Mark Aitken: Hello! And welcome to the Nurse and Midwife Support podcast. Your health matters. I’m Mark Aitken, your podcast host for today. I’m the Stakeholder Engagement Manager with Nurse and Midwife Support and I’m a registered nurse. Nurse and Midwife Support is the national support service for nurses, midwives and students. The service is anonymous, confidential and free. You can call us anytime about any issue you need support in relation to: 1800 667 877. Or contact us via the website at nmsupport.org.au.
My guest today is Ann Kinnear. Ann is the chief executive officer of The Australian College of Midwives. Welcome, and hello Ann!
Ann Kinnear: Hello Mark.
MA: Great to be here with you at the Australian College of Midwives offices and have you as our guest. Ann, would you please tell our listeners a bit about yourself? Your role at the College of Midwives, and why you think Nurse and Midwife Support is an important service for midwives?
AK: Thanks Mark, and thanks for the opportunity to chat with you about this. Obviously, first and foremost, I am a midwife. I came to midwifery through nursing, which many midwives did back in the day.
AK: Some still do, but the majority come through direct entry programs. But I did my training based at the Cairns Hospital in North Queensland. That was the old days when we did our hospital-based training.
MA: As did I.
AK: I decided that I wanted to become the charge nurse of the orthopaedics ward that I was working on. To do that, we needed a second certificate. So off I went to Scotland to do my midwifery training. That too, was hospital based training. My big plan was to do the 18 months training, 6 months grad and then a trip around Europe before going back to Cairns to get promoted to the management role.
AK: But I got caught up, I went to Africa for a year instead of doing the planned trip.
AK: All my friends had moved to London when I came back and they all said, well why don’t you come to London? We’ve got this marvellous hospital that has a wonderful maternity ward and you’re going to get great experience as a midwife here. So I said yes, that sounds good, but I needed to get a work permit. Work permit lead to another three years of work permit which lead to another three years and then permanent residency and I found myself progressing my career for 18 years in the UK.
AK: Ended up as the director of midwifery in a South London hospital, in the London burrow of Greenwich. Then when I eventually came back to Australia I decided that I’d had enough and wasn’t going to be a midwife anymore. But good friends in midwifery and elders of ACM, Pat Brodie and Nicky Leap, convinced me that I ought to go and work as the principal advisor of midwifery for the New South Wales government. Which I did, and I became the principal advisor for maternity services there. Of course, I thought that was my dream job, but then after about 7 or 8 years Pat Brodie and Nicky Leap again said we’ve got a job for you! Why don’t you be the CEO of the ACM?! I didn’t think I could be the CEO, but they were convinced I would be a good fit. I’d acquired a lot of generic skills that fit the bill, so here I am and this is my 8th year as CEO of the ACM. I’m basically responsible for managing the business of the ACM and making sure we’re meeting our objectives and achieving our missions and vision and essentially looking after the midwives so that they can look after the mothers and babies. In terms of Nurse and Midwife Support, in that role, obviously you’ve done a wonderful introduction there but I think that it’s a safe place for midwives and indeed nurses and students to talk about any health issues or anything that’s worrying them really. And be guided around staying or getting healthy for themselves so that they can be the best person that they can be, but also the best midwife that they can be.
AK: So, I think it’s really important that they know about the service and engage with you more.
MA: Thank you Ann, the College have certainly done a lot of work in getting the word out about Nurse and Midwife Support so we’re really grateful for that. You’ve certainly had an extensive and interesting career.
AK: It’s been diverse.
MA: As careers often are, for nurses and midwives. So, thanks very much for sharing that with our listeners. At the Australian College of Midwives National Conference in 2018 in Perth, which we were both at, I ran a workshop on self-care for midwives. The feedback was really positive, with nurses really connecting with the message about the importance of self-care. Why do you think that self-care is important for midwives?
AK: Well, I think self-care seems to be a new fad of a term but I think looking after yourself and caring about yourself has been really important for all health professionals. But we haven’t really spent time thinking about why it might be important. We’re so busy caring and giving that we often forget to care for ourselves.
