thru the pinard Podcast
a conversational podcast with @Academic_Liz with midwives & other birth professionals about their studies/ research & how it's changing our practice globally - email thruthepinard@gmail.com
thru the pinard Podcast
Ep 99 Karen Yates on how dual qualified and rural midwifery demands different skills but offers unique rewards.
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Ep 99 (http://ibit.ly/Re5V) Karen Yates on how dual qualified and rural midwifery demands different skills but offers unique rewards.
@PhDMidwives #research #midwifery #education #dualqualified #rural #retirementtravel
research link - ibit.ly/H5wrq
What does it take to stay true to your passion while adapting to life's changing demands? In this enlightening conversation, recently retired midwifery academic Karen Yates shares her remarkable journey from accidental midwife to respected researcher and mentor.
Karen's story begins unexpectedly in Darwin, where a brief student placement ignited a lifelong devotion to midwifery. After moving to Cairns, she navigated the challenges of the private healthcare system while raising young children, taking on night shifts that offered both family flexibility and greater clinical autonomy. Her gradual transition to education and research wasn't planned—it evolved organically from her interest in supporting midwives across Queensland's vast rural and remote communities.
The heart of our discussion explores Karen's PhD journey, which examined rural midwives working across dual roles. Her findings revealed professionals who identified passionately as midwives but accepted nursing duties as the necessary compromise for maintaining their cherished rural lifestyles. What began as a workplace investigation became a profound exploration of professional identity and work-life priorities. Most remarkably, Karen completed this rigorous research while unexpectedly serving in a demanding leadership position, demonstrating extraordinary determination and focus.
We also delve into how Queensland's rural midwifery landscape has transformed in recent years, with midwifery group practice models now established in areas where practitioners once couldn't imagine midwifery-only roles. Karen shares eye-opening stories about the stark differences between urban and rural practice, highlighting how simulation courses that deliberately mixed practitioners from different settings created powerful learning opportunities.
Now enjoying retirement, Karen continues mentoring PhD students while embracing travel, family time, and theatrical adventures. Her practical wisdom about maintaining balance, pursuing passionate research, and valuing lived experience provides inspiration for midwives at all career stages. Whether you're considering postgraduate study, navigating multiple professional roles, or seeking greater work-life harmony, this conversation offers valuable insights from someone who's navigated the journey with humour, pragmatism and unwavering commitment to midwifery.
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The aim is for this to be a fortnightly podcast with extra episodes thrown in
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Thank you very much for joining me , as per usual . Can you introduce yourself please ? Yeah , sure .
Speaker 2My name is Karen Yates . I'm actually retired now the last two and a half years , but prior to that I previous 10 years before my retirement , I was a midwife in academia and prior to that in clinical management education settings .
Speaker 1You've been doing some lots of travelling in your retirement too , which has been fun , I have been yes .
Karen's Midwifery Journey Begins
Speaker 2Unfortunately , my husband passed away six years ago and we were just planning to retire and , um , I was under strict instruction from him to make sure I still did it so good good that you're still doing it .
Speaker 1We kind of and I think that's something that and we talk about work-life balance as well while people are doing their studies , it is so easy to get caught up in the work minutiae that we forget to actually live our lives .
Speaker 2That's right yeah , yeah , and sometimes it takes something like that to make you stop and think , and not there's other things that are more important now yeah , and it's always the saying that if you don't make time for health , you will have to make time for illness .
Speaker 1That's right . So kind of an extension of that . Okay , let's go back to the very beginning . How did you get into midwifery ?
Speaker 2I kind of fell into it , really , because I grew up in Darwin and most of my high school years I wanted to be a herpetologist . Oh , okay , yeah . And I got to year 12 and thought , no , maybe that's not for me . And the other issue was , um , there was no university in those days in Darwin , yeah , and I had no idea what I wanted to do . My best friend wanted to be a nurse and I thought , well , you get paid while you're doing it . This was hospital training . Yep , and I'll just do that till I think of something better .
Speaker 2And then , in about the 11th month of the first year , we did a five-day placement in the maternity unit as student nurses . Yep , and , to be honest , at 17 , I don't think I even knew what a midwife was then , yeah , and that five days , this is for me . This is the job I want to do forever . This is perfect . So , again , because , historically , the way it was back then , I had to finish nursing , obviously , first , and then do midwifery . So I did that as soon as I possibly could and how long did you stay in darwin for after ?
Speaker 2um , another 10 years from when I started nursing , yeah , and then then we moved to cairns for my husband's work and I've been here ever since . I've been here 36 years you are a tropical girl .
Speaker 1Yeah , oh yes .
Speaker 2I was born in Sydney , but I can't live anywhere south of public hands .
Speaker 1I was gonna say no , there's , yeah , that's the humidity up . There is is another , is another kind of like world . What did you , what do you take away from your midwifery in Darwin ? What sticks with you ? As in the good and the bad , I know , times have changed a little bit times have changed .
Speaker 2Um , so some of the things I I enjoyed the whole time . It was a one year course back then hospital training , midwifery . I loved every day of it . Um , some of the people in the group I was in uh were doing midwifery for other reasons , working in flying doctors , for example , or uh additional qualification . So some of them had different experiences and felt and I do know in certain areas there was reputations of you know it was difficult to work in certain areas that students were not given a good time . I never felt that . I always felt really supported , loved it , loved every minute of it . Couldn't understand why anybody would want to go back to nursing .
