The Roles And Regulation Of Midwifery Nursing: A Critical Analysis

Task: 

Write an essay in which you critically analyse the role scope and work experiences of nurses who occupy a particular nursing work role.

Details of task: 

Select a nursing role of interest to you around which it will be possible to locate policy and published papers related to the role.

Search and retrieve information that will inform you about:

• The scope and regulation of practice as it relates to the role.
• What is known about the purpose, performance and outcomes of the role.
• What is known about role issues and the experiences of role incumbents.

Write an essay that reflects your reading and synthesis of key papers and documents, about the work role.  Essays will normally:

• Establish common features of the scope of the role and example activities that are/can be undertaken by role incumbents.  Please make sure that this discussion includes some analysis related to professional regulation, workplace governance and role enactment.
• Identify and discuss what is known about the benefits and outcomes that are gained or achieved for the profession and for clients as a result of people working in these roles.
• Explore and discuss what is known about the experiences and practical needs of people who work in the role. This may include aspects such as job satisfaction, training staff development needs, and learning at work.
• Identify and discuss likely or known strengths, weaknesses, or issues associated with the role (development, implementation or evaluation).

Roles of Midwives

Nursing is one the fulfilling careers both in the emotional aspect and in the services delivered to humanity. For this and more reasons, there are lots of people venturing into this profession which entails a lot of diverse roles and responsibilities. It is in humanity to procreate and bring forth generations so as to ensure continuity of their generations. This has been so since the times of the early humans. Families usually expect safe deliveries with exceptionally well babies. This is a dream enabled by health practitioners in medical fields, with lots of effort from the midwives (Gibbins, 2001). Midwives are the people to watch out for in child deliveries. Although they work alongside clinicians, their input is special and requires a lot of developmental training.  Midwifery is one of the specializations in nursing. This nursing role involves the care given to women during pregnancy as they approach delivery, the birth procedure and the post-delivery period. This is a career that helps humanity in procreation, and as such, it is treated with great respect. There are stipulated roles for the professionals in this line of work, and this facilitates responsibility.

The community has its expectations from this group, and therefore mistakes in this field are equally punishable by the law (Bryar, 2011). The possible outcomes of this practice also need to be known so as to ease the burden of the midwives.  Whatever brings good is likely to have its worst sides. These are the negativities in midwifery nursing. The impacts on the lives of the practitioners is also something that cannot be slightly taken. The hospital experiences remain in their memories as much as we refer to them as duty calls. This is where the strengths and weaknesses in child delivery and care come about.  Midwifery is a role in nursing that has undergone a lot of evolutional changes with time since it is a practice that began a long time ago with women mothering children from time immemorial. Modernity has seen it advance in instrumentation and skills. Service delivery in nursing is under strict regulations from both the government policies and nursing councils (Nursing, M., & Staff, C., 2012). The developmental aspects of midwifery right from the schooling and accreditation of certificates is also a subject to look into since our training directly affects the kind of skill we possess. This work looks into the details of these aspects of midwifery as a nursing career specialization area.

Regulation of Midwifery Profession

Midwives are blankly known to be involved in child delivery procedures. This is just but one among the many roles and responsibilities in their docket.  The health sector has a lot of intersection of roles with medics have to work together to ensure proper health care is provided to clients who are the patients and expectant mothers for our case. Clinicians work hand in hand with the nurses to ensure safe delivery and proper care for the neonates (Rafferty, 2003). The primary role of midwife nurses is on matters pertaining to women’s health issues. This is a very wide area with several roles. What a midwife nurse does entirely depends on the authorizations and what their licenses dictate. This is the regulation aspect that is also discussed in this work. The most common role associated with the midwives is the delivery of babies and the generalized care given to the expectant mothers before and after child delivery (Bryar, 2011). This is area entirely left for the nurse midwives. The actual child delivery is a midwife’s job. However, complications are always likely to arise. This is where the clinicians do come in to assist in medical attentions like surgical procedures. Midwives are equipped to deal with the pregnancy related issues and parturition. The history is usually useful in preparation for whatever complications that may arise during parturition. The nurses in this category are charged with the responsibility of prescription of the pharmacological treatments to their clients who are the expectant mothers. . The physical examinations are conducted in the wards and reception bays while the better part of the examination is carried out in the laboratory (Anderson, 2010). The midwife nurses control the care given to patients using these results. These maybe those of chronic and acute infections and the nurses here are obliged to care for these patients awaiting child delivery. This involves drug administration and generalized care as they await delivery. According to Williamson, the medical services provision often involves a lot of discussions and midwifery is no exception. The nurses here advise their clients on matters of both maternal and child health. These could be on physical therapies and diet (Williamson, 2003). They are counseled on whatever they should use or not use in the labor wards as they await labor.

