thru the pinard Podcast
a conversational podcast with @Academic_Liz with midwives & other birth professionals about their studies/ research & how it's changing our practice globally - email thruthepinard@gmail.com
thru the pinard Podcast
Ep 89 Virginia Stulz on thriving after burnout and reshaping maternal health education
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Ep 89 (http://ibit.ly/Re5V) Virginia Stulz on thriving after burnout and reshaping maternal health education
@PhDMidwives #research #midwifery #PIPE-MC @westernsydneyu #burnout #unicanberra #TTMEC
Research link - ibit.ly/2Obkq
What does it take to pivot from a registered nurse to a pioneering midwife, and what lessons can we learn from this journey? Join us as we shine a light on Virginia Stulz's inspiring career transition and her influential role in New South Wales' first Community Midwife Program. Virginia unveils her dedication to continuity of care and reveals the profound impact it has had on her practice. Her stories weave a rich tapestry of experience and passion, from her pivotal training days at Gosford Hospital to her academic research into stress and burnout among healthcare professionals.
Virginia's academic journey didn't just end with a PhD; it was a transformative path filled with emotional and psychological challenges, including the daunting task of finding one's identity post-dissertation. Listen as Virginia candidly shares the uncertainty she faced and how community acting became her unexpected refuge and companion. Her insights on balancing work and personal happiness provide vital lessons for anyone navigating demanding careers. These reflections are not just theoretical musings but are backed by Virginia's own research, which delves into the grim realities of burnout and the necessity of self-care in healthcare professions.
Beyond personal narratives, we explore the broader implications of Virginia's work in advancing maternal mental health education, particularly through the Pipe MC workshops. Discover how these initiatives are reshaping training for maternity clinicians and the significant progress they are making in Australia's healthcare landscape. We also touch on ongoing research projects evaluating educational programs, offering a glimpse into the future of midwifery and healthcare education. Virginia's dedication to improving the lives of healthcare professionals and the patients they serve is both inspiring and enlightening, making this episode a must-listen for anyone invested in the future of healthcare.
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Journey Into Midwifery and Research
Speaker 1Thank you very much for joining me, as per usual. Can you introduce yourself, please?
Speaker 2My name is Virginia Stultz and I'm currently working at the University of Canberra.
Speaker 1So let's go back to the beginning. How did you get into midwifery?
Speaker 2So I didn't always want to be a midwife. I worked as a registered nurse for a few years and then I decided that I wanted to study something. And so I thought well, in those days you did it in the hospital, training and you got paid and you studied while you were being paid and working. So I decided to do midwifery In my general training. I actually done a stint in a maternity unit and I didn't like it at all. In fact, when I saw a birth, a twin birth, I actually had to go out because I thought I was going to faint.
Speaker 1Oh my.
Speaker 2So years later I thought I'll give it a go, and I absolutely fell in love with it. So I actually did my training at Gosford Hospital and just worked as a midwife and have been for the past 35 years.
Speaker 1And that's a for those that don't know. That's a kind of a regional, a large regional area in New. South Wales. What did you enjoy about midwifery that made you stay in it?
Speaker 2I think the connection to women and babies. I also worked as a community midwife in the first community midwife program, actually in New South Wales at Gosford Hospital. So I basically finished my training and I went almost straight into that and those days we didn't do on-call, we did sort of 8 till 9 pm and I just love that. It was like continuity of care that students do today. And so I worked with three other midwives and we worked as a team and I love that connection, getting to know the women you know in the antenatal clinics and then during their births and then visiting them postnatally in their homes clinics and then during their births and then visiting them postnatally in their homes. So I worked in that program for probably about five years and then I just went on to do other things. I've always worked full-time and studied part-time and I went on to do my Master's in research. So that's how I got in into research and then then I'd always wanted to do a PhD and then I started my PhD.
Speaker 1So let's go back to your master's. So what got you interested enough to do a master's? What area did you do?
Speaker 2So it was back in those days. It was called called a Masters of Nursing with Honours. So I did my coursework and for the last year I did my research and the research. I'd actually left the Community Midwife Program at that point and I actually interviewed about 12, 14 women about their experiences on that Community midwife program. So the title of that thesis was mothers connecting. So it was all about the familiarity with the, the midwife and and the woman.
Speaker 1that was a long time ago what still sticks in your mind about doing that project?
Speaker 2I think how, how wonderful the women were and how they were willing to share right back in those days how the connection between the midwife and themselves was so important. And we know that now, right gold standard, and that's why we train our midwifery students about continuity of care and in those days when I was doing my training, that wasn't even part of the curriculum.
Speaker 1No, but it was the natural way that just kind of evolved and got good results, but there wasn't the evidence behind it yeah. So then, what was the gap between doing your master's and then starting your phd?