Speaker 2Just could not get it and what I , particularly in Darwin . I guess what I really came to appreciate after I left Morso was the variety and the sorts of things that we saw . Obviously the high Indigenous population seeing conditions that just aren't seen in most of the country . So some quite horrible things medically but um , and complications , but particularly in indigenous populations so then , where did you start working ?
Speaker 1were you in the hospital for the whole time in darwin , or was it community ?
Speaker 2yeah , I worked in the hospital the whole time .
Speaker 1Yeah , and what about when ? When you moved to cairns , was that hospital or community ?
Speaker 2yeah , when we moved to cairns I had two young children so I wanted to work part-time as a midwife and I approached the public hospital , the base hospital , and they had no part-time positions available at the time . So I approached the private hospital and managed to get a set roster three days , the same shifts every week , which was much easier for me with childcare , with having no family here . They were all back in Darwin , yeah , and so I worked in the private hospital for 10 years . The last three to four were under sufferance . I really didn't enjoy being in the .
Speaker 2I didn't like the private system from day one , but it suited my family and my life . For example , I think I was there third day in the place and I was looking after a woman in labor and we had the private obstetricians on speed dial if we needed them . So I came out and I said to the midwifery unit manager oh , now this mr so-and-so is wanting some pain relief . I'll just now um button number one for dr so-and-so , isn't it ? And I rang him and said oh , mr so-and-so needs pain relief . I examined her and she said da-da-da . And he didn't even listen to me . He just said examine her and ring me back . And I hung up and I looked at this woman and I said does he have shares in Telstra or something ? Why do I need to make another phone call ? I just told him I examined her . Oh no , you mustn't do that without him saying so , and but it was interesting , so I tended to .
Speaker 2Most probably over half the time of that 10 years was permanent night duty . Okay , Two reasons Again suited the family , but also you had a lot more autonomy on night duty . They didn't care if you didn't ring them at 2am .
Speaker 1You get grumpy when you ring them at that time . So how long did you stay in practice ? And in Cairns , because you obviously did move into the academia . So what was that kind of transitioning like ?
Speaker 2um , well , when I was actually still at the private hospital . I've always been interested in education . So , although my initial training was hospital-based , I started doing some clinical facilitation for James Hook University with nursing students at the time this is back back in the early 90s on placement , and really enjoyed that side of things and I thought , well , if they're coming out of this with a degree , I should really have a degree too . So I did a post-registration degree and so , yeah , I was interested in education and was doing some clinical facilitation and then after the 10 years , as I said , I moved to the base hospital and I think I was just really lucky to get a lot of experiences .
Speaker 2That sort of just fell in my lap . Really . I didn't apply for a lot of things , I just made my you know , my preferences known and um . So I got some , a lot of experience with education , particularly midwifery education , so working either as a facilitator or um , backfilling the midwifery educator when she was away , which I really enjoyed , and then got involved in more once the um jcu opened up the campus in cannes . I could do . I was doing some on-campus session tutorials and labs and things like that as well , because I've always really enjoyed that so what exposure do you had then , to research in working in the public sector , or even in the private sector ?
Speaker 1was there any research going ?
Speaker 2no , nothing at all . No , I remember in that post-registration degree , one of the subjects um we had to do was basically anatomy and physiology , but one of the assignments they gave us a whole raft of um data about thyroid function in rats , of all things and um , and we had to write a report , based on that data , of what you know what the conclusions were . But even that meant nothing to me . I didn't really understand it . Yeah , um and particularly , it was really quite quantitative and I've never had a bent for quantitative research anyway . So , yeah , no experience , even in the , in public hospital , it's the same thing .
Speaker 1Really no exposure to research
Transitioning to Education and Research
Speaker 1so then , how did you go into a postgraduate pathway ?
Speaker 2I again with the working with the students and thinking I should have a degree . I then thought , well , if they've got a degree , I probably should have one qualification higher . Yep , I did a master's , but that was coursework and it was a master's of nursing because at the time that was in the um very early 2000s , late 90s there wasn't a Master of Midwifery except as an entry practice course , which I was already a midwife . So I did a Master of Nursing and when I finished that that was going to be it , I said to my husband it was in the old days of external study , post your assignments oh , yes , walking the dog one evening post the last assignment Said that's it all done , never again . And he just looked at me , went till next time . No , no , that's it , I'm never doing anymore .
Speaker 2and then I um , there were some issues with one of the rural maternity services in the um up in the hint land on the table lands , and they were closed because of lack of procedural medical staff yeah so a review was conducted about how that could be reopened and one of the options the midwives presented a proposal to do a low-risk midwifery model of care and out of that review one of the recommendations was to create a position called a regional maternity services coordinator .
Speaker 2So I applied for that and got that position . I had no idea what it would entail and in fact at my interview , when they said , do you have any questions for us , as they do , I said well , it sounds really interesting , but I'm not exactly sure what I'll be doing as a midwife , how I can support other services , you know , without a budget . And they said , oh look , it's just going to be so amazing , you've got to be so busy before you know it and it's just going to be really exciting . So I walked out of the interview going great , excited , doing what I Excited doing what I didn't know .
Speaker 1Yeah , that's because they didn't know .
