Nurse Midwife

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In general terms, nurse midwifes include all those nurses (registered) who are through with programs (accredited) concerning themselves with midwifery.  These registered nurses become CNMS or certified nurse midwifes after being certified. It is important to note that nurse midwifes perform a wide range of functions including but not in any way limited to the prescription writing, prenatal care, preconception care, newborn care, management of menopause, labor as well as delivery care, counseling with regard to maintenance of health, examination of gynecological issues, prevention of diseases and finally assistance on family planning issues.In their day to day undertakings, nurse midwifes work hand in hand with physicians more so in issues revolving around pregnancies. However, it should be noted that the role nurse midwifes play is not only limited to issues revolving around pregnancies.


They are also actively involved in the provision of other healthcare services (general) alongside other professions in the medical field especially when it comes to availing healthcare resources (comprehensive). In the course of their service delivery, they are however required to refer women who need special care as well as advice (surgical or medical) to specialists.Before I expound more on my chosen topic ‘nursing midwifery’, it is important to note that the nurse midwifery philosophy is founded on availing care that is appropriate to women while at the same time recognizing as well as attending to their diverse needs. However, for quite a while, the only nurse midwifery facet that is well known as well as recognized is with regard to the aversion of pregnancy complications. However, as we shall see much later in the course of this discussion, nurse midwifery is not in any way limited to the facilitation of normal pregnancy. In this text, I also concern myself with the impact of the nurse midwife on the nursing profession in addition to laying down the relevance of the nurse midwife in the current day and age. In the last parts of this discussion, I will look briefly into the various requirements for certified nurse midwifes.


Nursing implications

According to Fields (2009) nursing midwifery has its origins in the early 1920s and since then, its relevance to the nursing profession has been on an exponential rise. Indeed, the role nursing midwifery has played in bringing down paternal as well as infant mortality cannot be overstated. With the primary and preventive care accounting for approximately 90% of the nurse midwifery profession, Linda (2008) in her article ‘Nurse MidwiferyExperience’notes that it mainly complements the nursing profession.Being one of nursing profession’s career options, nursing midwifery greatly aids the extension of healthcare help to ladies more so at the time of childbirth and even during the pregnancy period. According to Fields (2009), nursing is the root basis of nurse midwifery and with that in mind; nurse midwifery has informed quite a number progresses as far as the advancement of nursing as a profession is concerned. Laura  (2010) is of the opinion that activities revolving around nurse midwifery have been pivotal as far as laying foundation for the increasing relevance if the nursing profession is concerned going forward.


However, Linda (2008) notes that more needs to be done to align all the activities as well as practices of the nurse midwifery with those of the nursing profession so as to guarantee the acceptance of the same across the board. Indeed, it shall be noted that the definition of CNM from the perspective of ACNM distinctly separates nursing and midwifery where a CNM is taken to be an individual who has completed the prerequisite educational qualifications of both midwifery as well as nursing. This is one of the existing disparities or inconsistencies between nurse midwifery and the larger nursing profession. However, Laura  (2010) notes that as opposed to a decade ago, the nurse midwife role has come to be seen as an advanced nursing function and with that in mind, there are quite a number of integration efforts going on so as to ensure that nurse midwifery fully morphs into the nursing practice at an advanced level.In the opinion of Fields (2009), it has taken quite a while for the nurse midwifery to gain acceptability in the nursing profession. In that regard, there are quite a number of events (historical) which can be looked into in an attempt to fully understand the impact of the nurse midwifery on the nursing profession over time as well as the development of the same over time. One of such events was the founding of the Frontier Nursing service in Kentucky.


The significance of this was the use of the nursing model by midwifes where imported and essentially trained in Britain. However, at this time, nursing midwifery was tailored to address the various needs of all those living in areas that were in one way or the other underserved. This was the early periods of 1925.However, what ushered nurse midwifery or underscored the impact of the same upon the nursing profession was the establishment of the education program concerning itself with nurse midwifery at the Lobenstine Clinic. This program accelerated midwifery certification to those nurses who were already working in public health. Maude (2006) also noted that this was one of the most important events as the nurse midwifery as well as nursing [profession integration was concerned. This is essentially because it was from this point that the midwifery/nursing relationship was underscored as well as acknowledged.However, it was not until the 1940’s (mid) that the full relevance of nurse midwifery to nursing was appreciated.


