Role of the registered nurse in primary health care: meeting health care needs in the 21st century.

There is widespread interest in the redesign of primary health care practice models to increase access to quality health care. Registered nurses (RNs) are well positioned to assume direct care and leadership roles based on their understanding of patient, family, and system priorities. This project identified 16 exemplar primary health care practices that used RNs to the full extent of their scope of practice in team-based care. Interviews were conducted with practice representatives. RN activities were performed within three general contexts: episodic and preventive care, chronic disease management, and practice operations. RNs performed nine general functions in these contexts including telephone triage, assessment and documentation of health status, chronic illness case management, hospital transition management, delegated care for episodic illness, health coaching, medication reconciliation, staff supervision, and quality improvement leadership. These functions improved quality and efficiency and decreased cost. Implications for policy, practice, and RN education are considered.

Applicants to a nurse-midwifery education program disclose factors that influence their career choice.

The purpose of this study was to explore the factors that influenced nurses to choose midwifery as a career path. Forty-two application essays to the Frontier School of Midwifery and Family Nursing were reviewed. Content analysis was used to identify themes and to explore motivational factors. Six themes concerning motivation to become a midwife were identified. These included personal birth experience, love of maternity nursing, seeing midwifery as a calling, encouragement from others (especially midwives), an epiphany moment, and using nursing as a stepping stone to midwifery. The six themes were seen in more than 20% of the application essays. Several potential recruitment strategies stem from these themes, especially the importance of nurse-midwives' encouragement of others to pursue a midwifery career.

First birth stories of student midwives: keys to professional affective socialization.

The purpose of this article was to examine the professional affective socialization of midwifery students. Students from the Community-Based Nurse-Midwifery Education Program (CNEP) tell about their first births in their Lost My Hat stories posted on the electronic bulletin board of the Frontier School of Midwifery and Family Nursing. Qualitative analysis of 38 of these stories showed internalization of the values and beliefs of the midwifery model of care by students. Themes of the Lost My Hat stories were congruent with some of the aspects of the Model of Exemplary Midwifery Practice developed by Kennedy. Major themes included the circle of safety provided by the preceptor and a woman-centered approach to care. These findings can help midwifery educators promote socialization of students in the profession.