Speaker 2No , no . Well , it was newly created so that they had this vision of what this person might be able to do . So , as I said before , because from when I started midwifery , that's all I've ever wanted to do and on the odd occasion where I've worked , places where it's been maybe not so busy and you're redeployed to a nursing area always hated that . And so I was with that position . I thought , well , the first thing is I need to know what are the issues in these areas . So I did some visits around the tablelands in Cape York to the different services and talking to the midwives and the management about what their issues were . Lots of stuff that we still have issues today around education , access to education , backfill , that sort of thing , staffing , and we talked about redeployment and I sort of said I was making all these assumptions that well , I'd hate it , so they must hate it too . And it happens a lot more in the rural areas . So I thought , oh , instead of imposing my view , I probably should do some sort of research around this and see what actually and that's the first time I started thinking about research , but because research around this and see what actually and that's the first time I started thinking about research .
Speaker 2But because my master's was coursework , I didn't know where to start . So I said I had started having a conversation with one of the professors of nursing at the campus here , um , and we had some a couple of meetings and chatted back and forth . She wasn't a midwife , she was a nurse and but I was , you know . I said I'm interested in what these midwives think and and what , how they you know , their work-life balance is and those sorts of things . And she just started sending me some information and said I'll fill this in , write this in . And then I said to her one day , am I in a PhD ? She said very soon you will be . Yes , I love it . No intent to do it at all , it wasn't an ambition , and I started it when I was 46 . And my only ambition then was I wanted to finish by the time I was 50 .
Speaker 1Yeah , which I did do so if you're doing it for work and if it's something that you and this is what I tell people as well do something you're passionate about . But if you can do something that you're actually doing already and you get double the bang for your buck , as opposed to having to do twice as much work on different topics , because then your head is so kind of fragmented doing it anyway . If you're doing a review , if you're doing a exploration of something , then why not use that as something , as your focus for your research project ?
Speaker 2exactly so I found it very easy to stay engaged the whole way through . I didn't get to . I know some people have that experience of just wanting to throw it all in and finding it really challenging . I was fortunate in the first 18 months that in that position I could spend some time at work doing it as well , because the position was growing and I wasn't that busy . Unfortunately , I then agreed to take a five-week relief of the nursing director for women's and children's at the hospital . She was going . Could I do her job for five weeks ? So under sufferance I did she's oh , it'll be a really good experience .
Speaker 2You should do this two years and nine months later , when she never came back . Oh , no most of my phd was spent while I was working full-time as in a nursing director position . So , um , it was pretty full-on , but again , as you say , I I enjoyed what I was doing . I could see that it had application or it was important to me anyway , and I think the midwives that I interviewed for my PhD they seemed to really appreciate just having the opportunity to be heard .
Speaker 1Your title I think I found it here is my Passion is Midwifery .
Speaker 2Midwives Working Across Dual Roles in the Country yeah , so it was a qualitative study , phenomenological , and I interviewed midwives in four different rural facilities um that had birthing available . Uh , in the in the district um , the other main facility I could have used . They already had quite an established midwifery model of care so it wasn't really appropriate . They were in a different position um . So I interviewed midwives about their experience of working in that dual role . Because it's a rural hospital they might only have 100 births a year so there might be days and days where
The PhD Experience Unfolds
Speaker 2there's nobody in admitted as a maternity um person , so they would get deployed to ed or surgical or wherever .
Speaker 2The interesting thing was that most of them would have quite happily just worked in maternity . They didn't want to be redeployed . A couple liked the variety , but most of them didn't . But they couldn't see any other way in that particular environment and that model of care . And I actually asked all of them towards the end of the interview so if your model of care was restructured and you could just work as a midwife , would you ? And they all said oh , yes , but that . But they had no concept of that stage of midwifery group practice and that sort of thing , because they'd be used to the traditional way of working with rostered shifts and they just said , well , no , we're not , we don't have enough births . We could , we , we could come to work and there'd be no one here .
Speaker 1It's like we wouldn't come to work so did they identify as nurses with midwifery qualifications or did they identify as midwives ?
Speaker 2mostly midwives . Yeah , yeah , yeah , yeah . And , as I said , if they , if they had their way , they would just work as midwives . But the reason they did do both is the ultimate reason really was the desire to live local was stronger than the desire to just be a midwife . For a variety of reasons family history , partner's work . They just enjoyed the rural lifestyle . So , rather than move somewhere bigger where they wouldn't get redeployed , they were happy to endure that .
Speaker 1And that goes back to what we were talking about before the life balance , living and actually having a life , to that . So that was kind of like , well , let's say , a few years ago now . Yes , so thinking back to that , what's ? Can you think of something that surprised you about your PhD journey or the results ?
Speaker 2Um , surprised me . The actual process surprised me initially because , as I said , I hadn't didn't have any research background and , um , I the the professor that I initially had conversations with started off as my supervisor and one year into it she left to go to another university . So my secondary supervisor at the time , who I not had a single word with , who was at that time based in townsville , she took over as primary and someone else was brought on as secondary . I actually had no say in any of that and .
Speaker 2I know that's something I talked about . It worked well for me . It wasn't a bad thing , but I do talk to potential students now and candidates about , you know , shopping around for someone that suits you and your topic . Again , all of them were nurses . None of them were midwives , to to the extent that about partway through the second half , we brought on a third supervisor who was also a midwife , because I was having conversations with my supervisors about different aspects of midwifery in particular . Oh , we just do such and such . No , no , no , midwives don't do that . So I had to have another person on there that could stick up for me and go no , she's right that that's as it is and it works .
