Do hb midwives ever need RNs?

[paintedbison]

I'm a nurse and have worked antepartum and postpartum in a hospital setting for the last four years. I was supposed to start working at the birthing center I had my DS at, but we are now moving nine hours away. We're moving to Lubbock and there are no midwives in Lubbock... but there are a couple one and a half to two hours away that do homebirths in Lubbock.

Would it be dumb to try to get in touch with a couple of these midwives and ask if I could "assist" at homebirths? I'm getting really tired of the hospital environment but want to stay involved in the field. I'm just trying to figure out a way to make that possible...

[MsBlack]

WElllll....

for myself, I probably would never say that I 'needed an RN's help'--mainly because most of the RNs I've known have tended to have 'too medicalized' a view of birth and supporting birth, IMO (with a couple of notable exceptions).

However, I do appreciate good assistants and apprentices, if that person's attitudes, personality and goals mesh well enough with mine and no matter what their previous training/experience.

So I guess I'm saying that in your shoes I would not sell myself as an RN. Not that you should pretend NOT to be an RN--only that for most hbmws I've known, they are not so much interested in credentials as in ability and attitude of assistants.

good luck!

[paintedbison]

LOL... thanks for the response. I may have phrased it wrong by saying "need RNs". A better statement might have been "do they ever want RNs". I don't know how my homebirth "abilities" would measure up, since I have only done hospital work (which I'm really good at that aspect of things). But, I would certainly have a terrific attitude.

Do you need to be going to midwifery school to be an apprentice? I would like to pursue my CNM in the future... but with two little ones right now, I feel like my plate is full enough. What I would like to do is continue to gain experience in the field and to stay involved with birth... because I love all things related to birth.

[courtenay_e]

We have an RN here on the boards who is apprenticing. I think her preceptors appreciate her just fine! YOu have a certain skill set, right, that would make you useful at a birth. You've seen and appreciate natural birth? You can assist with things like BP, heart tones (you may need to learn to use a fetoscope, but I haven't found that difficult at all...), charting things? A lot of being a successful assistant is about getting to know the midwife's rythms during a birth, what she'll need/want where and when, etc. Being able to provide labor support if that is needed is a good skill to have...but women at home birth seem to need that less, in my experience...not that none of them need it, or that nobody ever has an intense birth, that's not the case...but homebirth is different.

Anyway, if it's something you feel like you would like to do, get to know the birthing community in your area, and find out who needs an assistant.

[alegna]

Some homebirth midwives here regularly have RNs at births. It just depends.

Wouldn't hurt to contact them.

(though admittedly I'm wary of the midwives who "need" RNs there... )

-Angela

[maxmama]

Originally Posted by alegna

Some homebirth midwives here regularly have RNs at births. It just depends.

Wouldn't hurt to contact them.

(though admittedly I'm wary of the midwives who "need" RNs there... )

-Angela

How about midwives who "need" an assistant for baby resus, then? Any baby can need help getting started.

For the OP, I would worry about what would be involved legally and liability-wise. I would be very careful, because I wouldn't risk my license for anything.

[time4another]

How about midwives who "need" an assistant for baby resus, then?

Most HBMWs have at least 1 attendant at a birth who is certified in Neonatal Resuscitation anyway. You don't need to be an RN to certify in it.

[Defenestrator]

If I were a midwife who was working 2 hours away from a population center where a lot of my births were coming from, I might be interested in hiring a birth assistant who had some assessment skills (vaginal exam, heart tones, etc.) plus some labor support skills so that I could send her out to a birth until I could get there. I would probably expect that assistant, if she didn't have much actual birth experience, to work for me for free for a while and get to the point where I felt ok about her starting at a birth without me, and then I would pay her a couple of hundred dollars per birth.

I think that the pp is right on track though about being careful about your license. Texas seems to me to be a state that has pretty well-defined roles for midwives and nurses, so you probably would be ok, but it is worth looking into.

[maxmama]

Originally Posted by time4another

Most HBMWs have at least 1 attendant at a birth who is certified in Neonatal Resuscitation anyway. You don't need to be an RN to certify in it.

Didn't say you did. The OP wasn't asking about being there in an RN capacity.

[alegna]

Originally Posted by maxmama

How about midwives who "need" an assistant for baby resus, then? Any baby can need help getting started.

For the OP, I would worry about what would be involved legally and liability-wise. I would be very careful, because I wouldn't risk my license for anything.

No need to roll eyes the MIDWIFE and her assistant midwife would both be certified in neonatal resuscitation

Originally Posted by time4another

Most HBMWs have at least 1 attendant at a birth who is certified in Neonatal Resuscitation anyway. You don't need to be an RN to certify in it.

