Supporting Healthy Spaces for Midwives

Posted by Katie Moriarty on
Shelagh and Sister Ursula in a scene from Episode 1.

Katie Moriarty looks at having a personal voice and support for health care workers, and a recent focus on trying to achieve joy within your workplace.

Editor’s Note: The opinions expressed in this blog post are solely those of the author.

“It is not time itself that we notice passing but the things it raises and reclaims for eternity: infancy, childhood, golden moments, red letter days, the darkest nights …. all washed away as if by water – born out of sight as if by tides.”

Welcome back to Call the Midwife—we are now in Season 6 (has that much time really passed?). There is a sense of change in the air.  We have entered the year 1962 and you can feel this shift from the time that the opening credits roll.     

This episode deals with love and joy along with pain and abuse – not only the actual recipient of this relationship but the secondary trauma that can occur from those surrounding this dysfunctional relationship. However, what I would like to write my blog posting about was the huge shift in leadership that occurred within Nonnatus House. As a Modern Day Midwife, I wanted to focus on the major shift of having a personal voice within your workplace and share some research and data regarding burnout, healthy environments within the work place, and a more modern or recent focus on trying to achieve joy within your workplace. 

The American Nurses Association (2017) describes a healthy work environment as being safe, empowering, and satisfying along with being a place where all members of the organization perform with a sense of professionalism, accountability, transparency, involvement, efficiency, and effectiveness while being mindful of the health and safety of all people. And the American Association of Critical-Care Nurses (2017) reaffirmed six standards for establishing and sustaining healthy work environments. These standards entailed skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition, and authentic leadership.

Yet we have research and data that 37 percent of newly licensed RNs are thinking of leaving their job, and that there is a 13 percent vacancy rate for RNs (Lucian Leape Institute, 2013). We know that our physician colleagues are also feeling stress and burnout and that 60 percent of MD survey respondents were considering leaving practice and that 70 percent of respondents knew at least one MD that had left their practice due to poor morale, (Lucian Leape Institute, 2013).

There have been a variety of studies that have been conducted and have shown an association of provider burnout with lower levels of empathy, more mistakes, less patient satisfaction, reduced adherence to treatment plans, and an overuse of resources (Bodenheimer, T., Sinsky, C., 2015). These impacts are not limited to only health care practitioners but other industries have also demonstrated a relationship between employees’ engagement and customer satisfaction, productivity, profit, employee turnover, along with accidents (Harter JK, Schmidt FL, Hayes TL., 2002). 

We know that when nurses (specifically nurse faculty members) search for employment opportunities they explore environments with encompass qualities such as being supportive, enjoyable, and institutions that are conducive to career development (Fontaine, Koh, & Carroll, 2012). Research that has explored incivility within academic settings has been reported to have “lasting and devastating effects on individuals and organizations, including low morale, high turnover, increased absenteeism, isolation and alienation, diminished quality of work, and increased illness and health issues” (Clark, 2013, p. 98). I work at Frontier Nursing University (FNU)—all community members are invited to participate in a philosophy of a Culture of Caring. It is believed that when everyone lives within a Culture of Caring, the community members can be highly invested, enthusiastic, and fully contribute to the FNU community, and show support for the FNU community endeavors.

It is believed that a Culture of Caring fosters institutional success, growth, and longevity. The elements within the Culture of Caring are professionalism, inclusivity, respect, positive communication, and mutual support. Each element is expanded upon and entails the following aspects:

  • Professionalism: Excellence, responsibility, transparent, consistent
  • Inclusivity: Equality, awareness, sensitivity, humility
  • Respect: Importance, unique, friendly, genuine interest
  • Positive Communication: Understanding, thoughtfulness, openness
  • Mutual Support: Helpful, awareness, patient, concern, kindness

I will just touch on aspects of exploring Joy within your work place—and expand in coming blog posts (as I have leadership styles on my brain at this point in  time—as this Modern Day Midwife struggles with current national leadership, impending legislative decisions, and their impact on women’s health).

The Institute for Healthcare Improvement (IHI) engaged with partners and colleagues in thinking about how to restore, foster and nurture joy in the health care workforce. They began to see an evolving path forward, with four key steps. The four steps are exploring or asking providers what matters to them; understanding the unique impediments to joy within a local context; committing to share in the responsibility of joy at work at all levels; and to use improvement science to test validated approaches in your organization. More on all of this in blogs to come—until them there are links below to explore!!

“For everything washed away -- a fresh potential dawned and in every wave of change became a new beginning.” 

Katie MoriartyKatie Moriarty, PhD, CNM, CAFCI, FACNM, RN is a professor on faculty at Frontier Nursing University and a Certified Nurse-Midwife with WSUPG CNM Service at Hutzel Women’s Hospital in Detroit, Michigan. Katie serves on the Board of Directors for the American College of Nurse-Midwives as the Region IV Representative. Previously she was the Associate Director of the Nurse-Midwifery Education Program at the University of Michigan.
Read More About Katie |  Read All Posts by Katie



American Association of Critical-Care Nurses (2017).  Six standards of healthy work environment.

American Nurses Association (2017).  Healthy Work Environment.

Bodenheimer, T., Sinsky, C. (2015). From the triple to quadruple aim: Care of the patient requires care of the provider. Annals of Family Medicine, 12(6), 573-576.  doi: 10.1370/afm.

Clark, C. (2013). National study on faculty-to-faculty incivility: Strategies to foster collegiality and civility. Nurse Educator, 38(3), 98-102.

Fontaine, D., Koh, E., & Carroll, T. (2012). Promoting a healthy workplace for nursing faculty and staff. Nursing Clinics of North America, 47(4), 557-566.

Harter JK, Schmidt FL, Hayes TL. (2002).  Business-unit-level relationship between employee satisfaction, employee engagement and business outcomes: a meta-analysis. J Appl Psychol, 87, 268-279.

Lucian Leape Institute (2013). Through the eyes of the workforce: creating joy, meaning and safer health care. Boston, MA: National Patient Safety Foundation.

Sood A, Sharma V, Schroeder DR, Gorman B.  (2014).  Stress Management and Resiliency Training (SMART) Program among Department of Radiology Faculty: A Pilot Randomized Clinical Trial. Explore, 10(6), 358-63. doi: 10.1016/j.explore.2014.08.002. Epub 2014 Aug 21.

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