Speaker 1And it's been interesting with my experience with my phd looking at midwifery phd journeys but also talking to so many different people that midwives ask different questions , which is fabulous and we want those different questions , but we also have to be really careful that we allow other professions to ask us the different questions as well , because otherwise we can become too insular , and that's when we want and it's really quite robust the discussions that you have with somebody outside the profession . Yeah , yeah , it's sitting there , going , but why ? Well , this is why , and if you have that really interesting conversation , but you need someone else who can actually then support you going actually , no , this is not you making it up , especially as a student role . This is actually what practice is and it's like , yeah , oh , okay , so it's not , oh , okay , yeah , that kind of professional , collegial discussion because I had some really interesting discussions in that first year with that first supervisor around things .
Speaker 2like she said to me one day well so how many births do you have to go to a year to keep your registration ? And I went none , you don't have to do that . And she couldn't understand it . It was very nursing , focused about specific skills and numbers and things like that .
Speaker 1Which is interesting because you don't have to nurse a certain number of people in a year to keep your nursing registration . That's right .
Speaker 2That's right , that's a really interesting way of looking at it . Yeah , she just assumed that as a midwife , I guess , which is a good thing for a nurse to see that whole spectrum of midwifery care , but assuming that midwives had to be involved in all elements at all times , or otherwise they wouldn't maintain their registration .
Speaker 1We still have the argument now that's an international kind of argument that you're not a real midwife unless you're catching babies . That if you're clinical , if you're working in research , if you're working in education , if you're working in governance and you're not still kind of having a clinical component , then you really shouldn't be calling yourself a midwife , which we know is garbage , yes , yeah , but that mentality of is still around , which , which is quite sad .
Speaker 2Even within yeah , within models of care . I think too , sometimes it's , you know , people that work in a standard sort of rostered hospital model of care , for whatever reason , are seen to be lesser midwives than somebody that's in a midwifery group practice .
Speaker 1And , like we've done a lot with midwifery group practice , research and continuity of care , we know where the growth standard is . That's been around for over 20 , over 200 , keep doing that a lot 200 2014 when the lancet kind of came out . We know the world health has actually now put it out in the last kind of few months that continuity is the kind of gold standard to go for , a midwifery led continuity in particular , um , and we know that's the aspiration and the goal . But when you look at it like 20 if you're lucky have access to that model , which means 80 , because when you look at home births in australia it's like 0.3 . So majority are going to be in the public or private system . They're not going to have that model of care and there shouldn't be this hierarchy . A lot of a lot of midwives feel that way , especially with the conversations and the flows within some conferences that are happening , um , and that's really disheartening to kind of see it is and interestingly I just had a conversation a few months ago with a um .
Speaker 2well , she approached me but she's interested in doing a PhD . She's a dual nurse and midwife but did a dual degree down south somewhere and she worked in midwifery group practice in southeast Queensland and loved it but felt burnt out after three years and she had some really good data and statistics around those rates of burnout and she was interested in looking into why that happens what are we ? Doing . It's not supporting people that they say this is the gold standard and they want to do it when they come out of them .
Speaker 2You know graduate as a midwife and then three years later they go . No , I can't , this is too hard . It's probably the way it's structured and resourced and things , but you know that was quite an interesting topic .
Speaker 1And then you've got others who don't want to go into the model because they don't want the on call , because they think they're always on call , yes , and it's like they're not . There is time off . That's still allowed into it , yeah , but we still have a lot of miscommunication on what the models are and and and , I think , who . Now it was at least prising , I think . Um , I think she looked at the manager's perception of continuity of care and setting it up and it was really interesting that it was the managers who weren't keen to have it set up as well . So you've got this barrier of people not wanting to work in because they don't understand it . You've got the managers , but then you're above the managers . You've got administration and beankeepers and the medical and other staff that fight it as well .
Speaker 2But hopefully , the future kind of keeps on changing yeah , I think some of it too comes goes right back to that hierarchical um developed , nursing and midwifery years ago from that very patriarchal sort of model and that this idea of people choosing their hours and coming in when they need to be there , it's like can we trust them ?
Speaker 1um , so you didn't pick your supervisors , so that takes that conversation out . Yeah , um , did you get a chance to pick the midwife who came on board ?
Speaker 2yes , yeah I didn't know her .
Speaker 1She was recommended by one of my other supervisors but , um , I got to know her well during the last sort of year and a half or so my phd yeah she was very supportive how did you keep your sanity then , if you're working at that level , which was meant to be only for a few weeks and ended up being for a couple of years ? If you're working at that level , how did you keep your sanity while also doing a phd and I think anything three to four years is full-time in kind of working , as well as on top of that , and that's huge , yeah I think part of it was um .
Speaker 2I didn't go into it with any particular preconceived ideas about what a phd would be , number one . But the other thing I did go into it with was the attitude that , like any other study I had done before , it's a beginning , a middle and an end . It's a project , yeah , and that's how you approach it . I I don't want to offend people , but this whole the journey of the phd does my head in a little bit . It's like , if I think that helped me anyway , just say , well , I have to start like I have to meet certain milestones and then I want and I put some of those on myself timelines that I wanted to finish by um . So I think that helped .
Speaker 2I had my children were older by then , so that wasn't such an issue and I had a very , very supportive husband , who you know . Towards the end of my PhD we were going away to Fraser Island for a week for his 50th birthday , nice and I got all this feedback from my supervisors two weeks before we left to finalise my thesis to be submitted and I said to him I hate to tell you this , but the laptop's coming with us to Fraser Island , I have to do this and he loved fishing and I don't like fishing , so that was okay . He could go off fishing and leave me to puddle away on my laptop .