Speaker 2so then I just worked. I worked, worked for 10 years in the public system and I then worked 10 years in the private system and I think I was doing my master's when I was sort of like in the middle of those two decades and then I was sort of like thinking about doing my PhD. But it wasn't the right time for me. I did a bit of casual work. I was working like I did. I think I did a three month stint at Gosford Hospital on their community midwife program. They didn't call it that, it was like a 12 hour. You would work in 12 hour shifts and on call. So I did that for a little while. And then I worked casually at both hospitals North Gosford and Gosford and then I decided the time was right to do a PhD. I was working clinically while I was doing my PhD.
Speaker 1So what was the question, the issue that you wanted to explore with your PhD?
Speaker 2So when I was working at North Gosford Private, I worked there as a manager for 12 months and I was doing 60 hour weeks and I got quite stressed and burnt out. So I was only in that position for probably 14 months and then I anecdotally I heard that nurses and midwives were stressed and burned out and I'd experienced burnt out, burn out. So I did my PhD on stress and burnout of nurses and midwives. So so back in those days we didn't, so it was a quantitative PhD. So I developed my own tool, I piloted the tool and I published that. Back in those days you didn't do PhD by publication, it was writing a thesis. So I published my pilot study that I actually developed the tool about stress. It was three areas stress, burnout and how the individual actually reacts to stress and burnout.
Speaker 2I went all around Australia and I was actually working full time as well. I went all around Australia and distributed surveys at conferences Yep, so midwifery and nursing conferences. Surveys at conferences yep, so midwifery and nursing conferences and that's how I. It was all hard copy, so I put everything into SPSS and that's how I learned stats, basically working, doing it all myself, analyzing the data and I suppose the biggest thing that came out. I had 565 midwives and the biggest thing that came out of it was that working longer hours produces a lot more deleterious effects, so I was asking them questions about sleep. You know, depression, anxiety, all those things. I finished my PhD in 2009, so it took me six years to do it because I was working full-time, so I did it part-time and I actually finished my PhD before I entered academia.
Speaker 1Yep.
Speaker 2Yeah, which is unusual these days too, I think.
Speaker 1It's different. Unfortunately, quite a few people see the only pathway post-PhD as academia, because the pathways for post-PhD are not clear except for academia, and that's something that we need to work on better in the future. Exactly, it isn't that clear how you use them in clinical or how you use them in a non-academic setting, but the academia want it as almost like your base level qualifications, but having a PhD doesn't necessarily mean you're going to be a good teacher. Exactly juggling all these balls, how did you go about picking your supervisors then?
Speaker 2so when I did my master's, I did my I I knew a really good supervisor. Well, she was a teacher actually she was teaching us in the, the units, the course units in my master's and I did my PhD at the same university. So she wasn't actually a midwife, she was a nurse, but she was a really good teacher and she was my primary supervisor. And then I had a statistician come on board probably two years into my PhD because I needed that stats knowledge and I had a third supervisor. So I actually just chose my primary supervisor and they sort of chose the extra supervisors.
Speaker 1Yeah, as their skills and talents were needed. Yes, yeah, so if you've gone through burnout yourself and you're feeling kind of fragile and vulnerable and all the things that you do when you kind of experience it yourself, yeah, you're now reading the responses of over 500 other nurses and midwives who have no doubt gone through similar levels. Yep, how did you protect yourself in doing that?
Speaker 2I think I was just so interested in it. In fact I was I viewed when I was analysing my data. You always think anecdotally and I used to hear it. We still hear it. Right, it's still rampant stress and burnout.
Speaker 2Nurses, midwives, are stressed and burned out, especially since the pandemic. But I was so interested in it and I would say to my supervisors are these, all these midwives are stressed and burned out? They're saying, actually, what's the data telling you? Virginia? Yeah, and actually they weren't that stressed and burnt out, they were only moderately stressed and stressed. There's only a few midwives and nurses that did have high burnout levels. But my sample they were moderately stressed. But I guess I was so interested in it and I really loved doing my PhD. I love the journey, I love the studying, I love. The best part of it was, you know, the data collection, going to the conferences and standing at the conference and saying this is what I'm doing. I'm doing my PhD, please do my survey. But I also had to have that balance right and you always have to do so. I exercise.
Speaker 2I've always exercised my whole life. I did ballet as a child, so I've always exercised every day. I run most days of the week, and that's how I keep my sanity, which is important, yeah. And also family. Family is very important too, and doing some things that are, you know, nice and relaxing that that you enjoy as well, like going to the ballet and the theater and things like that so how did you kind of organize your study period then?
Speaker 1because if you're working full-time and then studying, and were you still doing shifts at that stage or were you day like, how did you?
