166 | Chapter 7 organisational barriers in practice to implement stable employment arrangements for NQMs due to a history of autonomous and independent working midwives.30 Orientation in the workplace In this study, as in previous studies into NQMs,2,3 the stakeholders felt that, in practice, a proper introduction in the workplace is both important and applicable. In the first round, however, the stakeholders remarked that, in practice, this might not apply to community-based NQMs who are employed as locums. As self-employed midwives, locums face an organisational barrier in the form of hourly billing, which would make an introductory period far too costly. Consensus was achieved in the second round, when we reformulated the statement to include compensation for midwives who introduce NQMs to professional practice. Organisational barriers and midwives’ opinions regarding locum midwifery tend to impede support for practising NQMs. This finding resembles those of a previous study concerning support for practising NQMs, in which midwives were only willing to support NQMs if they were given the means to do so.4 Mentoring/group coaching Aside from workplace considerations, the stakeholders did reach consensus on support for NQMs in the form of mentoring or group coaching. Previous findings on Dutch midwives produced similar outcomes – experienced midwives feel that NQMs need to learn from experience in practice, coupled with mentoring, as that enables them to develop a good overview of their tasks and responsibilities.4 Thus, while this study shows the recognition of NQMs’ need for further professional development as midwives, no such facilities have yet been put in place. The situation regarding formal transition support is very similar. Systematic reviews of transition support for NQPs14,16,17 show that effective transition support involves combining professional practice with mentoring and training.14,16,17 Preparation for professional practice Midwifery academies are responsible for preparing undergraduates for their future career, according to stakeholders in this study. This resembles the findings of a study into effective support for Newly qualified healthcare professionals.31 However, NQMs in the Netherlands have to be prepared for the issues they will face in both communitybased and hospital-based working contexts, instead of focusing purely on communitybased midwifery.2 Furthermore, the commitment on the educational responsibilities to prepare students properly does not eliminate the need for organisational socialisation.
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