Determine the Defining Attributes

The attributes and essential characteristics of a concept are determined by the meaning of the identified concept. The components that constitute the concept should be applicable to any situation in which the concept is located. Walker and Avant (2011) consider determining the defining attributes as the ‘heart of concept analysis. The purpose of this step was to identify all those characteristics without which effective transition support would not be possible. Defining attributes of the concept exist when the analyst has identified all the different usages on examining the different concept, taking into consideration the characteristics that appear over and over again (Walker and Avant, 2011).

Based on Walker and Avant’s (2011) principle, any concept analysis should consist of more than one defining attribute; however, one needs to determine which attributes are appropriate for the purpose of exploration of the concept. Based on this principle,

CHAPTER 5 | 5.2.4.1 Positive Collegial Relationships

positive collegial relationships, learning opportunities, supervision, mentoring, orientation and commitment, as presented in Figure 5.1. These attributes were identified as they formed the basis for the existence of effective transition support.

There wouldn’t be any effective transition support without the existence of positive collegial relationships, learning opportunities, supervision, mentoring, orientation as well as commitment; and the discussion of each was covered in this step.

Source: Walker and Avant (2011)

Figure 5.1: Defining attributes of effective transition support

5.2.4.1 Positive Collegial Relationships

The foundation for effective transition support of newly graduated midwives is establishment and maintenance of positive collegial relationships between experienced and newly graduated midwives. In other words, effective transition

CHAPTER 5 | 5.2.4.1 Positive Collegial Relationships

support cannot be possible without the existence of positive collegial relationships between the two parties. It is important that establishment of positive collegial relationships starts right from the beginning of transition process, because during the first two stages of Duchscher’s (2009) transition theory, that is ‘the stage of doing, and the stage of being’, graduates suffer from transition shock and transition crisis.

Therefore, an environment conducive for positive collegial relationships should be established so that the graduates can have a shoulder to lean on.

Newly graduated midwives are so frustrated and anxious, and when the relationship is negative and unfriendly, frustration, anxiety as well as tension becomes worse for they don’t have anybody to turn to for support. It is therefore important that they interact with individuals who are empathetic, caring and compassionate in order to assist them go through transition stages with positive minds.

Establishment of a firm foundation of good and positive supervisory relationship and support system enables newly qualified midwives to confidently embrace the challenges and never ending learning opportunities that the real world of midwifery practice presents (Fenwick et al., 2012). In a study conducted by Kensington et al.

(2016), newly graduated midwives considered positive relationship with their experienced peers as very important and significant to their development, as it provided them with the opportunity for supervision, guidance, support and orientation.

Not only do positive relationships benefit newly graduated midwives but the entire maternity unit including even patients (Kensington et al., 2016). Tastan et al. (2013) reported that in a study they conducted, newly qualified midwives expressed their desire to access supportive supervisors who are positive, approachable, trustworthy and have clinical credibility, rather than negative experiences that deeply affect their long-term expectations.

CHAPTER 5 | 5.2.4.2 Learning Opportunities

5.2.4.2 Learning Opportunities

Creation of an environment conducive for learning opportunities is also very important for effective support of newly graduated midwives during their transition period;

because it is through learning opportunities whereby effective support is enhanced.

Despite the fact that newly graduated midwives have successfully completed their training, they need guidance on how to effectively integrate the knowledge and skills gained during training with practice. This will enable them to provide quality midwifery services.

Based on Duchscher’s (2009) transition theory, during the initial stages of transition, graduates are searching, doubting and questioning almost everything. It is therefore through positive learning opportunities whereby their questions and doubts can be addressed. Lennox and Foureur (2012) revealed that it is in a supportive learning environment whereby, skilled professionals are able to share their clinical knowledge and expertise to develop confident practitioners who feel valued and able to start on their professional career.

5.2.4.3 Mentoring

Mentoring is a strong and powerful tool for effective transition support, as it provides an opportunity for newly graduated midwives to learn and therefore effectively implement the knowledge and skills they have gained under the umbrella of an experienced midwife. This helps them to feel confident as they provide midwifery services to patients. It is through mentoring whereby effective communication skills between experienced and newly graduated midwives as well as with the patients are enhanced; resulting in graduates mastering effective communication skills through which they will effectively communicate with the patients. According to Feltham (2014), newly graduated midwives reported that they felt they were effectively

CHAPTER 5 | 5.2.4.4 Supervision

supported as experienced midwives walked with them through their transition journey teaching, guiding and showing them the way as their mentors. Literature also revealed the importance of mentoring when Haggerty et al. (2012) described mentoring as characterised by the mentee taking an active role in the relationship rather than the mentor so that “empowerment and personal accountability” are enhanced.

Lewis and McGowan (2015) concurred with Haggerty et al. (2012) when reporting that the purpose of mentoring is to enhance the mentee’s development by inspiring the mentee to a greater understanding of the role. Lewis and McGowan (2015) further indicated that the learning process is shared, in the sense that the mentee is learning about a role or increasing expertise whereas the mentor is learning about the process of stimulating developmental changes.

5.2.4.4 Supervision

For effective transition support to be possible, newly graduated midwives need to be supervised, as they are not yet fully competent and still lack the experience regarding provision of midwifery services. Therefore, for them to effectively transit from being students to becoming professionals, supervision is necessary so that they get an opportunity of learning to be competent and confident under close supervision of the experienced midwives.

Feltham (2014) revealed that graduates felt they were effectively supported, as they were closely supervised by the experienced midwives during performance of midwifery tasks. Kensington et al. (2016) concurred when reporting that newly qualified midwives never felt stranded during patient care because their senior colleagues provided them with the necessary supervision they needed, especially in the labour ward; which boosted their confidence.

CHAPTER 5 | 5.2.4.5 Orientation

5.2.4.5 Orientation

According to a transition theory by Duchscher (2009), orientation forms the foundation of effective transition process. Therefore, there is no way in which one can claim to effectively provide transition support when the process is not based on orientation as the foundation. The whole transition support has to start with orientation of the graduates. Graduates should be orientated to such aspects as the surrounding, routine, policies and guidelies regarding provision of quality midwifery services.

According to Lennox et al. (2012), orientation forms the basis of support for newly qualified staff members. The authors further reported that it is through orientation whereby newly qualified midwives can be able to function effectively in a familiar environment. Mason and Davies (2013) concurred when they reported that participants stated that they worked with confidence as they were well orientated.

Participants further reported that even though they were new in the ward, they felt like they have been working there for months. For these reasons, orientation becomes one of the cornerstones for effective transition support of newly graduated midwives.

5.2.4.6 Commitment

For transition support to be effective, newly graduated midwives should be committed and ready for support, because no matter how effective transition support might be there is no way in which the objective can be met if the recipients who are graduates are not committed and ready for support. Not only should the newly graduated midwives be committed to effective support but should also be committed to provision of quality midwifery services to patients. Therefore, when the graduates are committed to their effective support during their transition period, they will gain knowledge and skills, develop competence and confidence and become responsible and accountable;

which will therefore have a positive impact on their performance of midwifery services.

CHAPTER 5 | 5.2.5 Construction of a Model Case

A discussion about the defining attributes was followed by the next step which covered construction of a model, borderline as well as contrary cases.