Implications and recommendations for midwifery practice

The research study found consistent associations between impeded recovery time from current working practices, including a lack of formal methods to monitor this, and poorer emotional wellbeing outcomes. This has the potential to influence midwives’ ability to provide safe and effective care.

Modifying policies or aspects related to job design to promote safer working practices and supportive cultures could lead to better emotional wellbeing outcomes, which in turn may result in improved retention.

Recommendations:

  • Implement formal methods to record staff working extra unpaid hours (related to the inability to finish the shift on time) and missed rest breaks.*
  • Implement formal methods to monitor on-call working, ensuring working patterns and on-call schedules allow sufficient recovery time before midwives are required to be back on duty.*
    • * This could be seen as a barometer of the culture of a unit, defining the compassion, commitment, and willingness of an organization, or its leaders, to monitor and review the wellbeing of their staff.
  • Implement an off-duty policy that avoids midwives being scheduled to start a day shift within 24 hours of finishing a night shift. As a point of good practice, off-duty rosters should schedule at least two full days off when day rotations follow a night shift.
  • Record the frequency and number of times midwives are called away from a mandatory training session to provide care in the unit and use this as a further indicator of staffing capacity; explore strategies to protect study time.
  • Approve and publish off-duty at least six weeks in advance of scheduled shifts and use this as a further indicator of staffing capacity.