A man ... Certified Nurse Midwife?
Even before my nursing education began I received advice that as a man, and former Marine, I might find a better fit in the emergency department, intensive care or transport nursing. Great areas. Areas I have enjoyed working in as a nurse. But my heart is and always has been obstetrics. Having grown up in the '60s I assumed societal gender was a thing of the past. I quickly found this is not necessarily the case in labor and delivery, which was, and is, an area with predominately female providers many who believe that only women have the empathy needed to care for women in labor. Over the years I have also found many female providers, nurses, CNMs, who staunchly support me, and other men in labor and delivery, treating us not only as equals but also as nurses equally capable of caring for women in labor.
I also heard, and still do hear, that women in labor would rather be cared for by another woman. After 28 years in women's health, 18 years as a Certified Nurse Midwife, I have found that women in labor want the best possible care they can get; the size, color and gender of the provider are secondary. In all of my labor and delivery and women's health care experience, I have been rejected because of my gender only five times; four for religious reasons.
There are no accurate numbers on how many labor and delivery RNs are men. Minority Nurse reports that approximately 5.8% of all registered nurses are men (MinorityNurse.com http://www.minoritynurse.com/minority-nursing-statistics). Anecdotal evidence indicates that 0.05 to 1% of bedside labor and delivery RNs are men. The American College of Nurse Midwives approximately 2% of Certified Nurse Midwives are men (American College of Nurse Midwives http://www.midwife.org/index.asp?bid=277#). Certainly men, who are nurses and want to be in women's health, especially labor and delivery, need to learn from or female colleagues. Be open to 'non-male' ways of doing things. This should be obvious to any man in nursing. But it is also important to remember that it can be very appropriate to bring some 'maleness' into bedside practice.
* When I first walk into the room I greet the client and then I go out of my way to acknowledge the partner, especially if the partner is a man. Shake hands. Introduce myself. This is reflective of what our society considers normal 'male' behavior and helps to reestablish that although I am a man, I am the RN and this is normal.
* There is a fair amount of nursing research, as well as research in other fields, about an 'abiding presence'. I want the woman's partner to be that abiding presence. Often the partner, especially if a man, is set aside, even encouraged to stand or sit in the corner. I make it a priority to keep the partner at the bedside; right at the bedside. Keeping them close to the laboring woman acknowledges their importance.
* Touch is a basic tenet of nursing practice. In labor and delivery this can be augmented with a washcloth or hand fan. These are all interventions the laboring woman's partner can embrace. These activities will also keep the partner close.
* Keep the laboring woman covered. Obvious, but over the years I've watched many providers, RNs, CNMs, MDs who quite literally 'flip' the sheet up onto the woman's abdomen to do a vaginal exam. They know better. But performing 'compromising' exams becomes routine for us. However, it is not routine for the woman in the bed or her partner. I use a lot of draw-sheets. One around each leg will increase her sense of being covered, during an exam or even during delivery. Women in labor often want to move around, even when they are in bed. Kneeling, standing, sitting, switching sides, if we keep her shoulders and chest covered with a draw sheet she will feel less like she is being 'exposed'. Keeping the woman as covered as much as possible is not only professional but also shows courtesy to her and her partner.
* I often talk with the laboring woman while standing next to her partner. If not right next to her partner at least on the same side of the bed. When she looks up to see me I want her to see me behind or next to her partner. I am in their lives for a short while. I want the laboring woman and her partner to have, and leave with, the sense that they are the team; and I am only there to help them.
* Always make sure the partner changes a few diapers while in the hospital. After 28 years and three children of my own, I've become pretty good at it. I'll show the partner, or new mother, how to change a diaper, and then I immediately take it off so that one of them can put it on. Their satisfaction in being able to change the diaper far outweighs any wastage.
* If the woman is breastfeeding I make sure that I get the partner alone and tell them an old midwifery trick. Whenever the baby is nursing, bring the woman a drink. Water. Milk. Tea. Whatever it is she likes. Don't ask if she wants something; just put the glass within reach. It is a normal physiological response to breastfeeding to want to replace the fluids lost in the breast milk.
Nurse-Midwifery is the reason I became a nurse. Since I have been a nurse I have had the opportunity to work in a number of other nursing areas and loved what I did. But I always come back to women's health and especially labor and delivery. Although there have been challenges I have also found many colleagues who have helped me live my dream.
Bob Green RN, CNM
Bob Green RN, CNM
Clinical Assistant Professor
East Carolina University College of Nursing
Greenville, NC 27858
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|Date:||Jun 22, 2013|
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