THE LIVED EXPERIENCES OF NEWLY QUALIFIED MIDWIVES' TRANSITION DURING THE FIRST YEAR OF MIDWIFERY PRACTICE IN JAMAICA

Title: The lived experiences of newly qualified midwives’ transition during the first year of midwifery practice in Jamaica.

Background: The transition from a student to a newly qualified midwife is usually loaded with various expectations and responsibilities. In Jamaica, these experiences are further challenged by the migration of senior midwives searching for better opportunities. The result of this is the increased workload and great autonomy with very little support system in place for them. This study sought to explore in-depth, the challenges or opportunities of newly qualified midwives ‘successful transition into their midwifery practice.

Aim: To provide more in-depth insight and understanding of transitional experiences of newly qualified midwives into midwifery practice in Jamaica throughout their 12 months post-registration period.

Methodology: A phenomenological approach, which utilised a purposive sampling design, guided this study's data collection process. The study was conducted using semi-structured interviews at set time intervals: the initial three months, four to six months, and twelve months of practice with eight newly qualified midwives from three hospitals in Jamaica. Data was analysed using the interpretative phenomenology analysis informed by Smith, Flowers and Larkin (2009).

Findings and discussion: Five superordinate themes emerged: ‘Being a midwife and expectations’; ‘Transition shock’; ‘Confidence and competence to develop autonomous midwifery practice’; ‘Support and a sense of belonging’ and ‘Theory Practice Gap’. The findings revealed that newly qualified midwives entered the midwifery practice with high expectations and were expected to function autonomously in their employment. However, these were short-lived as transition shock sets in. Throughout the newly qualified midwives’ transition into practice, they experience a period of fear with various challenges. However, over time, their self-confidence and competence improved during their progression. This compelled them to adapt and gradually increased their confidence, becoming more assertive, advocating, and managing high-risk cases autonomously. The findings also revealed that some newly qualified midwives lacked support from the senior midwives. In some instances, this meant they had to rely on their peers; alternatively, they had to learn through socialised practise during their transition period. The study highlighted how newly qualified midwives successfully consolidated their learning throughout their one-year transition into midwifery practice. The orientation period was also found to be untailored, unstructured, and did not fulfil most participants' needs.

Conclusion: There is a need for newly qualified midwives in Jamaica to be supported during their orientation period. Also, a structured orientation and preceptorship programme is needed during their first year of midwifery practice to facilitate their smooth transition into midwifery practice. Future research must determine suitable strategies to enhance the newly qualified midwives’ transition into the hospital and community settings.