Speaker 2set up your study, yeah, so, interestingly enough and I still do it to this day I, if I'm I always set aside two hours. I always set aside two hours a day to do my phd, and I still do that now. As an academic, I write or spend something on those two hours that have to do with research somehow. And so I worked clinically for the first two years. So I worked. I would work like I was actually casual. So I worked casually and I was working full time and I was working as a community nurse.
Speaker 2I was doing a bit of community midwifery, I was working picking up ships at both the hospitals and then I so for the last four years of my PhD, I actually got a job as a research assistant for a gastroenterologist, and so I ended up being the research coordinator for a study that he was doing on cardiovascular health, comparing people either living in retirement villages or living in the community.
Speaker 2So I used to go out and collect the bloods and do anthropometrics, and so I did that for three years, and then the last two years of that I worked for him on another project. I think I was working eight days for him, yeah, and then the other two days I was still working full time, I think. I worked for a private obstetrician, so I do all his antenatal visits and his postnatal pap smears, and so I did. I sort of worked um in, you know, did a bit of both, but I always, if I didn't do two hours one day, I would catch up and do it on the weekend. You know, I do four hours on a Sunday or something and I don't think I could have done my PhD full-time. It would have driven me mad.
Speaker 1Yeah.
Speaker 2I needed that, you know, I just needed that socialisation of working and you know, working with people I don't think I could have done it full-time. That's why I'm sort of glad. I mean I had to do it part-time because I couldn't afford it, yeah, and because I had a mortgage so yeah. So I've always never really had children to worry about. It's all been about me really.
Speaker 1I look and I get that I'm the same and I'm in awe of people who do it with kids, and especially um women who are single and they've been the sole parent and they're still juggling kids and still juggling work and still juggling a PhD.
Speaker 2I don't know how they do it.
Speaker 1Like it's bad enough me looking after myself and working and doing a PhD.
Speaker 2I know, I don't know how they do it. No, I think a lot of them do it at the, you know the 10 o'clock at night. Yeah.
Speaker 1That's the end of their day. And it is because we give so much to everyone else first and then kind of fill our own baskets last of whatever energy is left.
Speaker 2And I guess people and even, like I don't think, phd students really know what it's like until they start it. They don't know Like it's such a big commitment. I think a lot of students at the end of that year go wow, I didn't realise this was such a big commitment. And it is a huge commitment. You've got to really be passionate about what you're studying right and also you've got to be very about what what you're what you're studying right and also you've got to be very, I guess, regimented in the fact that you've got to make sure that you do those two hours a day or 14 hours a week or whatever it is work out what your routine works for you and then make sure you're consistent with it.
Post-PhD Transition and Self-Care
Speaker 1Yeah, exactly, I think the first year can feel a lot like you're doing nothing and you're just reading and questioning and then talking a lot, and then suddenly the last year feels like all you're doing is thinking and writing, absolutely. But that's where I think doing it part-time is an advantage, because you then have that time when you're doing something else. It's always going in your brain like you never think about it. Yeah, but then those things are playing in your subconscious. And if you let your subconscious play, then when you kind of come back to it, or in the shower, or when you're gardening or walking your dogs, suddenly it's like oh, oh, where's, where's the recorder on my phone? I need to record this.
Speaker 2I know that's right yeah, that's what, and that's what I used to do, like I'd go for a bike ride and come back and if I thought of something it would be like, oh, that is a gem, I'd write it down. Or if you think of something in the middle of the night, you get up and write it down. I think it's such a even for six months, before I started my PhD and rolled, I was like reading. I was reading a breadth of literature. So I think it's really. It is such a journey and when I was finishing my PhD, I was really, I got really nervous about what I was going to do next. What am I going to do next? Yeah, it's just consumed you for six years and I was thinking what am I going to do next?
Speaker 1I think I've had. I've spoken to a few people, quite a few people who've talked about the fact that they've had a almost like a depression that has happened in those in particular like the waiting game for it once it's been submitted, and then you're waiting for it to come back, you can't do anything about it, but suddenly it's like what do I do with this? Then you get it back and you've got to do whatever changes and, depending on how fast or long that changes are, then you've got to wait for the university process to confer it and graduate it and, depending what university, that can be fast or that can be slow. But then it's like all of your time and energy has been involved in this project and now it's like but where do I go? Where do I fit? So some people have been able to continue, which has been fabulous, yeah. But a lot of others, that whole identity of who am I, who do?
Speaker 2I want to be now that I'm grown up, supposedly exactly, and it you're almost yeah, you're right, you almost go through like a depressive stage, sort of finally coming to that end of that stage. But what I did was I actually got into acting community acting oh cool. And just after I finished it, I got this main role. It was called Key for Two, and I had two boyfriends and I was always on stage with one or the other of them and it was so.
