby is internal or external to the mother) a recognition of the vital importance of the mother/baby relationship and the need to factor this in to workload considerations, especially for women with social challenges midwifery budgets managed by midwifery managers senior midwife midwifery directors who had equal standing on health service executives career pathways for midwives no HEC's on midwifery courses Mentoring for managers mandatory study leave for professional development clinical midwifery educators on each shift in every unit indemnity insurance for privately practising midwives 24 hour child care onsite flexible rosters mandatory safe skill mix anything else?   and that's just midwifery, nursing needs have parallels....   Imagine.    How long do you think we would be out for???????   In solidarity  ; -)     gives me goosebumps just thinking of the possibilities   When desire is greater than fear, we can achieve anything.  Martin Luther King and Gandhi showed us that passion for a just cause and commitment makes social change inevitable.   Carolyn Hastie council nominee for the Realnurses and Midwives team (NSWNA election June 03)