AK: We often speak about who cares for the carers…
AK: …in a way, your service does that and so does a peak national body like ourselves, the peak professional body for midwifery. We believe that we have a bit of a role in caring for them as well and a part of that is that they access services like yours. But in maternity services, and it’s probably the same across nursing, there are a lot of pressures and stressors in the system. The way that we provide healthcare has changed so much. There used to be peaks and troughs in the working day. The healthcare needs of the women and babies were quite acute, but they would drop off and then have longer lengths of stay. What we see now is that we have this acuity at a higher peak, constantly. And those who need care normally can’t wait. So that adds a pressure to the work environment. Work and home environments aren’t necessarily always supportive, and midwives often feel a little bit isolated and can be quite vulnerable in those spaces. And they don’t want to talk about that: a) to their employer, necessarily and b) probably not with your regulator.
But a service like yours gives them that confidential, private space to have those conversations. I was a supervisor of midwives in the UK and one of the things that I saw my role as was what I called rescuing clinicians.
AK: So, you’re trying to support and approach them before they ended up getting in trouble with their health, which could make them not very good health practitioners. So, I think looking after their registration is important: a) for their livelihood and b) for the care that they’re providing to mothers and babies.
Self-care is important for all of those things, for self and for those around them. It’s very serious, their self-care, because as I said it has such far reaching impacts on their lives.
MA: Indeed, thank you Ann. At Nurse and Midwife Support we talk about filling your own cup first.
MA: It’s a bit of a foreign concept for many nurses and midwives who are used to being in the service of others and caring for others first. But we try and reverse that, because if you actually fill your own mug first, then you will have a greater capacity (as you’ve said) to care for others. It’s not selfish, it’s an important thing to do. Our listeners can’t see us, but we’ve got our Nurse and Midwife Support mugs here. If any of you would like to order one of our mugs, you can do so online and contact us via the website. We can send you and your team some so that you can actually get into the routine of filling your own mug first. Your health matters. My self-care plan includes spending regular time in the garden, which I love. I have a very big garden. Daily mediation practice, which I’ve really come to in the last two or three years, especially since I’ve started with this job because I’ve really connected with the importance of mediation and mindfulness. Exercise: because it makes me feel good and spending time with people I love. Humour I think is very close to nurses and midwives. We like a good laugh. What do you do to maintain your self-care?
AK: It’s a good question Mark. You mentioned humour and laughter there and I think we should really be working at having more laughter in our lives. With laughter brings endorphins and that’s really central to our wellbeing in our work as midwives.
MA: I like it.
AK: So, laughter is really, very important. I too enjoy gardening, but I enjoy garden design and building things. I have this belief that I can actually do anything; I can learn about it, I’m relatively intelligent so I can figure it out. So, I’ll do bricklaying and carpentry and all of those sorts of things.
AK: I’m in a privileged position where if I don’t do it very well, I can pay someone to fix it. That brings me a lot of pleasure and a lot of relaxation, doing that. I spend a lot of time on my own, doing these things. So, you spend a lot of time reflecting as you’re working and gardening and weeding. We have a large/ish property as well, we walk the dogs so you spend time just thinking. I think something we should all get used to is that having silence is ok.
AK: By having silence, you become more at one with yourself. So, I do a fair bit of that. I would say that I’m not into meditation, but if I reflect on it, I think I do a lot of things that are meditative through being always positive and always thinking about the impact of things that are happening around me and not being negative about it. So, it is mindfulness, in a way. But I probably wouldn’t fess up to being a meditator.
MA: That’s a really good point Ann, because a lot of nurses and midwives that I meet are not into mindfulness or meditation. But when I reflect on the way that they look after themselves, just as you say, they’re really practicing those moments of mindfulness. Reconnecting or resetting themselves to feel good and refreshed and to be present in that moment with the women and families that they’re caring for. A lot of people are doing that naturally, so it doesn’t matter what we call it, as long as it fills your own mug as we say. What we’ve really connected with this year is that the code of conduct for midwives around health and wellbeing actually requires midwives to engage in their own health promotion and wellbeing. So, it’s the value that says:
Midwives promote health and wellbeing for women and their families, colleagues, the broarder community and themselves in a way that addresses health equality.