Speaker 1And that's actually not bad , because he gets to do something he enjoyed . You got to do something that you enjoyed you needed to do , but then at the end of the day you can put that away and then share your days and actually then have quality time together . Yeah .
Speaker 2Yeah , and I mean , as I say , he was even in the early days when my children were quite young . The post-registration degree , for example , that was external . The assignments were always due on a Monday and it was back in the old days of posting them , Yep . So if they were due on a Monday , I generally started them on a Saturday mid-morning and rush , rush , rush , rush to get it done . And there was numerous times where he would go I'd be working on something and getting very frustrated and he'd say okay , boys , we're going for a drive , let's leave mum , Let her tear her hair out by herself .
Speaker 1Oh , leave mum , let her . Let her tear her hair out by herself . Oh , nicely , switched on , well done . What did the kids think of you doing a PhD ? They understand what it was , or was it just ? Oh , you're just doing it after they went to bed , or ?
Speaker 2um no , they were kind of mid to late high school and stuff , um , so they knew what it was kind of . But they're very pragmatic about you . Know , I was just I'm studying again . Really , it's a bit like I . When my younger son was about eight or nine , I got home from work when I was still working clinical and I had a very busy day and he wanted me to take him to the shop . I said oh , gavin , I'm really tired , can we do this ? I said I've had a really busy day at work . And he looked at me and he said you've said it before before you just catch the babies . The women do all the work . Why are you tired ? And I was sort of reminded . I went oh yes , I've done a good job . But I was like I'm really tired . And it was the same with the study . Yeah , mum's just studying .
Speaker 1Yeah , did they understand the significance of it when you finished it ?
Speaker 2I think so . Yeah , they all came to my graduation . I'm very proud . My husband was extremely proud . He couldn't stop telling enough people about it . In fact bought me a car with personalized number plates as a surprise graduation present . I nearly fell over , so you got Dr , yeah , dr . Yates , but with an eight .
Speaker 1Oh nice .
Speaker 2Well , I didn't know about it . It was a surprise . And he took me to see this car and I said I've got a perfectly good four-year-old camry . What do I need a new car for ? Oh , I'll just have a look at it . We're just . I just told the guy we'd look at it and it's got a big orange bow . Still didn't click and it was only when I saw the number plate and I went . I started
Rural Midwifery Challenges and Insights
Speaker 2punching him in the arm saying you idiot , you idiot , and the salesman going I don't think you should hit him if he buys you a car .
Speaker 1He was very proud well , that kind of takes away . One of the other questions was how did you celebrate ?
Speaker 2I mean , as I said , we , um the whole family , came to the graduation . My granddaughter at the time was um nearly two . She was about 18 months , 20 months old . She thought it was very funny sitting around in that floppy hat afterwards yeah , it would have been some cute photos of that .
Speaker 1Yeah , put them up on the wall , post your graduation on one side and her on the other side . Do you know of ? So , when you're kind of looking back ? So we've had , let's face it , 15 years since your PhD came out . Now we've had 25 years of direct entry midwifery in this country . We've now had a couple of places that have gone back to now doing a dual degree . Yes , we've had . I know in Queensland there was , I think a few years ago , and you probably know better than I do there was some venues that were saying they were not going to take direct entry students anymore and they wanted dual qualified because to them it's better money for their employment , because they get two professions out of it . How have you seen the change over the last 15 years in the role of the dual qualified midwife ?
Speaker 2I think . Well , interestingly , certainly in this region , James Cook University had a dual degree and was kind of criticised in the early days about that . But that was what , when it was developed , which was probably about 15 , 20 years ago , was what industry partners wanted , especially in the rural areas . Again , they didn't perceive of how you could have a midwife only and utilise her to the best of her ability in a time . Having said that , now they're rolling , they're wrapping up the dual degree and going to introduce a bachelor of Midwifery in 2027 .
Speaker 1Oh really .
Speaker 2Yeah , and most of them , certainly in far north Queensland virtually all the services have a form of midwifery group practice . Yeah , so they're not reliant so heavily on that dual role because they're working just as midwives . Some have sort of a combination hybrid model where some midwifery group practice and some what they call core staff , and that meets the need of those , as you said , that don't necessarily want to be on call and happy with a roster shift . So it's interesting that I think as time's gone on it's becoming more acceptable and because people are seeing it as well . As I said , when I did my PhD and I interviewed those midwives , they couldn't conceive of how you could structure a model of care where they could just be a midwife . They just didn't , hadn't ever seen it , so they didn't get it .
Speaker 1yeah , one of the things I encourage my students , will encourage anyone , to do , is to go to a conference , especially an acm conference in another state . I did , I think it was in 2019 . I did the conference in um , rockhampton , I think it was in 2019 , I did the conference in Rockhampton , I think it was . Oh yeah , no , townsville , townsville , rockhampton , what's the northern one ? Townsville , townsville's more north , yeah , so I was in Rockhampton and I was doing something about military midwifery and birthing in the military , both as partners but also as females in the military , and kind of some of the special that they are a vulnerable group . Um , and I wanted to address that the townsville midwives who were going to come down , but it was the the same week of the floods , the big floods that were up there , so none of them came down because they couldn't get out and they had other things to do .