The nurses in this area of specialization operate under some stipulated rules. This is where the processes that the nurses engage in are controlled by some system of government policies and nursing councils. The acts clearly outline the roles, responsibilities, and rights of both the medic in operation and the clients. Regulation in midwifery is thorough since this is a sensitive area with needs to be handled with a lot of care. The rights here are under the reproductive care (Dimond, 2008). Confidentiality is a key aspect in dealing with the clients. The medical field calls for utmost secrecy on patient information. The midwifery profession is no exception, and therefore all the practitioners here have an obligation to maintain high level of confidentiality. Whatever a patient discusses with the midwife remains between the two of them. The clients have the right to choose whoever they want to care for them and wherever they want to be attended to. Respect is as well mandatory from practitioners. The midwives also have rights to be respected, and they include treatment with respect among others. They have rights to be guided and properly trained in relevant areas (Altranais, 2000). Expression is a right to both parties in the labor wards, and this is a two-way requirement. The activities the midwives engage in as well as their relations with the patients. Midwives are required to embrace consultation in the profession. They must consult with the medical or nurse in charge whenever there are any slight changes in the normal procedural steps of pregnancy, delivery and the aftermath. This is a rule and must be adhered to by the midwives (Dimond, 2008). All midwives are only allowed to be practice only after meeting certain certification criteria. Midwives must pass competence assessments to be allowed to operate in the medical field. All drug administrations are strictly with consultation with the medical practitioners or the nurses in charge. This can only be done contrary if the midwife nurse is permitted by the law. This makes this area of work to be complicated.

Duties are assigned based on the legal grounds. A nurse in this area can only perform on a patient when called on by the in charge. The operations must also be in respect of the rights of the clients in the wards. Patient rights are subject to consideration, and therefore nobody can operate on a patient without their consent. This is why the profession incorporates the client counseling (Phillips, 2000). Through this, the nurse midwife can talk in details with the patients on whatever goes on and advise them on whatever the right procedures are. It is then upon the patient in question to decide as to whether the procedures can be conducted on her or not. This is important because some religious beliefs collide with the hospital procedures like the blood transfusion process (Taylor, 2000). Some religions do not approve of transfusion services in hospitals, and thus prior talks before administering any form of treatment are necessary. There are cases where midwives have been sued in law courts with regards to such matters. Academic qualifications are imperative as well and must be produced before being registration as a certified nurse. Any modifications to this effect are also greatly punishable by the law (McHale & Gallagher, 2003).

This category of nurses are especially skilled in pregnancy care and child delivery and as such are employed in all related environments. Midwife nurses are deployed in hospitals, birth centers, public health sector, and community health activities. Midwives can as well work at home in the cases of births at the expectant person's home. The conditions in the homes, however, are subject to scrutiny (Lloyd Jones, 2001). They must be safe for such deliveries to be presided over by certified nurse midwives. The job prescription here extends right from the preconception to the post-partum period. The midwives provide gynecological services and are responsible for lots of successful births especially the vaginal births. The varying range of the working environments that these groups can be deployed to contributes to the many adversities that they face during their practices (Collins, 2010). Midwives more often than not work indoors in the labor wards or houses for the home deliveries. This is an environment that most of them are used to, and it comes with harshness at some point. Noise, for example, is a compulsory theme in normal vaginal child deliveries. The mothers often scream and make very loud weird sounds that may in the long run work to the disadvantage of the personnel. Hearing functions are affected by the long term effects for those who stay in the field for longer periods. The noise is so much a little thing to worry about as compared to the contaminants and infections they are exposed to. Midwives work involves being in contact with the patients who are at times sick of certain diseases (Casey, 2010). For this reason, the nurses remain covered in gloves, masks, and protective clothing for the better part of their duty shifts. This is a work hazard that is taught to the nurses in the preparatory schools, and therefore they must adhere to them for their safety measures.

There have been cases of nurses being infected in their places of work. This happens to a larger percentage of the midwives professionals, and they are therefore prepared for this. Being aware of the adversities is one thing and getting protection and cover is another thing all together (Norman, 2002). There are cases where the midwives get infections related to the respiratory system due to the air breathed of the patients and thus the contraction of airborne illnesses. These have also affected the expectant mothers in the wards who suffer from nosocomial infections, the hospital acquired infections. The hostility of the ward environments is what further makes it necessary to ensure the professionals are qualified in the areas of designation and that they can work with utmost safety standards (Collins, 2010). The midwife profession remains to be more of a calling than a profession which merely involves training and execution. There is the aspect of personality. The certified midwives often have to respond to duty calls at weird times of the night. They can be called to work during weekends and nights since births are spontaneous and therefore occur at any times of the day or night. For this reason, the nurses here must be dedicated to helping the humans and not inclined to the good money that they accrue in the course of their operations. This is a profession that brings forth life or sees one going down the drain (Engels, Gulden, Senden & van't, 1999).  