Speaker 2I'd never really done that acting before, and it was such a like that filled, that filled the hole for me after I finished my PhD and, um, you know, we practiced, we rehearsed for six months, and I had to, I had so many lines to learn and, yeah, that was six months with five other people, and we all became really close, like a family, and, in fact, when our performances finished because we do a performance Friday night, saturday afternoon, saturday matinee and Sunday afternoon for two weekends in a row a lot of us just felt depressed after that because we'd all become like a family and, all of a sudden, it was finishing. That was so much fun, though. So much fun, yeah, and I did go on to do other plays as well, but I think that's it.
Healthcare Shifts and PhD Challenges
Speaker 1It's finding where you get your happiness and making sure that you have that balance, um, because it is that our work can consume so much of our time, absolutely our space and our emotions, that if we don't and I keep remembering quite visually, and I used to have it in my old office, that, um, you can't pour from an empty cup, exactly yeah, you have to keep filling yourself and you've got to fill yourself up first before it, which brings so going back to the burnout. So, yeah, did you find or I'm not sure if it would have come up, but jane sandhill, I think, did burn out back in the 80s and in the mid 80s. Did you find much had changed in what she found or what had previously been reported, in the very small amount that was back then, to what you found when you did it?
Speaker 2Not really. I think the biggest finding of mine was that working longer hours produces many more deleterious effects. And I guess you know and I did interview a lot of nurses and midwives that were doing like they would be asked to do double shifts or they'd have to stay back. They'd be asked to stay back and they would. They may not necessarily wanted to, but they felt like that. They actually couldn't let their patients and women down, so they'd do those extra hours. And yeah, I think you know night duty, like working, clinically working those circadian rhythms are all interrupted and that has a huge effect as well.
Speaker 1And that's almost permanent because you don't really go back to kind of a normal rhythm. I found it always interesting that double shifts they were quite happy to do a morning and a late double shift. They were happy for you to do a late and night shift, yeah, but it was frowned upon and nobody allowed you to do a night and a morning shift yes, because they knew it was dangerous to work that long yeah, yet they'd still was dangerous to work that wrong.
Speaker 1Yeah, yet that still allowed you to do the other combinations. Yeah, that's interesting, isn't it? How is it different If you've slept all day in preparation for the night? Yeah, there is no difference in doing a night early than there is in doing an early-late or a night-night, yeah, but I guess the thing with that is a lot of well.
Speaker 2I mean, I never slept during the day. When I was on nights, I could only really sleep four hours, so I was a wreck by the time that night duty was over.
Speaker 1The worst combination is actually the late night, because most people have been up all day doing things and then suddenly they're expected to do a night shift as well, when they've had night, and they can actually get to be 24 hours.
Speaker 2Yeah, absolutely it's like and you know they say it's like being 0.8 or something. Yeah, so it is dangerous.
Speaker 1So, apart from that kind of outcome, what else surprised you about your PhD when you were doing it?
Speaker 2either the process of doing it or the results. I think the process surprised me. I had a really big hic, piloted my survey at a few hospitals and a few aged care facilities and then I couldn't get ethics to do my main study. Oh so I wanted to distribute my survey through a public hospital and a private hospital. The public hospital basically said no. The private hospital? I actually had to go and have a meeting with 10 people on their ethics board to say you know, they were asking me questions about it. They all agreed that they wanted to come on board for me to distribute the survey in their private hospital. And then the director of nursing of that private hospital said no, what were they afraid of?
Speaker 1They didn't want the results.
Speaker 2They didn't want the results, they didn't want their nurses and midwives to say we're all stressed and burnt out. So I opened a can of worms, right, yeah. So then I had to rethink how I was going to distribute my survey and within that year I actually wrote my literature review or my literature chapters, and then I decided I had to go back to my ethics committee at the uni and say I'm actually going to travel around Australia at conferences and distribute them myself. Yeah, so that's how I got around that. So that was it. That was a huge thing for me, because yeah, it was such a setback and it is, it's.
Speaker 1It's such a business point of view, isn't it? It's not caring for your employees are going. Oh, we let's see what happens and maybe we can do something. It's oh shit. If they come back and and they are stressed, then it's going to cost us money to fix it. And yeah, it's absolutely.
