Clinical Nurse Midwives (Cnms)

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Clinical nurse midwives (CNMs) are registered nurses, specialized in midwifery and nursing. They practice according to the standards of the American College of Nurse-Midwives ( ACNM). To keep their designation of CNM, they must have their certification and complete the continuing education requirement every five years. There are three major regulations that affect the role and scope of the nurse midwives in many states. They are, the need of a physician to supervise or a written collaborative agreement with a physician, a physician’s supervision in prescribing medicines or the level of prescriptive authority and the regulation controlling the midwives and out-of-hospital birth (OHB) (Walker, Lannen & Rossie, 2014). If the CNM could not get a physician to sign the agreement, they will not have the hospital admitting privileges. This would also cause economic disadvantages to the CNMs. They could lose their reimbursement. The supervisory requirement makes the practice of the CNMs impossible. This restriction could force the CNMs to move out of the state to be able to work. The prescribing authority restriction can lead the CNMs to discontinue their practice. This happens especially when there is no physician willing to partner with the CNM. If the prescription practices are not clear, it can create confusion. …show more content…

In the states that do not regulate, the OHB the reimbursement can be a problem. There are chances of inconsistencies in the communication between the OHB service provider and the medical facility if an emergency transfer of care warrants (Walker, Lannen & Rossie,

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