:

-Angela

[alegna]

Originally Posted by maxmama

Didn't say you did. The OP wasn't asking about being there in an RN capacity.

I thought that's exactly what she was asking? :

Many midwives here advertise that they have RNs and their attendants. Names on the website with RN next to them and everything... obviously attending in an RN capacity...

-Angela

[Maggi315]

I don't need an RN necessarily, but I would consider hiring one to work in the capacity of a labor assistant. I am an RN, and when i started attending homebirths,I had alot to unlearn!!! But the basic knowledge from being an RN was extremely helpful.

[maxmama]

Originally Posted by alegna

I thought that's exactly what she was asking? :

Many midwives here advertise that they have RNs and their attendants. Names on the website with RN next to them and everything... obviously attending in an RN capacity...

-Angela

Actually, it's hard to attend with an LM in an RN capacity in many states, depending on how the state nursing act is written. People can use their titles without acting in that role, though the ethics of that are quite sloppy. Would you like some reading on nursing as a discipline? It may clarify things for you.

[mendomidwife]

Perhaps this was already stated, but you need to check with your State Board of Nursing. In California, a RN cannot attend homebirth as an RN....i.e. she can't hold herself out to patients as being an RN, because it is not within the scope of practice. You could attend as a doula and the fact that you are an RN is an added benefit.

Carla

[alegna]

Originally Posted by maxmama

Actually, it's hard to attend with an LM in an RN capacity in many states, depending on how the state nursing act is written. People can use their titles without acting in that role, though the ethics of that are quite sloppy. Would you like some reading on nursing as a discipline? It may clarify things for you.

I expect that this is one of many areas that TX differs in regulation. I know that we have very open regulations on most things regarding midwifery and I expect this is another. I just looked at a midwife's webpage (certified in fact, not CNM) that advertises that she brings RNs including their names and pictures. I would venture a guess that that information would not be on a webpage if it was endangering her colleagues' licenses.

Since the OP is discussing TX I figured it might be valid information.

-Angela

[mwherbs]

I have had RN assistants and the best part is that they are already trained in many ways , that can also be a detriment because things are done differently at home than in the hospital. I prefer co-management and usually don't give orders, I like someone who can think on their feet and apply themselves to the situation. I would say seek out the legal info so you know what position that puts you in (I know that in the past some of the CNMs from other countries were not given CNM status but were able to be RNs and that they practiced openly in Texas as LMs -and still did a part time stint as OB RNs) and then call the local midwives and see if they have room for an assistant-- what I will say is that there isn't much money in it if any, so you may get some experience in homebirth and you may very well lend some expertise from your past experience but probably no pay.
take care

[Funny Face]

I think being an RN could be a plus when talking with some midwives (some CNMs for example because they can relate, are familiar with your skill set and know where you are coming from ) while it might be a negative or inconsequential to another midwife. I think your heart, your desire and how they match up with the particular midwife would be most important.

I would expect them to want to train you before you might get paid or even be promised a position. I know this was something I was considering when I become licensed (nursing student currently).

I'm 'working' with some midwives as an assistant, but it's more for experience because I'm not being paid.

The other question might be how much you are hoping to be paid. I know not many midwives have the funds to hire and pay someone what an RN usually makes in a hospital.

GL!

[maxmama]

Originally Posted by alegna

I expect that this is one of many areas that TX differs in regulation. I know that we have very open regulations on most things regarding midwifery and I expect this is another. I just looked at a midwife's webpage (certified in fact, not CNM) that advertises that she brings RNs including their names and pictures. I would venture a guess that that information would not be on a webpage if it was endangering her colleagues' licenses.

Since the OP is discussing TX I figured it might be valid information.

-Angela

Under the TX nursing law, RNs are not independent practitioners. CMs are not specifically mentioned as those who can delegate responsibility to RNs. This is a gray area that a CM may not be aware of, since they're not governed by the board of nursing.

[alegna]

Originally Posted by maxmama

Under the TX nursing law, RNs are not independent practitioners. CMs are not specifically mentioned as those who can delegate responsibility to RNs. This is a gray area that a CM may not be aware of, since they're not governed by the board of nursing.

Interesting. There are many well established RNs who work for certified midwives and CNMs here. I expect they are aware of the issue.

-Angela

[maxmama]

Originally Posted by alegna

Interesting. There are many well established RNs who work for certified midwives and CNMs here. I expect they are aware of the issue.

-Angela

CNMs are able to delegate to RNs.