136 | Chapter 6 between experienced midwives’ recognition of their roles in supporting NQMs and the actual support that they provided or wanted to provide. The high workload, independent work, and the lack of facilities to support NQMs in practice appeared to be barriers to supporting NQMs. Experienced midwives showed cooperative attitudes towards- and abilities in supporting their new colleagues. However, in practice, support for NQMs had a low priority: clients and the organisation of the practice were prioritised. Furthermore, experienced midwives expected other parties to be involved in the organisation of formal support for NQMs. Experienced community midwives, as commissioners of selfemployed locum NQMs, perceived themselves as not responsible for organising- or facilitating formal support for NQMs. This study reveals a discrepancy between experienced midwives’ expectations of NQMs’ performance of NQMs and the actual situations that they encounter in practice. On the one hand, experienced midwives perceived NQMs as knowledgeable and capable of caring for pregnant individuals, while on the other hand, they found that NQMs lacked autonomy, independence, and commitment. Studies have shown that NQMs need a recognised period of adjustment to meet the expectations of the work environment.1,9,10 However, NQMs in the Netherlands work mainly as locums in community-based care.6,21 This requires high levels of professional autonomy and competency,21 and does not leave room for an adjustment period that leads to reassurance and confidence. Furthermore, the findings in this study on NQMs’ performance show a difference between experienced midwives’ expectations on NQMs’ commitment to all aspects of the work and the reality in community-based practice. In a previous study based on NQMs’ perceptions,1 we found that NQMs in the Netherlands felt well prepared for providing care, but not yet prepared for running a business.1 Furthermore, the locum position of NQMs in practice might hinder NQMs’ commitment to the organisation of the practice. In this study, experienced midwives perceived differences in work attitude between NQMs and themselves. Experienced midwives felt that NQMs were less willing to make sacrifices in their private life to provide continuity of care. However, previous outcomes about Dutch NQMs’ perceptions suggest that NQMs are willing to make sacrifices for their clients, and to ensure that they have enough work as a midwife,1 and that they show high levels of work engagement compared to experienced midwives.25 An explanation for this discrepancy might be that experienced midwives did not notice NQMs’ commitment to their clients because NQMs work alone with their clients in the
RkJQdWJsaXNoZXIy MTk4NDMw