I am graduating from nursing school in May and am planning on at least attending births as a doula for friends. But I am also considering working with a partner and doing some doula work on the side. She is also a nurse, does not work in L&D, nor will I most likely work in any maternity type setting. To me, the separation between the two roles seems pretty simple, but I have also heard there can be some complicating factors as your responsibilty in general rises to whatever your highest license is. I know this has been an issue when midwives want to attend births as "just a doula". Has anyone been through this or have advice on whether this is possible and what steps I need to take to protect my license?
Any doulas who are also RNs?
I don't think it will interfere at all with my nursing license, unless someone progresses more quickly than expected and I found myself accidentally attending an "unassisted" childbirth. This is my fear, I don't know how to prove I wasn't "playing midwife" in this situation. But these situations are very rare, and may be avoided entirely by arranging to meet a mother at the hospital if she feels she is ready. But many women like to labor at home as long as possible.
Most of the time, I think the role of a doula is rather clear cut. You aren't there to make medical decisions, perform interventions, or give medical advice. Doulas provide comfort care. I think it would be fine as long as you acting only within the guidelines placed for doulas.
It will actually, for insurance issues. I know in my doula class, a nurse did say that the below is the case:
"I have also heard there can be some complicating factors as your responsibilty in general rises to whatever your highest license is"
Regardless of the role of the doula, insurance has to cover you whether or not you are working at the moment as a Nurse, i.e.,. if your in a public situation and somebody needs medical attention (car accident, heart attack at grocery store, etc) you would naturally use your medical training as a nurse. So insurance must cover you always. (I'm not 100% certain, although this is what I understood from the conversation in my doula class just this past fall.) Insurance doesn't care about the finer nuances of the role of the doula, unfortunately. I would use a very explicit birth doula contract that states that you will not use your RN training in your services. That should help a great deal.
As an LPN, I have no qualifications or experience outside of nuring clinicals that is related to L&D nursing. Local hospitals are no longer hiring LPNs, and my work experience is split between nursing homes and group homes for the developmentally disabled.
It would be down to scope of practice issues (which include resuscitation), and where the line is drawn in emergencies that occur outside a hospital without a midwife present. But it's not like most people are giving birth out in the jungle where medical care is scarce. Are there situations where a doula should call an ambulance and let paramedics take over? They could be there within minutes. Or is this a hypothetical situation that doulas don't really face?
My nursing is the main reason I don't take UCs, I can't risk that. I will attend homebirths assuming they are having a MW and we have talked about what will happen if mom progresses too fast. I have a hb on my books for August and the plan is to call the ambulance if MW doesn't look like she'll make it (MW is hours away). There is no conflict IMO if you at least call the ambulance for support. You will still use your training in the mean time but you want to make sure you're not trying to go at it alone IMO. No conflict of interest or worries then. I am certified in adult and child CPR as well as neonatal resuscitation and I will use them if necessary.