Speaker 1But I was like I'm a southerner , I'm anelaide girl and to me Queensland is a very big state and yep , Brisbane , and I kept forgetting the fact that 95% of Queensland is rural and remote . And so going up to Townsville , going up to Rocky and being at that conference and listening to what was happening around Queensland outside of Brisbane was a massive eye-opener . And now I could understand why Queensland is seen as a leader in a lot of midwifery things , because they have to to actually adapt and to progress and so leading in midwifery group practice and leading in some of the continuity of care models . And it was really , yeah , really quite eye-opening because the population is so dispersed .
Speaker 2Interestingly , one of the things that I when I was in the educational in the hospital in the public system was they were running a program to upskill rural midwives . So there was a workbook and activities they did online and then they would come in for a two-week placement at king's base hospital and , um , while we're evaluating that and doing that , one of the suggestions was that the midwives in kens should go out to those rural areas and see what it's like . We couldn't get them to do it because most of them felt totally inadequate as a nurse wasn't the midwifery bit they were happy with .
Speaker 2But they said oh , if , oh , if I get sent to surgical or ED , I won't know what I'm doing . I had absolutely no idea . So it was quite interesting that the midwives coming in to upskill but going the other way we couldn't get it to work .
Speaker 1One of my honours students did hers on looking at transfers and transfers from rural to city and so did some interviews on people that were being transferred and their experiences and got it published , which was brilliant , and it was about the misconceptions of the city staff . And we're not just talking midwives , they're talking obstetricians , nurses , everyone working the city of there's nothing out in the bush that they're not qualified , they can't handle anything and even the communication going back or the explanations going back or they won't understand that there was so much that she pulled out and she experiences because she lives out there . Still , we should be doing that more in that kind of getting people in and saying , actually this is the skill level that we have and there are some people who do round and do short-term contracts and things like that . But if you've got an area healthcare system , but we also are so focused on our urban healthcares that they don't have the satellite connections anymore like they used to , yeah , yeah , the other thing .
Speaker 2Interestingly , when I was still in that same role , we used to run a MACROM course which was Maternity Crisis Resource Management , similar to the prompt , and it was for Cairns and Hintland and Cape and Torres as well .
Speaker 2So when we ran I was one of the facilitators and we would have two obstetricians and six midwives on each course and we tried to split 50 , 50 , 50 where we could , from Cairns , but then from Maribor or Atherton or Thursday Island or somewhere , and it was absolutely amazing and such an eye-opener for the urban staff . Yeah , here , number one , what the rural stuff did and , as you say , talking about transfers , and there were the rural midwives would talk about sometimes they'd bring um , they had nobody on , so they have to someone's complicated . They had to transfer as an hour's drive from austin to cairns in labor do we go because she's in labor ? And then they get to the cairns hospital . So they'd preempt that and go early because of that and get to the , get to cairns hospital and be frowned upon . What have you brought in now for ? She's this too early and it's like because it took an hour to get here .
Speaker 1Yeah .
Speaker 2And just sitting in when we do the scenarios and we do the debrief , and it'd be like the Cairns midwife such and such having a massive PPH . Well , I just pushed that red button on the wall and thousands of people come running .
Speaker 1And the midwife from Tully says I pushed the red button on the wall and if I'm lucky I'll get an EN and that's it that's it , yeah , yeah , and I think every student , whether it be it doesn't matter what health care profession you are every health care professional student should have a rural placement , absolutely yeah . So they understand that the resources that are on tap in the city are not , which is why your assessment skills have to be spot on , which is why your critical thinking and forward planning . If you've got someone coming in and going , okay , it's not progressing , okay , it's going to take us an hour and a half to get the staff in to get theater ready . So when are we thinking that ? When do we start that cooling now ? Then you realize the on-call roster's out of date because it's a public hospital and they've swapped rosters and you don't know who's on . Yeah , it's a very different experience .
Speaker 2But it was very educational . It was so good to have done that split and have them both , instead of having sort of rural staff in one course and then , you know , cairns-based staff in another . It was very , very enlightening for a lot of people .
Speaker 1So what did you do after you finished your PhD ? Did you use or expand that experience ?
Speaker 2um , not that particular study . When I finished my phd um I also sort of similar timing with the um , the acting nursing director role , so they advertised the position . It was several times trying . I said I would stay on when the , the incumbent , had resigned . It was another year after she resigned before I got out of the position because I tried to recruit and couldn't and they kept trying to talk me into doing it .
Speaker 1I said look , it's not me , I don't want management .
Speaker 2I don't want to do it . Yeah , but I said , for continuity , I'll stay until you recruit . And in the end I had to pull the pin because they just weren't recruiting . Yeah , and I was going back to the regional coordinator position which someone else had been sitting in for that two , two and a half years and a number of people . Oh , you won't be able to do that , you'll be bored . You know , it's not the same . I was no , no , it'll be good , I'm looking forward to it .
Speaker 2And within a few weeks I was like yeah , nah I need another challenge and a position got advertised at the university
Balancing Life, Work and Research
Speaker 2like on an ongoing level b so I thought I'll give it a go .
Speaker 1I've got a phd I might get in yes yeah so what kind of research then did you start doing from the university base ?
Speaker 2One of the early ones I did was a fairly small study but it was around about the dual degree and there was a paper out of that double degree destinations nursing or midwifery and I interviewed first year students , students , fourth year students and or not interviewed I was sorry , it was a survey yeah , and grads one to two years out from two different universities that offered a dual degree and not . I wasn't particularly surprised but the vast majority wanted , did the dual degree but wanted to be midwives . Yeah , and the reason they did the dual degree was either a direct entry course wasn't available so say Townsville for example , they had families they couldn't relocate to somewhere to do it , so they did the dual degree and , interestingly , a fairly good chunk um perceived that the changes in morbidity and and things in the population and health standards that the nursing would give them a good background to apply that , but still in midwifery .
