The role of the clinical midwife specialist in bereavement and loss: a service review

The role of the clinical midwife specialist in bereavement and loss: a service review

O’Connell, O (1), Verling, AM (1), Meaney, S (1,2), O’Donoghue, K (1,2,3)

(1) Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Ireland; (2) National Perinatal Epidemiology Centre, University College Cork, Ireland; (3) The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Ireland.

Background
In Ireland in 1998 A report of the Commission of Nursing identified the need for the development of clinical nurse and midwife specialist roles. This year, over 20 years later, following the recommendation of the National Bereavement Standards in the Maternity Services, a CMS in bereavement CMSb) has been appointed to all 19 Maternity Units in Ireland. The Role of the CMS is defined as having five core competencies: clinical, education, consultation, advocacy and research and audit but work has not been undertaken to evaluate the role in practice. We wished to establish to what extent these competencies were met in a maternity unit in which the role of CMSb is long established.

Methods
Both the CMSb in post in a large maternity unit in Ireland, each of whom work 29.25 hours, giving a total of 58.5 hours, contemporaneously recorded their working activities for one week. This data was analysed in detail and compared to the CMS competencies.

Results
Clinical focus involved 45% direct patient contact and 30% indirect patient care and planning. Time spent in education, professional role development, service development and research accounted respectively for 6%, 3%, 4% and 4% of the time. Time to present and attend at a bereavement conference (16 hours) was within personal hours within this week.

Conclusion
It is notable how a relatively large part of time was spent in clinical focus i.e. 75% of the week. While there is overlap between the CMSb core competencies this left relatively little time is left to facilitate the tasks directly associated with advocacy, consultation and research/audit including role and service development. This was however further addressed in the CMSb personal time in this week.

Ethics statement
Ethical approval was not required as this work was a review of service provided by authors

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