32 | Chapter 2 Figure 2. Job demands, job resources and personal resources experienced by Dutch primary care midwives (N=31) Job demands Important job demands (figure 2) are working as a locum midwife, balancing work and private life, adjusting to local practice and protocols, dealing with emotions from clients, and administrative and organizational tasks. Working as a locum midwife was experienced as highly demanding. NQMs faced unexpected challenges, such as the number of shifts they have to work on a fulltime basis and working shifts in different practices. On the one hand, employers expected flexibility from NQMs, as they needed the locum midwife to fill a gap in the work schedule. NQMs wanted to work as much as they could, so they took all the work they could get. The reasons for this were twofold: for themselves, to gain experience and, secondly, to appear employable to their employers. Participants stated that they have to learn to manage their work hours and to have sufficient time off. Yes, you know …you have no job-security, so you take all the work you can get everywhere. And, yes, I can recall, the insecurity that belongs to locum midwifery … that increases pressure”. (A1) You want to work everywhere and therefore you will cross personal boundaries. (D5) As a locum midwife, NQMs had to learn to get the right amount of work as well as balancing work and private life. Combining work with their private life was also mentioned as physically and mentally demanding. During on-call shifts, they had to sleep within the practice area, which affected their private life, especially for NQMs with partners and children. The irregularity in working hours also influenced leisure time activities. When I was working, everything went all right, but when I was at home, I collapsed so to speak. Then, emotions came up, so to speak. (B1) Colleagues were mentioned as both a demand and a resource. Support from colleagues was mentioned as a resource for NQMs, but as a locum midwife, colleagues were also their employers. NQMs worry that consulting a colleague may imply incompetency. Participants mentioned that they are aware of their colleagues’ different roles. I can deal very well with my colleagues, but sometimes when I am in doubt about a small issue, I think: yes, I can call my colleague, but then they could think: why is this employee working for us? (D7)
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