Midwives Mentoring Midwives: A Review of the Evidence and Best Practice Recommendations.

Mentoring involves a reciprocal relationship between a more experienced person (mentor) who offers guidance and counsel to a less experienced person (mentee). Reported benefits of mentoring among students of varying health professions include skill acquisition, understanding of the professional role, acclimation to the culture of the health profession, and personal and professional development. Globally, the midwifery profession has a long-standing history of mentoring students and new graduate midwives. However, only one study has described a formal mentoring program within the US midwifery profession. Therefore, to inform best practice for both formal and informal mentoring programs, current mentoring programs are summarized and a state of the science review on mentoring within midwifery in the United States and internationally was conducted. Three types of mentoring relationships are discussed: (1) student to student (peer), (2) midwife to student, and (3) midwife to new graduate midwife. Effective models and recommended approaches for the development and expansion of mentoring are discussed, to sustain, diversify, and scale up the midwifery workforce. Personal attributes and action steps of effective mentors and mentees are provided.

Intrathecal Opioid Dosing During Spinal Anesthesia for Cesarean Section: An Integrative Review.

Approximately one in three women in the United States deliver via Cesarean section (CS), making it one of the most common surgical procedures in the country. Neuraxial (spinal or epidural) anesthesia is the most effective and common anesthetic approach for pain relief during a CS in the United States and often associated with adverse effects such as nausea, vomiting, and pruritus. While recommended dose ranges exist to protect patient safety, there are a lack of guidelines for opioid doses that both optimize postoperative pain management and minimize side effects. This integrative review synthesizes the evidence regarding best practice of opioid dosing in neuraxial anesthesia for planned CS. Evidence supports the use of lower doses of intrathecal (IT) opioids, specifically 0.1 morphine, to achieve optimal pain management with minimal nausea, vomiting, and pruritus. Lower IT doses have potential to achieve pain management and to alleviate preventable side effects in women delivering via CS.