A Look into Nurse Midwives
Catarina Nguyen
California State University, Fullerton
N322 Concepts of Professional Nursing
Rebecca Otten, EdD
October 25, 2016
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Signature: Catarina Nguyen
A nurse midwife’s profession is both an art and a science. They provide the utmost exceptional care to mothers during the difficult laboring process and to newborns welcomed into the world. Midwives also recognize the art of conversing with patients and easing their anxiety and nerves during the beautiful but strenuous process of giving birth. However, assisting with the birthing process is only a fraction of what midwives perform. They have a wide scope of practice in women’s health that include, gynecological follow-up appointments, additional assistance post-pregnancy, and reproductive health (Varney & Thompson, 2016). Nurse midwives can generally work alone when providing services in uncomplicated births and low risk patients. They can also collaborate along side physicians and gynecologists on the treatment of high-risk patients (Varney & Thompson, 2016). Similar to doctors, midwives assess, diagnose, evaluate, and treat patients. Also, they have an extensive knowledge and skills to give mothers and newborns the best care. They are sworn to do no harm to patients and advocate for their health and safety. Although the path to becoming a nurse midwife can be arduous, it is unequivocally rewarding and gratifying. Registered nurses should know the core values and the challenges they may face on the journey to becoming a nurse midwife. The benefits of the profession are working in numerous settings other than the hospital. However, nurses should also consider that the availability in midwife programs is scarce to prepare students to face the difficulties ahead. Lastly, accommodating to the core values will allow registered nurses to become better equipped at taking on the position of nurse midwifery.
Numerous Work Settings
There are many skills for nurse midwives to learn. Another skill for midwives is learning to do home births. Midwives can collaborate with paramedics to perform home births whether emergency or planned. According to Pauley & Dale (2016), “553 midwives providing responses suggested that midwives were positive about the importance of homebirth and confident about their ability to support birth in the home environment” (p. 429). For nurses who want to experience travelling and prefer being outside in different settings rather than in a hospital, they can choose to do home births. There are many women who would rather do a homebirth than in the hospital. Pauley & Dale (2016) says, “The UK homebirth rate is around 2%; however, 10% of women suggested they would like a homebirth” (p. 429). During the homebirth process, nurse midwives would be further emerged in the birthing process without the help of an OB/GYN. Nurse midwives going into homebirths need to be confident with their abilities to work without an OB/GYN. Fortunately nurse midwives will have help from the paramedics as well during the birthing process. Both paramedics and nurse midwives can attend skill drills offered in a home setting to further their education (Pauley & Dale, 2016). These drills are performed to ensure that the birth can be achieved safely and that nurse midwives are competent enough to make informed decisions to support the patient (Pauley & Dale, 2016). Homebirths are on the rise and gives nurse midwives other opportunities to work outside of the hospital. It creates more jobs for students after they become certified.
Necessary Newborn Resuscitation Skills
Further education and basic life support resuscitation for newborns are mandatory skills for the midwifery profession. “Recognizing newborns at risk of respiratory distress at birth and effectively commencing resuscitation are essential midwifery skills” (Kassab, Alnuaimi, Mohammad, Creedy, & Hamadneh, 2016). Recognizing high-risk situations and acting fast on newborns with complications and problems is a necessary skill for the survival of babies. Having the basic equipment and competent knowledge of neonatal resuscitation decreases newborn mortality (Kassab et al., 2016). Sometimes newborns with respiratory problems may be in critical condition but do not necessarily need resuscitation. It is the nurse midwife’s responsibility to identify these situations and control proper ventilation. Not only are the basic resuscitation skills necessary for high-risk newborn situations, but also the communication skills to collaborate in intense situations with OB/GYNs and pediatricians. Communication is crucial in developing teamwork and efficiency. Kassab et al. (2016) states, “Lack of support and miscommunication between pediatricians and midwives at the time of birth and while providing care to newborns were barriers identified by many midwives” (p. 300). Many nurse midwives felt that their superiors abandoned them during high-risk situations. When they needed the pediatrician’s help, contacting them was difficult not only because they were not answering, but also because the midwives did not have time to wait for an answer during an intense critical circumstance. Communication, knowledge, safety, and advocating for the patient are the core values of any nurse midwife. Nurse midwives also need to frequently renew their education to restore their knowledge on numerous skills for the profession. For some midwives, education on resuscitation needs to be addressed due to their familiarity with more low risk healthy pregnancies than critical care circumstances. Kassab et al. (2016) says, “Other midwives who had obtained a certificate in resuscitation also identified the need to continuously update their knowledge and skills through courses and workshops” (p. 301). Through communication and comprehension of pediatric resuscitation skills, nurse midwives can reduce the risks of infant mortality. It is imperative for future nurse midwives to master this skill that will be expected in the field.
Challenges Involved On the Pathway
The number of accredited certified nurse midwifery programs is scarce. Because of this, there is also a lack of clinical preceptors participating in each program for students. For a registered nurse, this scarcity makes it increasingly limited for many registered nurses to further their education. Registered nurses should definitely take this into consideration when deciding on midwife programs. According to Germano, Schorn, Phillippi, & Schuiling (2014), “The American College of Nurse-Midwives (ACNM) has a strategic goal of certification of 1000 new midwives per year; however, availability of clinical preceptors is a limiting factor in meeting this goal” (para. 8). This becomes a huge barrier for students in getting the full experience of the nurse midwife field. A survey was done to ask practicing midwives why they are choosing not to serve as a preceptor. Germano et al. states, “Participants stated that practice administrators were reluctant to take students for reasons including generalized resistance, fears of litigation or violating patient privacy, a lack of support for education program contracts, and concerns about practice productivity” (para. 12). Many of participants feel that students are not prepared for the clinical setting and need more skill sets before practicing in the clinical field (Germano et al., 2014). These challenges can greatly affect the outcome of competent future nurse midwives.
Conclusion
Although the road to becoming a nurse midwife can seem grueling, it has many benefits and is a rewarding career altogether. Nurse midwives get to be a part of the birthing process and bringing new life to the world each and every day. It is about supporting and advocating for the patient and newborn. Nurse midwives get to be there for the happiest milestone in a women’s life. There are many options for nurse midwives to practice in different settings. Registered nurses who want to pursue this profession need to know the necessary skills for the practice. They should also understand the challenges that are faced when starting the program. Overall, a Certified Nurse Midwife profession is something worth researching. There is no better feeling than aiding in bringing a beautiful new human into the world.
References
Germano, E., Schorn, M. N., Phillippi, J. C., & Schuiling, K. (2014). Factors that influence midwives to serve as preceptors: An American College of Nurse‐ Midwives survey. Journal of Midwifery & Women’s Health, 59(2), 167-175.
Kassab, M., Alnuaimi, K., Mohammad, K., Creedy, D., & Hamadneh, S. (2016). Midwives’ Experiences, Education, and Support Needs Regarding Basic Newborn Resuscitation in Jordan. Clinical Nursing Research, 25(3), 291-309.
Pauley, T., & Dale, A. (2016). Train together to work together: Reviewing feedback of community based skills drills training for midwives and paramedics. British Journal Of Midwifery, 24(6), 428-432.
Varney, H., & Thompson, J. (2016). A history of midwifery in the United States: The midwife said fear not. New York, NY: Springer Publishing Company, LLC.