I think that’s great. It’s actually in our code of conduct and it requires us to engage with our own self-care and our own wellbeing. As you’re listening to this, hopefully you’re thinking about your self-care and how to put those plans into place. There are some great resources on the Nurse and Midwife Support website, and I know the college has some great resources on their website as well because I’ve seen them.
MA: What advice do you have for midwives who may be in the process of developing their own self-care plans. You know, if you were thinking about doing it more formally, what advice would you have?
AK: I think the first thing is that we have to realise that we have to be active about our self-care. It’s not something that happens passively or automatically. We have to bring it forward in our level of consciousness and be aware of its importance for yourself. Not even as a midwife, but as a person and a friend and a lover and all of those things that we are to other people. Being active about it. Of course, you said that the Nurse and Midwife Support website has great tips. I was reading your tips about exercise and diet and sleep, we all know those things, but it’s actually bringing it forward so that we think about it for ourselves. It’s a practice what you preach kind of approach, for yourself. Then thinking about how our thoughts impact on us, it’s not just about sleep and exercise and diet, it’s also about our thoughts. I was listening to a woman speak about the impact of our thoughts: how if you’re someone that often has negative thoughts and you stew about things and your thoughts are taking over. She said that, you are not your thoughts. You can moderate your thoughts. You can ignore your thoughts. So, it’s about bringing that to your level of consciousness as well about being positive. It’s an old adage, but the cup half full really does work around your attitudes, around people and your work and how you go about your work. So, I think that midwives do need to be active about it. They need to find time for their own space. And, again, enjoy the silence and don’t be afraid to ask for help. There is no one way or formula for self-care. People need to do it in their own context and their own place. But, please be active about it and get onto it and make sure that you are filling your mug with all of the things that give you resilience for your well-being.
MA: Thanks Ann. I really like that thing about being unafraid to ask for help. At Nurse and Midwife Support, we really like to be in the space of health promotion and early intervention. So that we’re supporting people very early on if they feel like they need support. So, just as Ann says listeners, please call NM Support anytime. We’re available 24/7 on 1800 667 877. Now Ann, you’ve recently announced your retirement?
AK: I did!
MA: How are you feeling about that?
AK: I’m feeling quite excited about it because I think it offers new opportunities to learn and grow. When you say that you’re retiring, it doesn’t mean that you’re actually stopping. You’re not grinding to a halt and sitting on your veranda, waiting to die. I think people need to realise that just because you’re retired, it doesn’t mean your mind stops being active. I think it’s really important that we adjust our mind-set of the way that we’re working. We’re moving away from the traditional working hours and traditional employment models, but you continue to function and work and use your skills in other ways. For example, I have a high interest in land care and Greening Australia, and I have every intention of getting involved in those organisations and using the skills that I have acquired from my career in to assisting the types of work that they do. Also, I will continue to work on the boards that I am a member of and do other work that people ask me to do that interests me. I’m fortunate in that I don’t have to work, but I will work if it’s interesting and I want to do it.
MA: Sounds very exciting to me Ann. When I first heard that, when you told me last year when we were at the Australian College of Midwives National Conference, you were telling me that you were retiring and that you would be finishing up in September of 2019 this year. I thought, what a great plan! How wonderful it was that you had put a lot of thought into your transition into retirement, and how considerate you’ve been to the Australian College of Midwives in relation to the succession plan. I think your example highlights the importance of career transition, planning and communication around changing your career or leaving your job. So, what advice do you have for midwives who might be asking themselves, what next? Or, how do I plan for the next stage of my career or life? It might not be retirement, it might be a new job, might be moving to a new area. What advice do you have, Ann?