Celebrating Achievements and Career Transitions
Speaker 2I think that was a huge setback for me. I didn't know that I'd ever get it done right. But the other thing I really loved about doing is basically, I learnt statistics because I'd done a qualitative Masters and I love stats and I love quant stuff. Now I mean, I love both, I do both now and I use SPSS all the time and I just I sort of felt like I learned statistics doing that PhD because my statistician would say to me you've got to do this. You know, um, you've got to learn how to do this. You've got to and you'll figure out. You, you won't know the analysis to do, but you'll. I can tell you which ones to do, but you've got to do them. And now I, now, when my students give me some data, I go, okay, I know exactly what, what analyses you're going to use. And so back then I didn't, but obviously now, because I finished my PhD in 2009, so it was a long time ago, yeah, there's a modified few versions, but most of the statistical tests haven't changed too much.
Speaker 1the big one, but there have been more added now with the descriptive stats and some of the presentations and the kind of tables and graphs and things. Yeah, absolutely yeah, which does make life a lot more interesting. Before we go into a little bit more of the serious stuff, some fun stuff. How did you celebrate?
Speaker 2I celebrated with my graduations. I always went to my graduations with my family and you know, even my undergrad I did a Bachelor of Health Sciences in Nursing part-time as well, because you know I was a registered nurse and a registered midwife and had never done a degree. So even then I did that with one of my colleagues I was working with at Gosford Hospital and we her family and my family went together to the graduation. We went out for dinner and I always mean I just felt I think graduations are so important and I think it's really important to go to my students graduation too. That is so exciting to see my students graduate as well.
Speaker 1I quite love and I try to always sit on the same side of the stage that they're coming up, because you get to kind of like giggle and wave to them not in the front row on stage, obviously, because it's too, serious, but yeah, I think that's. It's part of that journey, isn't it? The belief that, especially in post-grad, the belief that your supervisor's having you to complete it. Even not everyone has belief that they can start it, but if you've got someone saying, yeah, you can do this, come on, let's go do it.
Speaker 1Definitely. That helps to fire up your intrinsic inside belief. And then when you go out, it's kind of like you cannot do this by yourself, no matter what you try. Exactly, oh no.
Speaker 2It's a village, big village, yeah, village. Yeah, absolutely as well as your family as well. Yeah, because they used to. Honestly that I'm sure everyone got sick of me talking about my PhD because that's all you talk about right when you're doing your PhD absolutely with your tool?
Speaker 1has it been used since you did it?
Speaker 2I'm not so sure about that because I didn't, like I should have probably copyrighted it and printed, penned it, whatever you do, but I I don't know. I I did. I have had some emails like over the years to say can I use your tool? And I'll say yes, but just acknowledge me and you in your.
Speaker 1But no, I don't think I've never seen, seen anyone except you know, like I haven't seen it cited or anything so when you look at some of the, the more recent um research that has been using instrument tools, how much has it differed from the, the things that you were focusing on?
Speaker 2I think probably, probably, they're very, very similar, very similar findings. Yeah, my survey included a section on like the environment and the work environment and then another section on the individual's reactions to stress, or how they like their person, almost like their personality, how they react to situations, and then just another section just on like stress symptoms, like symptoms of stress, like anxiety have you experienced, how often have you experienced, anxiety and depression? The other thing I learned about doing my pilot was one of the questions because they're all like it scale answers, right. One of the questions because when you receive feedback from your pilot survey, one of my questions had a lot of the questions were never, sometimes, frequently, and one of my pilot respondents asked me to put never and occasionally together and I did do that and I shouldn't have done it because they're quite separate never and occasionally, so always. That was a really good lesson for me to learn that you actually have to make the decision at the end of the day, because I couldn't analyze that question. It was.
Speaker 1I mean the absolutes are really difficult to include as well, because it's it's an absolute never, always, and very few things in the world are never or always exactly those absolutes. So how do you change those words to stay the same meaning without being absolutes?
Speaker 2Yeah, and they're very subjective as well. They were very subjective, um so yeah, so I guess I, with those subjectivity, the data was so subjective I had to use, all you know, non-parametric statistics instead of parametric statistics. So, but you know, it was a interesting interesting. You know how you learn things as you go along doing your PhD. That's why it's such a great journey.
Speaker 1You pick up so many skills. How do you see the relationship between burnout and moral injury, moral distress?
Speaker 2uh, I think they're very similar. So in my thesis I wrote about because they're stress is yeah there's good stress, eustress yeah eustress.
Speaker 2So eustress is stress which makes you get up out of bed in the morning. It makes you feel like you can actually be motivated, inspired, moral distress, distress. You know, burnout is distress, really, isn't it? So I think both of them are very similar, they align with each other. But I guess burnout is, you know, it's the, the emotional exhaustion, yeah, um, you know the depersonalization, um, and moral distress, I guess it's probably more about that person's morality. So that might be a sort of a distinction there.
Speaker 1Because you get to that compassion fatigue where you just and that's where it's really hard to know, when you've reached that factor, whether it's kind of a protective reaction and whether you can come back or whether you want to come back. And I know that COVID has certainly ramped that up- an awful lot especially in the UK and America and countries in Europe and in Victoria, in Australia and Victoria, because they got hit with Absolutely the shutdown for so long, but the compassion fatigue, absolutely.
