Q: When is a new midwife ready to be a good preceptor? How
much experience should she or he have?
A: In my first job as a new graduate, I was permitted to practice on my
own for six months and subsequently expected to have a midwifery
student with me for most of my shifts, either for antepartum or
intrapartum care. I felt prepared enough for antepartum care, but I did
find intrapartum teaching to be more challenging as a new practitioner
myself, especially since I trained in a direct-entry program. I was open
with the students and told them, “If I can do this, so can you if you
study hard!” And I think I demonstrated to them never to be ashamed
or afraid to ask for help if something is presenting that you do not feel qualified to do, because patient safety is Priority Number One.
A: I believe this should be determined on a case-by-case basis. Each
practice is so varied by state and throughout the country. Certain new
midwives could do 20 births a year or 150 births a year, they could
work with medical students and residents or not, they could see many
higher risk patients or none at all. Personally, I felt ready after a year or two in practice. I did come to midwifery with previous teaching
experience, so I may have felt ready sooner than other new midwives.
When is a Midwife Ready to be a Preceptor?
A: My thinking is three to five years, depending on the volume of
practice experience. The didactic lessons are two dimensional, and
precepting helps to bring that information into a 360-degree view.
Among the programs, there seems to be some variation regarding the
requirements a student must meet to graduate. Therefore, the preceptor
must take the burden, the responsibility to ensure the student receives
a just understanding of the CNM role, the impact of poor judgement,
the clarity of hearing and meeting the needs of the woman, and the
understanding that the women’s needs supersede those of the CNM’s
agenda. Only experience can mold this. Thus, a preceptor must have
the time to evolve and be comfortable in this role.
It would be ideal if precepting could be integrated throughout the
didactic learning, with much watching and listening to start with
and slowing adding the skills until the transformation. Much like a
caterpillar to a butterfly, it takes time and patience to nurture and
build a safe practitioner.
Quickening is the official member publication and digital news site for the American College of Nurse-Midwives. Content is written by and for ACNM members and staff.