AK: I think the main thing is to keep your mind open to new possibilities and always work to your strengths. If you think about it, we all have lots of strengths and skills that are transferrable or used in other ways. I think, seize opportunities! If other opportunities arrive, think about them carefully. The things to do would be to think about your strengths, how can that work there? And do you actually want to change jobs? There might be an opportunity and you might have everyone around you saying that it’s the perfect job, but is it actually the job that you want? Take time to think about these things carefully. I think it’s perfectly ok to be a very skilled and experienced clinician. Not everyone has to go along the career trajectories that are traditional. We are lifelong learners so as a clinician you should be learning every day. I realise that the more I learn, the more I realise what I don’t know. I think that’s really important, to have that in the forefront of your mind as well. Talking to others, recognising that those you admire are often great confidants and keen to help you through these things. You know, I’d say my whole career was never planned. I took opportunities, I seized them and it’s been a total accident that I’ve ended up where I am. But it’s been a joyful accident, for me.
MA: I really like that term, joyful accident. I think a lot of midwives listening to this (and indeed, the nurses listening to this too) would really relate to that. I remember many times in my career, yesterday was 35 years since I started in my nursing career. I think we naturally reflect on our careers and the highlights within that. Ann, has there been a career highlight? Or several?
AK: I think there has to be several, because your career is not homogenous. It has different facets and places and contexts where you will have achieved something. I’ve thought of a few. One was when I was quite a newly qualified midwife, a woman had come in and her baby had died. She had a stillborn, and she needed to be cared for. So I got assigned to look after this woman that I didn’t know. You know, obviously, it took the entire shift for her to give birth to her beautiful baby. We formed a bond in that time. She left and was very grateful. I think as midwives, it’s very special when you spend time with women who are giving birth to their dead babies. They really appreciate the bond that comes.
AK: But what made a difference around that particular woman, for me, was that around three years later I was obviously a lot more experienced and had become the midwife in charge of the birth suite in South London. She called the hospital, and asked for me. It turned out that she was at 21 weeks with twins. She was afraid that they had died. So, I said, goodness, come in! I was able to facilitate her getting the care she needed over the next couple of weeks while she was worried. She was reassured that the babies were fine, but of course, they died. Women often know what’s coming with that. We facilitated a wonderful experience for her, and that, for me, was a highlight because it shows what you can do for women in not so nice circumstances. Using your position, as you come up through the ranks and get managerial positions and other positions of authority, you have opportunities to do so much good for others. As a supervisor of midwives in London, for example, I helped a woman who wanted to have her breech birth at home. We made all sorts of arrangements so that she could. Once I came back to Australia, for example, as I said I was the principal advisor for maternity services in New South Wales. We developed a policy called towards normal birth in New South Wales, and it made an enormous difference to the way that the maternity services throughout New South Wales were asked to change the way that they thought about birth and how they had to try and promote things that would encourage normal birth. That’s not to say that some women didn’t need intervention, but it was about making sure that all of those that didn’t need it were not taken down that path. A big highlight for me here at the College was when they reviewed the National Regulation and Accreditation scheme. We secured the recognition of midwifery as a distinct profession. For me, that was a real highlight. To be here in 2019 and it’s only last September that it was enacted into the national law is incredible to me. I’ve been so used to midwifery as a distinct profession, right from when I qualified as a midwife in Scotland in 1985. So, that’s a huge achievement here, given the circumstances. There are an awful lot of highlights, I think, and it’s nice to have an occasion to think about them. So, thank you.
MA: Well thanks for sharing, Ann! The stories that you’ve shared, especially around supporting women going through the stillbirth of a child, a baby, is very poignant. Many midwives will connect with that.
MA: Thanks so much for sharing that, thanks Ann. I cannot believe we’ve come to the end of this podcast. Today we’ve talked about Nurse and Midwife Support, the importance of self-care to well-being and thriving as a midwife. We’ve talked about career transition, and the importance of planning for different stages of your career. We’ve reflected on, and celebrated, your career Ann. And what a great career it’s been! Thank you, Ann, you’ve been a great guest. I know that midwives listening to this will benefit from your words of wisdom. You can find out more at nmsupport.org.au
Or you can call us anytime on 1800 667 877. If you found this podcast useful, please share it with other midwives, nurses and students. Your health matters. Look after yourselves, and each other. Speak to you next time.