Credentials

As part of my class towards my BSN, I am asked to answer an opinion based question with adequate support of that opinion. I will share with you here question #2 and my response.

Question:
What do you think should be the entry level of education into professional nursing practice?

My response:
The topic of academic credentialing is one that has fascinated me, personally, for some years now. When I first became interested in childbirth, I slowly realized that I felt lead to become a midwife. One who would calmly guide birthing women during their pregnancies and births, facilitating gently childbirth and peaceful postpartum experiences.

Historically, women received this type of care generally from the women in their families, who would all surround the birthing woman and lend her their strength and enhance her endurance and specifically from the community midwife. However, throughout the years, matriarchal childbirth has faded behind the medicalization that is now commonplace.

In researching my available choices regarding my educational path into midwifery I had to consider many factors. Many of which focused on the "Professionalism" of Midwifery and the formal education required in order to be considered a "Professional."

There are two types of midwives, basically. Direct-entry midwives (those who learn through apprenticeship or direct practice) and Certified Nurse Midwives (those who learned the skill of nursing first, then continued into specialized training to become CNMs).

In my heart, I embraced the direct-entry (home birth) midwives. I value their innate trust in the birthing process and the respect and empowerment they infuse into the women they touch. However, I had serious reservations about the social standing of these midwives in today's society, leaving them open to legal problems and uncertainty.

Home birth midwives are not viewed as "professionals." They do not acquire their knowledge through well-defined academic pathways. Nor do they necessarily have to belong to or adhere to any professional organization or standard of practice. Furthermore, they are not protected by the profession's standards and codes, as outlined in Nunnery (1997).

So, in making my own personal choice about my journey into midwifery, I had to weigh all of the information. Finally, I was led to the decision to submit to the social authority placed on Registered Nurses and Certified Nurse Midwives. In doing so, I am also embracing the umbrella of protection provided by adhering to their established scope of practice, standards and code of ethics.

However, this is not to say that I do not respect direct-entry midwives or their mode of education. In fact, their mode of education make sense to me. The new apprentices learn at the knee of experienced midwife. They learn the process of childbirth inside and out with an experienced provider, hands on.

This process looked more and more appealing to me as I got deeper and deeper into nursing school. I would stay up late into the night making a 6 page nursing care plan for an elderly man with COPD. I would think to myself, "HOW is this going to help me become a good midwife?" I would wonder if my time couldn't be spent more wisely going on prenatals with the community midwife, observing the way she palpated the uterus and identified the presenting part.

But, I would remind myself, society has recognized this pathway, and I was committed to making the best choice for not only me but my family as well.

So, I can see the value in many various modes of education. Formal, academic education in a university surpasses other modes of learning merely by allowing one to become academically credentialed, something that is of high value in our society, perhaps to the point of hindering free trade and inflating the growing job monopoly created by the education-based hierarchy (Collins, 1979). It does not, in my opinion, automatically, make one more knowledgeable, more prepared or more able to provide care for someone.

In today's society it is a necessity to complete a formal academic education in order to provide healthcare. It protects the healthcare provider and the patient alike. Apprenticeships into nursing are not available. Nor, would they be socially acceptable.

Considering the available options of entry into nursing, it is my opinion that it would be acceptable to enter into nursing at the diploma level just as much as the baccallareate level as long as the combination of academic knowlege and skill competency is present.

A single piece of paper does not say all there is to say about ones skill level or ability to provide safe, competent care.

Collins, R. (1979)The credential society. New York. Academic Press, 1979. Retrieved September 2, 2008, from http://home.earthlink.net/~fheapblog/id14.html

Nunnery, R. K. (1997). Advancing Your career: Concepts of Professional Nursing. F. A. Davis Company. Philadelphia, PA.