Avery M D, DelGiudice G T
J Nurse Midwifery. 1993 Mar-Apr;38(2 Suppl):9S-17S. doi: 10.1016/0091-2182(93)90092-u.
Nurse-midwifery practice has been defined by the American College of Nurse-Midwives (ACNM) as "the independent management of essentially normal newborns and women ... occurring within a health care system which provides for medical consultation, collaborative management or referral .... "As the health care delivery system in the United States becomes increasingly complex and reliant on new forms of technology, it has become necessary to clarify roles and responsibilities for the nurse-midwife. In addition, mechanisms for acquiring new skills and for collaborating with physician colleagues must be well understood. A question frequently asked is where the boundaries of nurse-midwifery practice end and those of medical practice begin. Although practice scenarios vary for individual nurse-midwives and nurse-midwifery services, recent statements approved by the ACNM Board of Directors discuss these issues in an attempt to clarify the potentially confusing areas of collaboration and skill acquisition. This article explores the areas of expanded nurse-midwifery practice and collaborative management. Although individual clinical skills are not necessarily endorsed, a step-by-step approach that nurse-midwives can use for incorporation of new skills is presented. The concepts discussed will be a valuable tool to nurse-midwives in their practice.
美国护士助产士学院（ACNM）将护士助产士的执业定义为“在一个提供医疗咨询、协作管理或转诊服务的医疗保健系统内，对基本正常的新生儿和妇女进行独立管理……”。随着美国医疗保健服务系统日益复杂且依赖新的技术形式，明确护士助产士的角色和职责变得十分必要。此外，还必须清楚了解获取新技能以及与医生同事协作的机制。一个经常被问到的问题是护士助产士执业的边界在哪里，而医疗执业的边界又从何处开始。尽管不同的护士助产士个体以及护士助产士服务的实际情况有所不同，但ACNM董事会最近批准的声明对这些问题进行了讨论，试图厘清协作和技能获取方面可能令人困惑的领域。本文探讨了护士助产士扩大执业范围和协作管理的领域。虽然不一定认可个人的临床技能，但文中介绍了护士助产士可用于融入新技能的循序渐进的方法。所讨论的概念将成为护士助产士在其执业过程中的宝贵工具。