In Linda (2008) own words, “….the foundation of midwifery in nursing was entrenched on the establishment of the national organization of public health nurses which came to be morphed in American Nurses Association…”Linda (2008) goes ahead to note that in the current day and age, nurse midwifery has come to reestablish itself into quite a versatile practice and its ability to fit into the nursing profession or the various healthcare delivery systems is largely laudable. Nurse midwifes now aid the nursing profession by availing vital services across the healthcare spectrum including at birth centers, physician offices, and hospitals as well as in private practice. Further, the relevance of the nurse midwife in the nursing profession as far as imparting postpartum as well as prenatal advice as well as availing physical and emotional support to all those concerned goes a long way to round the nursing profession.From the above discussion, the impact of nurse midwifes on the nursing profession cannot be once again overstated. It hence remains to be a very important healthcare system arm. In that regard, it is important to note that the role nurse midwifery plays as far as the nursing profession is concerned will continue to be more vital as well as central going forward.


The relevance/roles of Nurse Midwife in the 21st Century

To underscore the growing role of nurse midwifes in the health profession, the US News and World Report in the first quarter of 2005 noted that in the next one decade, nurse midwifery shall be fully morphed into the nursing profession not as a complimentary service or role but as a central function in the delivery of care to mothers during the pregnancy period and on delivery. This shall more so see an increased collaboration between physicians and nurse midwifes (certified) while pursuing an enhanced health status for women not only in the US but all over the world. As Laura  (2010) notes, “nurse midwifes are a vital component in the advancement of healthcare across the board.”It is important to note that the nurse midwife role encompasses a wide variety of duties and responsibilities chief which remains the provision of treatment as well as medical care to patients (obstetrical) usually under the Obstetrician supervision. In this regard, it might also be helpful to note that the nurse midwife provides or avails useful advice to patients on various health practices (postnatal and prenatal).


The nurse midwife also plays a central role in patient examination (initial) and after this examination comes the patients care as well as treatment and ensuring a safe delivery. When it comes to patient examination at the period of pregnancy, the nurse midwife may perform the analysis of physical as well as laboratory test findings so as to identify deviations from the norm. When it comes to the diet as well as prenatal health practices of a patient, the nurse midwife instructional role is viral to ensure that the progress of patients is normal and in accordance to what is expected. Other vital roles of the nurse midwife in the current day and age include the administration of medications as well as patient reassurance during the labor period. After delivery, the nurse midwife can go ahead to ensure that the infant as well as the patient are responding as is expected by performing a number of examinations (post partum) as well as treatments.


It is important to note that in the recent past, the role of the nurse midwife has changed from what was traditionally regarded as the preserve of the nurse midwife. Today, we have nurse midwifes charged with the role of administering emergency steps which are stipulated when at the time of delivery or even pregnancy, there are clear deviations from the norm. However, the nurse midwife should at all times work closely with the physician or Obstetrician. However, today we still have some of the traditional roles of nurse midwifes still being played. This includes but is not limited to paying regular visits to patients so as to advise them on self care and ensure that the patient as well as the infant is progressing as they should. It is important to note that such visits can be either conducted at home or in the hospital during the postpartum period. Another traditional role of nurse midwifes which has found relevance in the current day and age includes coming up with classes for families as well as patients for purposes of availing information as regards family orientation, childbirth as well as pregnancy.


Training and the future of the nurse midwife

As already noted in the earlier sections of this text, since 1920s, the nurse midwifes tradition has been in existence and it is against this backdrop that a number of colleges have come up to inform further development in this field. To practice in the field, there is need for certification which comes only after satisfying a number of laid down requirements including passing through a nursing program (accredited) and consequent licensure in the same. This should be followed by successful completion of a nurse midwifery program from a reputable college.According to Joy (2009), the nurse midwifery is expected to regain its relevance going forward as a result of the central role it plays in the healthcare system. He is of the opinion that organizations across the spectrum will continue paying more to the qualified profession in this noble and important field.


Conclusion

It is important to note that due to its versatility, nurse midwifery continues to find a niche in the various facets of healthcare system. With this in mind, there is a projected demand for nurse midwifes going forward and to underline these expectations, the Department of labor is of the opinion that 2011 shall see a substantial increase in employment opportunities for those who are fully qualified in nurse midwifery. In conclusion therefore, nursing midwifery continues to be a relatively stable specialization and similarly, the impact of nurse midwifery on the nursing profession shall continue to be well defined going forward.


References

Joy E. W. (2009): The Professionalization of Childbirth, Canadian journal of nursing

Research. 23 (6), 34-46

Laura E. E. (2010): Careers in the field of midwifery, Journal of advanced nursing.

16(2), 19-24

Linda, W. (2008):  Nurse midwifery Experience. Nursing management journal 34(2), 47-

49)

Maude C. (2006): The status of nursemidwifery. Journal of obstetric, Gynecologic, &

Neonatal Nursing. 17(2), 22-34

Fields, J. (2009): Prenatal and postpartum care. Primary healthcare journal, 49(3), 52-72





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