General discussion | 191 Established midwives were willing to support NQMS if facilitated. They also believed that practice owners cannot act as employers. In their behaviour, they prioritized client care and practice organization over supporting NQMs. So, we expected midwives to act in accordance with their positive attitude towards supporting NQMs, but they behaved differently. Another explanation for the discrepancy between midwives’ attitudes and behaviour in supporting NQMs could be found in the JD-R model. This explanation is connected to the high level of exhaustion among Dutch midwives.42 Exhausted midwives lack the energy for performing tasks outside their assigned role, which is sometimes required to support the smooth functioning of the organization.42,43 They focus on inrole performance through carrying out tasks for which they are directly responsible. Caring for pregnant women and maintaining the organization of the practice are their priority, and they may cope with exhaustion by underperforming in other roles, such as supporting new colleagues.42 Established midwives perceived NQMs as lacking commitment to their practice organization, and as prioritizing their time away from work over being available for practice (Chapter 6). Our findings on NQMs’ work engagement (Chapter 4) suggest the opposite. NQMs were highly engaged in their work, as shown in Chapter 4. There are several explanations for these differences in perceptions of NQMs in practice. Firstly, generational differences in the prioritization of work and private life could help explain the differences in work attitudes.44,45 Differences in opinion between generations regarding the balance between work and private life exist, and challenge intergenerational teams to deal with these differences.44,45 Dutch midwives expected NQMs to fit into the current practice organization as they did themselves when they entered practice (Chapter 6). They felt themselves to be more committed to their jobs than they perceived NQMs to be. Although they struggled to let go of their work during their time off (Chapters 2, 3), NQMs tried to balance their professional and private lives, . They did so by setting boundaries, which was experienced by established midwives as reduced commitment to their jobs. Secondly, NQMs have weaker links to their workplaces and teams due to locum or temporary employment contracts (Chapters 2,3). It is known that commitment to an organization depends on the quality of the socialization within an organization.46 Temporary or locum employment, combined with a lack of support in the practice, may play a role in the attitudes and behaviour of NQMs. When established midwives began their transition into practice, their situation was different from that of NQMs today. They often started as a new partner in a practice organization, and their final internships often happened in the practice where they would have their first jobs, which meant that they had their induction period before graduation, and were already familiar with the practice during their transition period. (Chapter 6).
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