Just like any other profession, midwifery nursing is all about competence and expertise in the field. This time the field is a hospital environment, and it requires top notch competence since lives are at stake here. The midwifery line of work requires a lot of accuracy lest we lose lives (Timmins, 2002).This is so because the decisions made here directly affect the welfare of the expectant mothers. These operations are conducted with the help of other medical practitioners such as the clinical laboratory technologists and the clinicians. Cooperation is thus necessary in the hospital environment. Misdiagnosis from the laboratory or the clinicians can adversely affect medications and medical steps when handling the expectant mothers (Johnson, 2016).  Wrong pharmacological decisions can negatively affect the newborns and the mothers. The midwives must, therefore, have clear resolved minds when making their decisions to avoid unnecessary mistakes that can be fatal.  Sound minds are a requirement here with nurses having to beat some designated deadlines imposed by the superiors like the nurse in charge. A midwife nurse must, therefore, be able to make decisions but must also know that consultation and respecting jurisdiction is part of the job (Chin, & Kramer, 2008).

Experience is more of the incumbents’ descriptive word. This is because it only comes with a lot of practices and dedication. For the above-stated reason, there is system put in place for the new personnel to learn from the rest through continuous meetings and organized training programs. The incumbents share their experiences in the field with the new recruits and this way the knowledge is passed through generations. The medical field is open to consultations since the people dealt with are in compromised states (Johnson, 2016). The schooling students are in systems where they are attached to medical centers where they get the real life experience in the field. The incumbents must, therefore, be ready to help in the training of their successors in the field. They must be respected by the juniors to facilitate this orientation.

Developing midwifery entails the possible measures that can be undertaken to ensure midwifery as a profession is steered forward. Moving a step ahead in midwifery first calls for the presence of qualified personnel who k now whatever they are supposed to do and they give it their best. This is where passion comes in (Bryant?Lukosius, 2004).  Nurses should not be salary oriented. The urge to help should form the greater part of personalities in nursing. This way people will be more compelled to work and give back to the society. Research should be conducted in various aspects directly influencing the success of this profession. This includes genetic disorders which continue to grossly affect the unborn kids. Proper solutions should be found on these to make this profession more fulfilling. All relevant areas should also be researched on to help in the child bearing processes (Breier-Mackie & Sarah, 2006).

The benefits that come along with this role are numerous especially to the maternal fraternity. The midwives often get salaries and the emotional fulfillment from the services that they render. Midwives have a great impact on the lives of the mothers that they help through with their pregnancy all through to delivery and post-partum care. These are a special group of nurses and many at times deal with the healthy expectant mothers. Midwives have a unique way of dealing with their clients that make them feel so comfortable. This is mainly because their services and procedures tend to be inclined on the client's preferences.  Midwives conduct counseling sessions with the clients which make them more comfortable with the pregnancies (Kennedy, 2008). The role of these nurses can only be fully understood by the women who have passed through them. The government has its policies on childbirths. In United States pregnancies are viewed from their onset regarding the possible negativities. For this reason, a lot of tests are often conducted during the pregnancy. These are at times conducted without much knowledge being passed to the beneficiaries. This is where the midwives do come in. Those who are able to seek healthcare services in the private sectors do have their midwives in place to guide them through their pregnancies (Collins, 2010). They are the experts in reproductive health and thus have all the necessary skills to guide one through a safe parturition. Midwives enable the beneficiaries to understand all that pregnancy entails and even give them the possible options that they have for their case. This follows thorough examinations in offices and in the hospital set ups. A mother is, therefore, able to decide on whichever practices she would like to be used on her. The midwife nurse helps the mothers weigh their options and decide on safe birth procedures that are fit considering their medical history and examination results. A woman can thus give birth by labor induction or the cesarean section if her condition demands for either of these (Chiarella, 2008). There exists safe, normal vaginal births with no such interventions. Only a midwife can help a woman with this. Giving birth to offspring is something all humans look forward to, and for this reason, the role of the midwife nurses continues to be acknowledged as time goes by. Their input is irreplaceable.   