Speaker 2So , although most of them didn't want to do it , to be able to work in both jobs , they wanted to be midwives , so that was interesting . Um , I did a little bit of a couple of small projects around the education side of things . I was always interested in the use of technology and we had at the time five campuses jcu for , and if you were a subject coordinator you would video conference the lecture once a week to those other sites , which was very challenging . Two-hour lectures should be bad . So I looked at things like the use of back-channel technology to facilitate question and answering and those sorts of things . And then , mostly after that , it's been around what I've worked with PhD students and helping with their research , again mostly around not mostly , but a lot of it just seems to have been around rural aspects and , again , as I said , qualitative , because that interests me .
Speaker 1And the lived experience is important to help ground kind of researching questions for students who are exploring as well or who may not have actually had as much time in the rural area . Yeah , yeah , yeah , um , what is something from your experience as a student and being supervised ? Have you taken on board now that you use or don't use for your students ?
Speaker 2I like the structure of having set meetings , whether they're weekly or fortnightly , depending on the student's enrolment status and other issues . There was a lot of flexibility , which suited me at the time when I did mine . But it would be things that sometimes I would get an email from my supervisor and go oh , it's been six weeks since we met . How about you call in on Thursday and bring this , this and this , and I go , oh God , I'll have to do this , this and this so it was fairly .
Speaker 2There was no sort of rigid's not the right word , but it was . She left a lot of it up to me to contact her when I needed something .
Speaker 1And sometimes you don't know when you need something .
Speaker 2Well no , especially if you've not done any research or any kind of honors or masters research beforehand and in the early days , like we , when I talked about what I wanted to do and and um about this , this experience of these midwives and dual roles and came across , well , yes , phenomenology that'd be appropriate in a lived experience . Oh yeah , I don't think I could say the word when I started and it took a lot of reading and it was one of those you know aha moments partway through . I was reading a paper that had been published and I was like they're saying that they used Heideggerian interpretive phenomenology . But that's a Sirlian analysis .
Speaker 2I understand something I understand it and I was very excited to tell my supervisor . And I've just had one of my students I actually just submitted last week her thesis , for example , and she's also done a phenomenological study and it's actually about she's a midwife , not a nurse , but it's about nurses in rural and road areas providing care to pregnant women and birthing women because they're around their midwives . Yes , amazing , but she was the same early days struggling with the phenomenology and and then same thing .
Speaker 1But aha , I got it it like that first year of reading you just is whatever brain cells are working suddenly don't work because there's all this extra layer coming in . And then , every now and then , there's this these two neurons start connecting and then start connecting with something else and it's like I'm not stupid , you're just functioning on a much higher level , but you feel as though I should be getting this faster . It shouldn't be this much of an hassle and that's .
Speaker 2I found that with all the students I've had , it's very common , because you're doing all that early reading around philosophy and methodology and things and it's just like this is never going to make sense . I'm never going to understand this .
Speaker 1It's far too complex and and I think every student I've ever had is and that's like yep , I can tell you , you will , you'll get there and I don't believe that you're going to get to a stage where they're going to be able to have these conversations and and at an equal level they're going to go , no , no , no , no , I can't , no , and then you suddenly start arguing back , or so not arguing back , but you start holding your own in conversation , going , no , that's what I mean , this is what I mean .
Speaker 2And you kind of go oh , actually , yeah , I do know the data , I do know you're kind of what I'm talking about it is and it's interesting when you talk to them as they're progressing through and it's even somebody , say halfway through and you talk about now you know when you're finished , you're supervising , and they're like what ?
Speaker 1yes , you can and you will . Yeah , it doesn't end . You just keep leveling up .
Speaker 2You kind of do the phd , you go up to the next level , you go to postdoc in your early career and then , once you get that , you level up again in your mid-career and then you level up again and you kind of like late career and then you level up again and your retirement , yeah yeah , well , I had when I retired um , I was still on four panels and I stayed on those uh , kept an adjunct position and because I particularly wanted to see them through , I've been there from when they started and um see and so down to well , one's just submitted um , and then I've got one other student who's probably about a year off , submitting six months to a year , and I'm not taking any new ones on only mainly because of the travel and stuff . Um , I've been tempted a couple of times . I've been sent things and I'm like , oh no , no , I'm not , I'm gonna start from scratch to that four to six year commitment but you can always come on as a , as a critical friend .
Speaker 1Yeah , as part . Where look , we really need to have this debate kind of . Can we tap your kind of do this reading ? Can you tap in ? We want some discussions as a way to help guide us and I have done that a couple of times .
Speaker 2I've done that um with one of the one , the student . I was talking about a potential student um that was looking at the burnout in the group practice . You know she's got a panel set up and it was actually at the burnout in the group practice . You know she's got a panel set up and was actually at another university because she'd already had conversations with them before she came to Cairns . But we've had a couple of meetings just to chat about things and just from a different perspective .
Speaker 1And I think that role of not the supervisor role , but that critical friend role and mentor role is very much underrated . It's something that , because so many people are worried about everything , has to count in the workloads and we are overworked in a lot of ways . But the the kind of the consequences of those conversations to the student are immeasurable , because they can help re-guide them , they , they can lower their stress , so then they can actually have that belief in themselves again .