Speaker 2That's probably just another term for burnout. It's, you know, feeling highly anxious, not being able to sleep, not being able to concentrate properly, and some midwives actually were so burnt out because what I did in my PhD. I was wanting to do a qualitative PhD, right, but because of the way I did it I had to be turned out being quant and I did actually want to do some.
Speaker 2So I end up interviewing five midwives who were totally burnt out yeah and I was going to interview you know some that were, you know, lower stress, but one or two of them actually had left the profession because they were so burnt out. Yeah, but I never published that data because my supervisor said you have to finish your PhD, you're going off on tangents. And I had so much data I mean my, my PhD. I had two volumes from my PhD. One volume was the thesis and the second volume was bigger than the first volume. It was my appendices of all my analyses.
Speaker 1Yeah, so it's quite large it would be. I mean, I know you've kind of moved on a little bit, but it would be interesting to have a look at those five studies, those five interviews and repeat another five interviews now and do a comparison.
Speaker 215 or so later and actually go.
Speaker 1Well, here were the issues back then. How much have we moved on? Because, sadly, I think there's going to be a lot that's going to be together.
Speaker 2Yeah, true, but I'm not sure I could find those interviews now, liz. I think I probably destroyed them.
Speaker 1And plus the kind of the filing systems and formats have changed. Yeah, absolutely.
Speaker 2I think they're on tapes. Even I don't know what they were in those days. That seems like I'm going back in time.
Speaker 1But it'd be an interesting activity to do. So what did you do after you're celebrated, you're awarded, you're now doctor? Where did you go after that?
Speaker 2So I went straight into academia. I went for a lecturer B at Newcastle Uni and I got into that role because I had a PhD right and so I convened their master's program and then I ended up convening their new Bachelor of Midwifery 10 or 11 years ago, yeah. So I did that for three years at Newcastle Uni and then a senior lecturer position came up at Charles Darwin University and I applied for that and they were introducing a new Bachelor of Midwifery curriculum as well. So I got that job, lived in Darwin for four years, and the last year of my years in Darwin I actually worked as a Senior Midwifery Advisor for NT Government. So it was a really different job.
Speaker 2I wouldn't have got it if I was living, you know, lots more opportunities up in Darwin and the Territory. And yeah, I mean that was a great job. It was quite stressful, you know. You'd get deadlines and reports, You'd have to address them and they'd have to go up to the chief officer within 24 hours. But it was a very different style of writing. And then I just I was working in that.
Speaker 2I worked in that role for 12 months and I wanted to go back to academia. It was a great team I was working with up there as well. There was a small team, I had media support, I had admin support, We'd do all the nurse midwifery awards, We'd go down to Alice Springs as a team and we had lots of fun. And then a job came up at Western Sydney University as Associate Professor. So I went and applied for it and I didn't think I'd get it and I got that job. And I worked in that job as a conjoint between Nepean and Bloom Mountain Local Health District and Western Sydney for seven years, actually six and a half years. It was a great job.
Speaker 1So what type of research did you do and what kind of? Because you've set up a few programs over the years, yeah, so how did that come about? I think one was IPE program yeah, that's.
Advancing Maternal Mental Health Education
Speaker 2Yeah, that's the um, that's the pipe project yeah, so that's the perinatal interprofessional psychosocial education for maternity clinicians, otherwise known as pipe mc. So when I was at western sydney university, one of the clinicians that were was with us, louise Everett. She was a clinical midwifery consultant, which she still is. She wanted to do a PhD and I said well, you should come and do your PhD at Western Sydney. So she came because she's actually working with complex women with perinatal mental health issues, and so she started her PhD with us myself and I'm a co-supervisor, and Virginia Schmid is the primary and Rakeem Elmer is the other co-supervisor. So within a year of her candidature we applied for a grant a perinatal emerging priorities grant and we got the grant. Cool, so very good.
Speaker 2And that's basically been enabled us to do Pipe MC workshops across Australia, both online and face-to-face, so we're educating maternity clinicians across the board. So it's a full-day workshop. We did that for two years. So child and family health nurses, subs workers, mental health workers, obstetricians, gps, um. So we've we've done that and then now we've developed a we're actually doing train the trainer now.
Speaker 2So we've developed a course that's available as a Moodle on the Western Sydney University platform and people can actually hopefully I've actually introduced it into ACT here now. So I did two or three workshops here in Queen Bee in the ACT and two people out of my workshops went and has done the Train the Trainer workshop in the west in virginia a few months ago and so they'll become the trainers in the act. So hopefully it'll like hopefully we're hoping that it will be like a mandatory thing that clinicians maternity clinicians, working with women with complex complexities, with perinatal mental health will actually you know, you might do the course for you know, a year, every year or something like that, but that's been a huge project. So Louise was able to come out, step out of her clinical midwifery consultant role and work four days on the project.
