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Aims. To determine a demographic profile, employment history and career plans of a sample of nursing unit managers (first-line managers) in New South Wales (NSW), Australia in 1999. To compare the profile of first-line nurse managers in 1999 with those in 1989.Background. This study replicates another undertaken a decade earlier (see Duffield 1992). Tracking the changes to nurse manager positions is important, given changes to the educational preparation of nurses and restructuring within hospitals which have occurred in the past decade.Method. The same questionnaire was used in both studies, with minor amendments and the addition of two items to reflect changes to organizational structures, whereby nurse managers are now responsible for non-nursing staff. In 1999 all first-line nurse managers in the largest health service in NSW were invited to participate in the study.Results. A response rate of 77% was achieved. There were few differences of note in the demographic profile from 1989 to 1999. However educationally, first-line nurse managers in 1999 were more highly qualified. A greater proportion had higher degrees and increasingly, in the management discipline.Conclusion. Perhaps reflecting these qualifications, more managers in 1999 indicated their intention to move to more senior management positions in the next decade. The mode for experience in this role of 1 year in both 1989 and 1999 reflects a worrying trend of high turnover and inexperience amongst this group of managers. While maternity relief might account for this result, further research needs to determine more precise reasons. The ad hoc bases on which expert clinicians (clinical nurse specialists) act as the manager in his/her absence need to be critically examined. Alternative strategies such as introducing a formal second- in-charge position may ensure more successful recruitment and retention of staff to these critical management positions. [ABSTRACT FROM AUTHOR]

In 2001, a new model of midwifery care was established in the Birth Centre at St George Hospital, a metropolitan hospital in NSW. The new model was designed to encompass the principles and recommendations from numerous government reports and research. The model also build on the previous successful implementation of a team midwifery program (Homer et al 2001b; Homer et al 2001a). Four newly graduated midwives, together with four more experienced midwives were employed to work in the models of midwifery care. This small study evaluates the first 10 months' using qualitative and quantitative data. As this is a small study, no firm conclusion can be reached. The results of the evaluation however demonstrated that with appropriate support and mentoring, newly graduated midwives can work in an innovative model of midwifery care within a birth centre environment.

This paper reports the costs of providing a new model of maternity care compared to standard care in an Australian public hospital. The mean cost of providing care per woman was lower in the group who had the new model of care compared with standard care ($2,579 versus $3,483). Cost savings associated with new model of care were maintained even after costs associated with admission to special care nursery were excluded. The cost saving was also sustained even when the caesarean section rate in the new model of care increased to beyond that of the standard care group.