Speaker 2Yeah , yeah , jcu has it structured with advisory panels that there's what they call an advisor mentor and a primary advisor and a secondary , and the advisor mentor's role is more around mentoring the advisors , not the candidate , and that's predominantly what I've done . And some panels I've come on at the beginning they've said to me oh well , you know , if you just want to meet once every three or six months or something , we'll , we'll do and I I can't . I can't do it if I'm involved , I'm involved . I don't want things being sent off that with my name on it that I haven't even read or had feedback on . But I need to start , yeah , letting that go and just being that , well , as you say , critical thing rather than in an official capacity .
Speaker 1Oh , you'd be a prime person to kind of tick in as a marker as well . Hmm , because you can do that wherever you are .
Speaker 2Yeah Well , yeah well , people do say that since I've retired , but no , no , because you're too busy enjoying life when you're traveling laptops not come with me on holiday so normally I kind of say so what's next ?
Speaker 1what's happening next ? Now you've retired , you've you've got a couple of students still kind of going , um , what are your focuses on for like the next kind of five years ? So it's not work . What other kind of grand adventures or things do you want to achieve now that you have that freedom to do it ?
Speaker 2um , I guess mainly the travel . Uh , I've got a 15 year old granddaughter who lives in kansas as well , so um spend a lot of time with my family and um we do some travel . She and I went and saw beetlejuice a month ago , which had a ball in melbourne . Um wasn't sure that it was my type of show , but she was really keen and I . It was amazing . It was a fabulous show it's about the experiences .
Speaker 1Isn't it that the memories and the experiences ?
Retirement and Future Adventures
Speaker 2yeah , I . I go to probably five or six shows a year . So syd Melbourne , brisbane , depending on what's on , we just go for a couple of days and just go to the show and come back and enjoy that the theatre .
Speaker 1We need to do more of that when we're actually working as well . Absolutely , have that balance .
Speaker 2I had one of those a couple of months ago now , but the Facebook memory things cropped up . It was when I was still working and I'd taken a week's annual leave . I didn't go anywhere . I can't remember why I had the time off . Now it was about six or seven years ago and I had this day off and so I went and I had breakfast out , then I went and had a massage , then I did a couple other things , bought a pair of shoes , all this and it was my self-care day and I put it on Facebook . I've done these things and I'm just relaxing now in the evening with a glass of wine , and I should do this once a month , and then it's like suddenly six months has gone by and you haven't done it because you're working yeah , and it's so easy .
Speaker 1What advice would you give to someone who's trying to contact you to they're not sure about whether it's worth doing a PhD because they're not interested in going into academia . They want to stay clinical um .
Speaker 2I think that's really important . I think we need to encourage people because very few um nurses or midwives with PhDs stay clinical . They end up in academia or they're in academia first and then they're expected to to do the PhD um I I just think my concern in a lot of areas in clinical areas is research is given a very low priority . I in my academic role , we had several meetings with Cairns hospital staff around at the then executive director of nursing wanted to raise the profile of research . So we had , we ran a couple of workshops and we've got people that were in certain areas um to put in suggestions what they are interested in , just really small , even qa type projects . But it never got past day one because it was like well , they're not going to give me time , I have to do some of my own time . Yeah , I'm , I'm point eight and I work eight shifts but I can't do the research in those eight shifts . They won't let me .
Speaker 1So I think the more that it's seen in the clinical area , that will raise the profile and how important it is so , apart from giving allocated time for research , for people to do that research , what else do we need to do to get more clinicians involved in , yeah , as you said , starting with quality assurance , starting with little kind of cpi projects that then need to be disseminated so that we can see what's happening , because dissemination is the big part that gets missed , and that's why conferences state conferences are fabulous , national conferences are fabulous , more expensive , international ones kind of like even more expensive , but getting that sharing of that knowledge is how we kind of go . Oh , that works with them . I wonder if it works for us . Yeah , yeah . So what are the other ways that we can get clinicians involved ?
Speaker 2again . I think they need to be seeing it . So if you've got people doing a phd in the workplace , in the clinical environment , um , and having again that just that support to have the time , because it's very hard to keep , no matter how motivated people are , if it suddenly means they're doing all this on the day off , yeah , they quickly lose that motivation and their health and well-being as well .
Speaker 1Excellent , so where's your next travels to ?
Speaker 2uh , ireland , spain and portugal , oh , excellent , and that's not next year .
Speaker 1Five weeks , but oh beautiful . Hopefully it's not too hot over there .
Speaker 2Well , hopefully not . I went to Croatia last year in June and they had the last 10 days I was there had a heat wave . It was over 38 degrees every day . It was very hot and I had planned this originally just Spain and Portugal trip for June this year . And I said to my travel agent when I go back from Croatia I said , can we push it back a couple of months ? I don't want to , spain's going to be , and the other day it was 46 degrees in Spain . Yeah , yeah . So hopefully by August it'll be probably September by the time I get to Spain I'll be in Ireland for two weeks first , so second half of August .
Speaker 1Yeah , worried a little bit about June next year and the ICM in Portugal and hoping it's too hot because I'm hoping to in the UK a month before that as well . So that'll be kind of like nice . Oh , ireland's pretty , so green . Yeah , yeah , excellent . Thank you so much for your time . Thank you , hope it was helpful , absolutely .