The nursing profession just like the other health jobs has its worst moments. The results in this profession of midwifery are at times good, and the bad news are also never forgotten. Good and evil are bedfellows. In the verge of bringing forth a new family member, there are always expectations in the labor wards. The outcomes are always celebrated or mourned depending on what prevails. Midwifery call for strong hearted women. There are cases when the newborns come out healthy and become healthy infants (Flarity, Gentry, & Mesnikoff, 2013). This is the better anticipated part. There occurs some uncertainties in pregnancies. Still birth is one of the possible outcomes in midwifery. Miscarriages are also a possibility and so is abortion. Some babies die while still in the mother's womb in the verge of awaited labors, and these are brought out to rescue the mothers (Ketefian, S., 2001) There are also cases where mothers have lost their babies in the middle of activities and accidents. Mothers have also died while giving birth leaving newborns on their own. All these occur in day to day midwifery nursing profession. Babies have also been born prematurely or with abnormalities. The nurses who have been in this profession for long enough have seen all these happen (Collins, 2010). The joy, however, cannot be overlooked by these negativities. Parents have celebrated in wards for their successfully born healthy infants very many times. These outnumber the negativities. Therefore there is no need to panic, and neither should expectant mothers be reluctant to go for the clinic programs put in place for their kinds. Midwifery as a role in nursing exposes the nurses to a lot, something that makes nursing to be more emotional and socially connected (Nursing, A., & Council, M. A., 2012). Before anybody decides to pick this as a career one should be fully aware of all that it entails and learn to be strong.

The happenings in the field are most of the time due to negligence on some part. There are instances where the expectant mothers have been discrete with valuable medical history information that have eventually affected them during birth even leading to the death of some (Butterworth, 2013). Midwifery is about openness with the health personnel so as to know the way forward when forced to deal with previous medical issues.  Genetic disorders are hereditary and are normally passed to the offspring. For this reason, the midwifery nurses do ensure that all families that have genetic disorders in their histories are screened for the same so as to counter it on time. Screening services have at times affected the unborn children, especially where probes are used like in endoscopy (World Health Organization., 2001). They are not commonly carried out unless there is a cause of alarm like he presence of a family disorder and the need to correct or terminate pregnancies. These are presided over by the medical practitioners, but the midwives help in counseling and decision making. This emphasizes the necessity of the transparency from the pregnant mothers. Abortions are also conducted with midwives on the front. These are the medical abortions decided on after a thorough examination of all possible avenues (Hunter, 2001). There are situations where the unborn child compromises the health of the mother and abortion is thus recommended so as to save a life. This has been debated on over the times but is still unavoidable. Medically it is a practice in the books and is carried out when the medics deem fit. The patient’s consent is always sought since it is in the autonomy of the medical ethics act where the patients have the right to decide what medical practices are done on them and must give consent for the same to proceed. The outcomes in this line of work are so diverse and must be expected (Dunphy, Winland-Brown, 2011).

Midwifery as a part of nursing has its personal attributes to the individuals in this area of work. This profession entails a lot of engagement, and therefore it calls for a lot of good people skills. The counseling programs bring the professional in close contact with the clients. This way they can deal with them as though they were even related.  This is very key for the success of the professionals. Good people skills are necessary and so is teamwork (ABA, 2007). Proper coordination and teamwork in the wards are very necessary to ensure the nurses can beat the deadlines and attend to all the patients. Dedication and commitment are also a strength in the midwifery nursing profession (Fullerton, 2011). It is for this reason that they work for extra and weird hours just to ensure all clients are catered for. All these personal traits when combined with academic qualifications and work experience result in very helpful midwives. These are the kind of people we need to guide us in ushering in new members of the family.

A misfit that occurs in this medical field is the lack of dedication and humane act in some nurses. However, that is entirely personal and cannot be used as a qualification criteria since people tend to pretend when seeking job positions. A significant weakness in this profession still lies in the lack of some information (Walsh, 2003). Clients have been referred to gynecologists very many times for extra care. This also applies to genetic counseling procedures when hereditary concerns are raised. This is because the midwives lack some level of information. The referrals make clients uncomfortable as they feel confidentiality is at stake. This can be worked on by review of the curriculum to incorporate these relevant areas and adjustment in the training programs of this group of nurses (O'Lynn, 2007). Seminars and training sessions can be organized for those already in the field.

Conclusion:

Nurses directly contribute to our wellbeing as humans.  This line of work is entangled in a number of challenges amongst which there is the health risk, but they somehow find ways to execute their duties. They rely on training programs on safety and working experience to remain efficient and safe at the same time. There are faults in the system with the need for more research, but the successes still outnumber the failures. Disease transmission from ailing clients to these nurses remains the greatest challenge requiring attention and solution. These are mainly from the contact with the body fluids such as blood. Protective clothing are in place to help curb these occurrences but their use is at times not appropriate and this emphasizes the need for proper training of the nurses. The midwife role in nursing is a profession to be proud of as it fulfills socially and emotionally. It never feels like a job at some point. These are the benefits accrued by those enrolled in this profession. Necessary steps should be taken to ensure all the trainees are well equipped and that all operations remain as stipulated in the regulation acts. This way skilled professionals will deliver services to mankind without avoidable adversities and the people in the profession will be more fulfilled. All the stakeholders from the trainers, incumbents, government and clients should work in harmony to make the profession better.

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