An online campaign has been launched to gather personal stories from student midwives who have suffering bullying in Irish hospitals, in some cases severe enough to force them out of the profession.
The new “Bullied by the HSE” campaign says it has attracted a considerable online response since launching last month.
Those familiar with the conditions, particularly in some maternity hospitals, say student nurses in particular are routinely singled out for abuse by senior colleagues. The treatment can lead to a reliance on medication and counselling, and an inability to complete training.
"What we sense is that it's probably a very entrenched problem and one that has certainly been exasperated by a number of factors," said Jo Murphy-Lawless, Adjunct Assistant Professor at Trinity College Dublin's School of Nursing & Midwifery.
Ms Murphy-Lawless claimed both a hierarchal structure, as well as staffing and retention pressures, have contributed to the culture.
“I would be amazed if it [the new campaign] hadn’t started,” she said, pointing to a survey of Trinity midwifery students from 2015 that showed almost 60 per cent of respondents had experienced bullying while on placement in hospitals.
High proportions of respondents said they had “felt victimised or bullied” with adverse effects on their mental health.
Further insights
Separate research conducted by the Irish Nurses and Midwives Organisation (INMO) between 2010 and 2014, conducted in conjunction with both the University of Limerick and NUI Galway, offered further insights.
During that time, it said, there was “a significant shift from a majority of respondents NOT experiencing bullying (38.5 per cent experienced bullying in the \[2010\] UL survey), to a majority of respondents (51.9 per cent) experiencing bullying in the most recent survey”.
Cutbacks in health services had “exacerbated stress levels amongst staff” which had inflamed the problem, the INMO found.
The new campaign, run through Facebook, is inviting the testimonies of midwifery students. Its organisers, speaking on condition of anonymity, said that by mid-August, the campaign had about 500 followers as well as thousands of page views and approximately 30 credible accounts of bullying.
A lot of people leave midwifery because of the way they are treated
“I have been in a fog,” said one midwife involved with the campaign. “They go on about pay [as an issue in nursing]. My pay is not a problem; for me it’s the conditions. It’s how you are treated and you are treated like an absolute dog.”
A number of former midwifery students and others familiar with the industry said that while there were obviously good members of staff, bullying typically occurred between more established employees and trainees on placement.
"It's definitely an issue," said Patricia Hughes, former director of midwifery and nursing at the Coombe Maternity Hospital who now runs a private consultancy.
She said she had not known how big a problem it was in the profession until the “eye-opening” Trinity College survey in 2015. Colleagues subsequently told her about research on the issue stretching back to the 1970s.
“I remember thinking if we knew it was a problem then, why didn’t we do something about it earlier? But we have it [an understanding] now,” she said.
Mutual support
For Ms Hughes, it has a lot to do with changes in the profession. Midwifery became a four-year college-based qualification in the 2000s. While not criticising that system, Ms Hughes said before that there was probably more mutual support among nurses training to become midwives.
The new Facebook campaign is based on a similar UK page which, according to its organiser Amanda Burleigh, had 2,200 members within 15 months.
“I set the page up because I was trying to go through the proper channels and the biggest message that comes from this is that the proper channels weren’t working,” she said.
Carolyn Hastie, a former midwife and now academic in Australia, said the problem there had become endemic. “A lot of people leave midwifery because of the way they are treated,” she said.
Phil Ní Sheaghdha, general secretary of the INMO, said bullying exists in both midwifery and general nursing and that it was partly a reflection of resourcing problems.
“There is no doubt this is an issue. The preferred way to deal with it is to put robust preventative measures [in place],” she said. “To ensure that you get to the problem long before it develops.” The INMO has engaged with the HSE on how best to deal with the issue.
In a detailed statement, the HSE said all its employees and students were entitled to work with “dignity and respect” in environments free of bullying and harassment.
It said that in the past year it has introduced a complaint notification process as part of its “Dignity at Work” policy. It is also rolling out preventative training for managers in conjunction with the Dublin Rape Crisis Centre across the HSE.
Meanwhile, the HSE's human resources division has formed an "academic partnership" with the Anti-Bullying Centre at Dublin City University, it said.
Case Study: ‘I dreaded seeing her coming into the ward’
Sarah was on the verge of completing her four-year midwifery course when she decided she could take no more.
After three years of hard study, sacrificing much of her personal life and simultaneously raising her three children, she decided to leave.
“I became scared of the constant belittling of me as a person and as a student midwife. I dreaded seeing her coming into the ward,” she said of a senior colleague in handwritten notes taken to record her experience.
At this stage I don't know if it will ever change. It's too late for me but I hope it will
During her training she would be diagnosed with post-traumatic stress disorder, require private counselling and anti-depressants.
“I felt just totally useless, no good to anyone,” she recalls now.
Sarah’s story (her name has been changed) is similar to those of other student midwives – unlucky enough to be singled out by a senior member of staff, openly humiliated, told she was not up to the job and given little support.
“I needed to be guided, encouraged and taught,” her notes recorded at the time. “Instead I felt humiliated, stupid and totally incompetent.”
The salt in the wound for Sarah was that she had come so far.
As she explains it, being from an underprivileged area of Dublin she had felt proud of getting into college.
“I just put my head down and studied. For the first time in my life everything had fallen into place,” she remembers. “I didn’t know I was going to come out a broken person. I was pursuing my dream.”
Sarah never failed an exam in the three years of study and did well with her course work. She was aware too of others who had been bullied on placement.
“I do feel it’s a culture within midwifery and nursing,” she said. “At this stage I don’t know if it will ever change. It’s too late for me but I hope it will.”
