The role of advanced midwives regarding maternity care in tertiary hospitals in Gauteng

Abstract

The researcher explored the role of advanced midwives allocated in maternity care in tertiary hospitals in Gauteng. Advanced midwives form part of the multidisciplinary team in Gauteng tertiary hospitals in accordance with the staffing norms as prescribed by the Maternity Guidelines of South Africa for advanced practice nurses. Advanced practice nursing (APN) strengthens nursing and advanced practices to assist and fill in where there is a shortage of physicians in rural and densely populated areas. The scope of practice in tertiary hospitals for advanced practice nurses is not explicit; the role of advanced midwives in these hospitals is not clearly defined and, as a result, the role of the advanced midwife and physician overlap in tertiary hospitals in South Africa. A qualitative, exploratory, descriptive and contextual research design was followed. Advanced midwives allocated in three selected tertiary hospitals in Gauteng served as the study population. After conducting a pilot study at the fourth tertiary hospital in Gauteng, data collection occurred during three focus group interviews. Field notes were taken. Application letters for obtaining ethical permission and permission in the setting were sent to the chief executive officers (CEOs) of the three selected hospitals. All ethical principles were strictly adhered to. A moderator was used to conduct the focus groups in a quiet setting of each hospital. Participation was voluntary and informed consent was signed. The collected data was analysed by using the 8 steps of the Tesch’s model of data analysis. Trustworthiness was adhered to with confirmability, credibility, dependability and transferability. The study findings were discussed and confirmed by literature control. The limitation of this study was highlighted. The findings revealed three main themes: positive attributes of advanced midwives, responsibilities of advanced midwives in tertiary hospitals and challenges posed by patients who do not adhere to the admission criteria. The recommendations were made for the support and supervision of the utilisation of advanced midwives in tertiary hospitals by the Gauteng Department of Health employing body, support by training institutions/universities, support for advanced midwives by nursing management, and self-empowerment of the advanced midwife. The conclusion was that advanced midwives are not optimally utilised. Support recommendations were made to different stakeholders on strengthening multidisciplinary team decision making on management of patient care. Further research studies on the placement of advanced midwives within tertiary hospitals were recommended.