Speaker 1And to have that as part of her, to have it as her PhD is brilliant as well, because you can have that as part of her, or to have it as her phd is brilliant as well, because you can absolutely your focus and double your smartness, instead of separating your brain into two very distinct areas yeah, well, she had.
Speaker 2She had to do that though because sometimes and it still is, because she's still doing her phds, we're just about to put her um, put a paper in on her PhD. So it's quite separate but it's similar, right. So we always used to say to her you know, you've got to focus on your PhD because the pipe project would take over, so she'd be focusing and organising that and she should have been doing PhD. But yeah, she's now, she's had you she's, yeah, she's now she's had, you know, some leave and she's really focused now. And you know it's coming to an end, the pipe project this year. It will be finished June, this June, but there will be hopefully those trainers out there trained and there's a huge platform. It's a. You know, we wrote modules as well. We wrote, I think it was about nine modules and one of them is self-care. Yeah, and it's all about, you know, teaching, trauma-informed care and also those, you know, conversations. How do you have those difficult conversations with women? And I'm teaching it to my undergrads as well.
Speaker 1I think a lot of curriculums now have perinatal mental health, so those facilitation skills that I developed in the program have sort of helped me in that space teaching as well in in that area yeah, one of the conversations that I was having this week is the gloriousness that we get to update and to improve the topics that we teach by bringing in kind of concepts like trauma-informed care, and then you kind of bring it in oh, I've just seen that, or where can I fit that in?
Speaker 1Well, I'm teaching third year, so let's do this now and then the following year you go oh, actually, you know this would be really good if we could bring it into first year. So let's put it into. How can we get into first year? Let's embed it. Yeah, definitely, get used to it. So that kind of constant cycle of renewal, yep, yeah, that scaffolding of that, yes, yes, and I think that's the exciting part of academia is you do get to see what's happening, bring it in and go. Okay, it takes a long time for change to happen in the health care and we haven't got 10, 15 years to wait for change to occur and I know it's going to take possibly three years before they're qualified, but they're still looking after women and pregnant people in their continuities.
Speaker 1And when they're wrong, absolutely yeah, that changes, we can start that change. And when they're on, absolutely yeah, and it changes, we can start that change. And in bed it becomes automatic. For them.
Speaker 2Yeah, yeah, yeah, and we do a lot of role plays in those workshops and I do role plays with my students as well and they do it really well. I know that, like people that would come into the workshop, they'd say I hate role-playing. But at the end of the day, because we've done pre and post surveys and we've done six month later surveys.
Speaker 1At the end of the day, they basically said that that's where most of their learning occurred in the role plays, and they enjoyed that part so many people, when we think about education and the use of simulation, they think of simulation as high-tech simulation and of all the mannequins, the whiz bangs yeah what they forget is that role play is psychologically the most important form of simulation because it actually evokes a lot more.
Speaker 1It's a lot more realistic, the fidelity is there and if you get someone who really throws themselves into the role, you can kind of create quite a lot of emotion. That we know through storytelling is what sticks with people.
Speaker 2Absolutely yeah, and we actually didn't call it role play in our modules. We called it something else and I can't think what it was called because because of that connotation that people don't like role plays no, I think it's because I got made fun at or laughed at at school and we kind of tend to carry that through us as an experienced supervisor.
Speaker 1Now, yeah, and going through looking at the way that, in particular, phd studies have changed, we've gone from increasingly from the monolith we've gone to publication, publication by publication, which originally was bought in for those at the end of their career so they could kind of like put everything together and get a qualification and almost credit for what they've already done and now it's like you need anywhere between, I think, three and 12 publications, depending on where you're doing your phd.
Speaker 1Well, well, yep, couple of places in the uk are 12. Wow, when we look at how hard it is to actually get published now. I know it is With the rejection rate and we know that WOMBI, which is Women of Birth, I think on their front page. The last time I read it they had an 87%, 85% rejection rate. 85% rejection, so 15%. Once you get through that first cull, you still may not get through.
Speaker 2Yeah, if your paper does go to review, though, there's 4% chance of getting it rejected. It still might get rejected. So once you get past that under the door, you're right. But yeah, it's getting very difficult to publish, liz, and you know it's actually quite expensive to publish in open access journals that's the other thing. Yeah, it's totally expensive if your university doesn't fund that particular journal. Like I published a Q2 journal a few months ago and my university doesn't support that because they only publish Q1s.
