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CNM Burnout

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I just came across an old topic that was talking about CNM burnout rates. The poster claimed that most CNM's burn out around the 5 year mark. Seems bizarre and incorrect to me. Any thoughts?

LibraSunCNM, MSN

Specializes in OB. Has 10 years experience.

That does seem a little bizarre. I know several midwives who have stopped doing deliveries and taken office/clinic/Planned Parenthood jobs where they didn't have to work nights. But I don't actually know any midwives who have left the profession completely. Just my completely anecdotal info!

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience.

Not a CNM, but I've been a patient for four of my five pregnancies and births, and now stick w/ them for well-woman care as well. Anecdotally, many of these individuals had been practicing quite a long time, and then there were the younger, newer CNMs. What LibraSunCNM said sounds reasonable. I know my husband's best friend is married to a family practice MD; she stopped taking OB patients after their kids were born, because it made her schedule so unpredictable. In her practice, the patient's primary was basically on call for the two weeks leading up to the EDD, and then she'd stay with the pt throughout labor even if she had to call in the OB-GYN MD. She enjoyed this part of her work, but it was just too hard once she became a mom who is "on duty" 24/7/365.

queenanneslace, ADN, MSN, APRN, CNM

Specializes in Nurse-Midwife.

I know more than one midwife who has burnt out. My anecdotal report doesn't really mean anything.

I've spoken to midwives who haven't burnt out YET, but struggle to keep working in their jobs - for various reasons: job demands, client demands, and challenging relationships with the medical community. Midwifery doesn't exist in a bubble - and often midwives are doing much, much more than providing health care services to their clients and patients. They're negotiating with physicians, they're negotiating with insurance companies, they're running businesses that are open 24/7.

I spoke recently with one midwife who said she felt like she was constantly protecting her patients from interference from the nursing and OB staff. She said she felt like she couldn't leave the labor room, or her patient's labor would be manipulated to fit into the obstetrical mold. That gets tiring.

There are a number of articles that discuss midwifery burnout - in the US and worldwide - that offer more perspective on it.

Occupational burnout and work factors in community and hospital midwives: A survey analysis

BURNOUT EXPERIENCED BY NURSE-MIDWIVES - Beaver - 2011 - Journal of Nurse-Midwifery - Wiley Online Library

http://www.academicjournals.org/article/article1379405698_Alparslan%20and%20Doganer.pdf

Maybe there is a bubble where midwives practice and feel joyful and fulfilled every day they go to work - they don't feel like they have to defend and justify their practice - and where they feel that they are paid adequately for the services that they provide. I do hear, quite often, that midwives struggle to do this. There is still a lot of misunderstanding about nurse-midwifery - and CNMs are still fighting battles for recognition, respect and payment for the services they provide.

As a provider, you must learn self-care before you can care for your clients. Work life balance is very important to the equation.

Some midwives choose to practice is a large setting where they have predictable days on/off and do not put themselves on/call 24/7 for the sake of the client. For the family, it is a special event and birth is typically a one or two day event in their otherwise full life. For the midwife, it would be an EVERY night event if you were to guarantee the clients that you will be there for them no matter what!

Healthcare is an industry, and as such, is ever-changing. Policies are dictated by law, by hospital, by practice, by insurance reimbursement, and by collaborating physicians. If a practice is to survive and the midwives are to flourish, they must know themselves and what they need to be able to flourish. Then they must understand the culture and laws that affect their practice. It is complex and midwifery is more than just catching babies.