Latest newsletter for midwives

Paulette Lewis MBE is a highly experienced leader and director with a career in midwifery and nursing which has spanned over three decades. She holds many leadership roles including as a non-executive director, management consultant, Chair of the Croydon BME Forum and President of the Caribbean Nurses & Midwives Association (UK).

In her role within the Caribbean Nurses & Midwives Association (UK), she holds one-to-one sessions with midwives and nurses who have moved here from the Caribbean. She listens to their lived experiences, how the excitement they feel when planning their move all too often turns into frustration at the difficulties they face after arriving.

In this article, Paulette talks about what midwives and nurses from overseas tell her and maintains we should be doing more to support individuals as they make this significant cultural transition.

The NMC’s latest data shows that there has been a large increase in the number of nurses and midwives from outside Europe joining their register – amounting to 22,745 people between March 2021 and March 2022 compared to 9,152 the previous year.  

These midwives and nurses are skilled professionals who are respected in their fields of practice. We have invited them to the UK to help us address the chronic staff shortages in the health and social care sector. Yet feedback from some of the recruits and the diaspora groups supporting them indicates unsettling factors about their experiences of coming to work here.

So, my question is, why aren’t we doing more to support them? Why aren’t we prioritising the needs of the people behind the numbers, to make sure they can settle, adapt, develop and thrive in this country? It makes economic and organisational sense in the long run and would in turn benefit people using maternity and healthcare services.

Cultural norms and values differ across the world, and we carry these with us in our travels. We expect those coming here to adapt to our ways and culture but we must also put systems in place to understand their culture in order to give the appropriate support they need to transition. Breaking down barriers and misunderstandings is a two-way process.

And let’s not forget that organisations have their own cultures and behaviours, and very different policies and hierarchies. Imagine coming from a system which has a medical-led model and having to adjust to the very different ways midwives work here, or struggling to understand the cultural norms of your colleagues because it’s different to what you’re used to.  Meeting the developmental needs of midwives and nurses transitioning into a new culture can be challenging. Therefore they need support and we need a better understanding of their needs.

The challenges don’t just disappear over time. I recently spoke to someone who has worked here for years but never joined a union and didn’t know how to raise issues. Unions weren’t something they had in the country where they trained. They have been working all this time in the UK without the same protection that their colleagues enjoy, simply because no one thought to tell them about it.

How can we give more support?

The best place for us to start is listening. When we sit down with individuals to try and understand them, who they are, and where they come from, we are better placed to support them in the way they need. The organisations that are best at welcoming midwives from overseas take time to listen and work collaboratively with the individuals they recruit. They don’t have one blanket approach for all – they individualise the process. They recognise the huge diversity of this group, who come from numerous countries, cultures and practice backgrounds.

As well as trying to understand and listen, we need to spend time helping people really feel that they belong and are valued for their contribution. Key to this is making staff at all levels of the organisation and people who use our services aware of the value that staff from abroad can bring to the organisation and service delivery.  If we improve everyone’s awareness and understanding and allow people to feel like a welcome part of the team, not just an ‘international recruit’, they can contribute so much more.

That sense of belonging is important outside of work too, and that’s where employers who work closely with diaspora organisations such as the Caribbean Nurses & Midwives Association (UK) are going that one step further to support people. Last week I joined an outing with a group of midwives and nurses, which gave them an opportunity to explore the culture here in the UK while building up their support network. Employers might not be able to offer anything like this, but they can easily link their new staff to groups that do.

And what about ongoing development? Far too many of the midwives I speak to say they join in the lower bands and stay there for years while watching others who trained in the UK move up quickly through the ranks. We need to be asking why this is so often the case and holding organisations to account for not supporting all staff to develop, progress and achieve their full potential.

All of this feels even more urgent in the wake of the Ockenden Maternity Review (2022), which emphasises how crucial it is to work as a team and for everyone to feel confident to speak up and be listened to. As midwives, it’s imperative we listen to women and families. We also need to listen to each other and respect the different cultures, expertise and insight our diverse workforce brings.

So, while we talk about numbers and data, and what that tells us about the midwifery and nursing workforce, let’s not forgot that we are talking about individuals, each with their own lived experiences. If we improve our understanding of these experiences, then we are better equipped to improve how we welcome professionals who trained in other countries. If we do invest the time and effort to do this and support them throughout their careers, they’ll want to stay, and offer continued support and expertise to the health and social care sector in the UK. They’ll bring all the benefits that come with diversity and ultimately, we’ll get better outcomes for women, babies and families.

This isn’t just a numbers game – let’s think about the long-term impact for everyone. We are all in it together as we learned from Covid-19. Let our efforts count and let everyone feel valued and respected as we depend on them to deliver a safe quality service. The health and well-being of all our staff is paramount.

What else can I expect when I read this midwifery newsletter?

You can read about our latest annual registration data report and our May Council meeting in Derry-Londonderry. There’s also a guest article by Paulette Lewis, President of the Caribbean Nurses and Midwives Association UK. She spoke to us about the cultural transition midwives and nurses from overseas make when they come to work in the UK. You’ll also find features on the latest Birthrights report on racial inequality in maternity care, and the Ockenden report.  

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