ABSTRACT
This article describes an innovative program developed by the University of California, San Diego Nurse-Midwifery Education Program to supplement the experiential background of prospective nurse-midwifery students. This preprogram enables RNs without previous labor and delivery (maternal/newborn) nursing experience to complete the bridge program and enter the UCSD student nurse-midwifery program on the same clinical level as other students and complete it within the standard time frame. The rationale for the program, its structural framework, and evaluation tools are presented. The authors hope that a description of the program will allow other institutions to replicate UCSD's success.
Subject(s)
Education, Nursing, Graduate , Midwifery/education , California , Curriculum , Humans , Organizational Innovation , Preceptorship , Program EvaluationABSTRACT
The purpose of this article is to describe how the graduate-level nurse-midwifery education program at the University of California, San Diego, has operationalized the nursing concept of role transition for nurse-midwifery students. A theoretical background of role transition is presented. Specific strategies used to facilitate role transition are discussed. Evaluation of the current strategies in use are presented.
Subject(s)
Adaptation, Psychological , Education, Nursing, Graduate/methods , Nurse Midwives/education , Nurse Midwives/psychology , Role , Students, Nursing/psychology , Clinical Competence , Faculty, Nursing , Humans , Interprofessional Relations , Mentors , SocializationABSTRACT
Increasingly, nurses nationwide are assuming expanded roles in the provision of health care. Certified nurse-midwives (CNMs) are one example. These practitioners function in varied settings from the home to the level three hospital. As with any change, the transition to this present role has been a long and, very often, a difficult one. Their efficacy, safety, and cost-effectiveness is today unquestioned; however, impediments to practice still exist. Whether the impediment be in securing hospital privileges or prescriptive capability, the CNM continues to strive to overcome these obstacles in order to ensure the accessibility of nurse-midwifery care to all women.
Subject(s)
Midwifery/history , Nurse Midwives/history , Female , History, 20th Century , History, Ancient , History, Medieval , Humans , Job Description , United StatesABSTRACT
Anemia is the most common hematologic complication of pregnancy and is associated with increased rates of premature birth, low birth weight and perinatal mortality. Iron deficiency is the most common cause of anemia, and most pregnant women benefit from daily supplementation of 30 to 60 mg of elemental iron. Folic acid deficiency, the most common cause of megaloblastic anemia in pregnancy, is associated with open neural tube defects and other complications. It is recommended that daily supplementation with 4 mg of folic acid be started at least one month before conception and continued through the first trimester. Other less common causes of anemia include glucose-6-phosphate dehydrogenase deficiency, sickle cell trait and disease, and the thalassemias. The primary care provider should emphasize risk evaluation, dietary and preconceptual counseling, testing and appropriate treatment.
Subject(s)
Anemia , Pregnancy Complications, Hematologic , Anemia/diagnosis , Anemia/metabolism , Anemia/therapy , Anemia, Iron-Deficiency/diagnosis , Anemia, Iron-Deficiency/drug therapy , Anemia, Iron-Deficiency/metabolism , Anemia, Sickle Cell/diagnosis , Anemia, Sickle Cell/etiology , Anemia, Sickle Cell/therapy , Female , Folic Acid Deficiency/diagnosis , Folic Acid Deficiency/drug therapy , Folic Acid Deficiency/metabolism , Humans , Pregnancy , Pregnancy Complications, Hematologic/diagnosis , Pregnancy Complications, Hematologic/metabolism , Pregnancy Complications, Hematologic/therapy , Thalassemia/diagnosis , Thalassemia/drug therapyABSTRACT
Within recent years, the general educational arena has placed a greater emphasis on the incorporation of critical thinking within student curricula. Critical thinking as a learning tool teaches students the art of reason and logic, and encourages the preparation for dynamic situations that occur outside the classroom. The authors believe that critical thinking and nurse-midwifery are inherently intertwined. To utilize the nurse-midwifery management process in the provision of sound and safe practice, the nurse-midwife must also be a critical thinker. The management process of data gathering, assessment, diagnosis, planning, implementation, and evaluation parallels the domains of the critical thinker's process: intellectual standards, modes of reasoning, traits of mind, reasoning abilities, and elements of thought. This article presents similarities between the two models.
Subject(s)
Models, Nursing , Nurse Midwives , Nursing Process , Thinking , Humans , Nurse Midwives/organization & administration , Nursing, SupervisoryABSTRACT
A university-based program of perinatal care was extended to serve a spectrum of underserved populations through both urban and rural outreach. The program centered on the use of a multidisciplinary health care team comprised of a physician, nurse-midwife, health educator, social worker, nutritionist, pediatric nurse-practitioner, and patient case manager for health service delivery. It emphasized a decentralized service model with central referral and management of high-risk problems. The program has become a model for perinatal access and is reflected in current state legislation. The implementation of this program in four geographically rural communities is presented. Selected indices of perinatal outcome are presented, with San Diego County, CA, and national statistics as comparisons.
