Perceived job demands and resources of newly qualified midwives working in primary care settings in the Netherlands | 33 Working in different regions was mentally demanding for NQMs. They were expected to know the regional protocols and had to apply them in their decision-making. Furthermore, they had to know the different practitioners within the local communities. Managing emotional client conversations was also experienced as demanding. …to start an emotional conversation. Because, during placements .. as supervising midwife, you do not leave that kind of responsibilities to students.... So, as a student I did not practice such difficult conversations. (B4) Working autonomously was identified by participants as both a job demand and a job resource. Before graduation, during placements, they worked with supervising midwives. On the one hand, they felt relieved to be now working autonomously. On the other hand, participants mentioned that they had been used to working with a supervisor and after graduation they missed the company and assurance of a supervisor. When you are facing a home delivery and eh, the maternity care assistant is nine out of ten times too late. Then you really stand alone. (A5) Participants experienced the planning and organisation of their day-to-day work as a locum midwife as highly demanding. Administrative tasks, such as preparing invoices and writing practice reports, were new to most NQMs. Also, they had to learn to manage their time and their tasks during prenatal clinics such as telephone calls, referrals and administration within a set time schedule. Before graduation, they worked together with their supervisors on such tasks. NQMs had to develop routines in their work, before they actually managed to fit all their work into their schedules effectively. .. I took a lot of time at home, preparing myself for the prenatal visits. Afterwards, I went to the practice and still ran out of time. Therefore there was a lot of catching up to do. (A4) Job resources Important job resources were support from colleagues, peers and family (as shown in figure 2). Colleagues as experts were important for sharing decision-making. Deliberating on decisions with team members helped NQMs to feel safe and confident. Sometimes the potential availability of 24/7 support was experienced as a resource. It’s just the simple approach, you may call me in the middle of the night. Having a colleague available. .. just to deliberate with them. That idea gives me confidence, you know. (B6) Peers were important because they encountered similar difficulties. Recognition and mutual understanding were important sources of support. Family was also experienced
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