Speaker 1Yeah, but how are Q2s going to get up to Q1s if we don't actually help them with publications Exactly? And there's been a lot of controversy around publications and the publication houses and how much money they are gouging and owner of IP and all of that. So we won't kind of go into that. But how do you support students through that? Do you counsel them on which way to go? I mean, I think we should be going more towards creative and increasing the creative PhDs that we do. But that also involves people thinking outside the square. But it's really interesting that there's and I know someone who's done it wrote a romantic novel book and that was her artefact and so looking at the stories behind it and where it kind of fitted in, that was the exegesis and I think when we look at so much digital capacity, we've got the creativeness coming through and the art and science of midwifery that I think, as supervisors, that's going to be a future requirement for us to do is to be comfortable looking at non-traditional PhDs.
Speaker 2Absolutely. Yeah, that's really interesting. I mean, I guess I support my students. It's sometimes figuring out the best journal for that particular amount of what the data looks like amount of what the data looks like. And the other thing is it's increasingly common for journals to say 5,000-word limit yeah, so the one that Louise is putting in at the moment. You know massive words. So some journals say 8,000. Some say you know, some only say 3,000. So that's the difficulty of actually squeezing a huge amount of data into one article.
Speaker 1And they don't want you to salami slice. So you can't kind of if you're doing a multi-method and you can't just do the survey here and put your brains out doing it then it's just kind of like but if you want me to go into enough detail, because then the reviewers' comments come back and need more information, need more information, it's like, well, I haven't got the words.
Speaker 2So what do you do now? Well, if that happens, liz and that has happened to me quite a lot I just put in the extra words and I don't worry about the word limit then Okay, because if they do that, they want that to be a longer article.
Speaker 1Yeah, that's a good point. I've kind of always sat there and gone. How do we reduce this?
Speaker 2No, if they're asking extra information, put it in.
Speaker 1Yeah, so what are you doing now? What are you kind of?
Speaker 2what areas are you playing in now? So I'm actually working at university of canberra now and I am teaching and doing research. So I'm education and research focused. So I've been teaching um undergrads mainly, and I also have a phd student who came with me from Western Sydney. So he's actually just he's about. Well. He's probably got another year and a bit to go on his PhD. He used grounded theory for his PhD and I used grounded theory for my master's, so very difficult concepts to understand grounded theory, but he's starting. I think he's finally just doing so beautifully now. So so he transferred across with me and I still co-supervise Louise from Western Sydney and two other PhD students from I co-supervise from Western Sydney as well because one of them I was primary and I have had to step down. So so still supervising hdr students and all the admin that goes along with it what's your research areas?
Speaker 1are you doing?
Evaluating Education Programs and Research
Speaker 2you know what's coming up so my research areas I have. Before I left western sydney I did a pilot randomised control trial on using a peanut ball for women with epidurals. That paper's currently under review. It's been sitting there for a while. It was a minor revision, so that's sort of my thing. The peanut ball I did publish a qualitative paper. I did a qualitative paper with women about it wasn't women, rather, it was midwives how they you know their experience with the peanut ball. So I published that paper and the next step is really just to apply for an MREF grant. So I can do a large RCT. So I can do a large RCT. I've also I also have been doing some work with colleagues at University of Canberra on surveying or interviewing rather, and surveying health professionals and women about vaccinations in pregnancy. So that's, we're doing quite a few interviews with that at the moment and I'm also doing some research in the space of domestic violence. So I'm working with people that I work with at Western Sydney and Western Sydney researchers as well as other researchers at other institutions.
Speaker 2On where Bendigo Bank gave us a big grant and we're doing a study on evaluating projects in schools in the Hawkesbury area. So we're actually going. There's lots of evaluation programs about how students and teachers learn about domestic violence. Ooh, so we're evaluating the program. So we're doing pre and post surveys with students and teachers. That's about to start in the next few months.
Speaker 2And the other big project I've worked on is, as a lead is actually surveying students and midwives as well. So we surveyed midwives about the characteristics of undergraduate programs, and that paper's under review actually. Oh, that would be interesting to read. And we're still collecting. We're actually writing a second paper about um. We're comparing the midwives responses those that worked in coc models and those that didn't. Yeah, so we're writing that paper at the moment. And then we're also I, and then we're also collecting students' survey data. So we survey them at the end of their Bachelor of Midwifery and then we go back to them six months into their new grad and then 12 months into their new grad. So we're still recruiting those students. That's been a fairly slow process though.
Speaker 1So they're the main areas that I've been working in yeah, oh, so you've got lots of exciting things in the future yep yeah, hopefully, yeah, cool, um, thank you very much for your time.
Speaker 2No worries, liz, it's been really nice to chat. Actually, I really enjoyed it.