What is your risk in a doula role as an RN?

[HeartsOpenWide, RN]

I am currently training to be a certified Doula while I am in nursing school. I have one more birth before my certification. My concern is if I will still be able to practice as a Doula if I am a RN due to liability issues. If I am an RN in a Doula role at a home birth, if something goes wrong could I be at risk even though the Doula role does not include medical interventions, being that I will have more education and training than the average non-nurse Doula?

[Thornbird]

Once you are an RN you are responsible all the time for using the knowledge, assessment and judgement skills of an RN. But, when working as a Doula would be limited to the activities a Doula is certfied for. You would not be able to administer any meds for example. You should identufy yourself as a Doula only and not an RN Doula to avoid confusion for the patient, family and doctor/midwife. The only issue with your nursing license would be if something went wrong that an RN should recognize and you failed to take an appropriate action that a "prudent" off-duty RN would, such as advise that medical intervention is needed. If you advertise and are hired as an Nurse/Doula then the usual professional standards could apply including supervision by a MD/CNM and possibly being given orders by them. Since this is not the role of the Doula, I wouldn't think you would want that. It could help though if something starts happening that you can inform them that you are also an RN and medical intervention is needed. Think of all those people who run child daycare businesses and advertise that they are nurses. They are not offering nursing services but letting parents know that they have that level of competency to make them feel more secure that their child is in good hands. It's always tricky when you have more than one certification/licensure to stay within scope of practice for the area you are working. You may also check your state regs and with the BON for further info, but this is generally accurate.

[HeartsOpenWide, RN]

I would not advertise myself as a RN/Doula. I was just wondering if being an RN in a Doula roll would have any liability risks. I was thinking a long the lines of a home birth situation (all though I have never been to one). The midwives that do HB in my area are mostly LM (I am in CA). I thinking worse case scenario where I am hired as the doula but something goes wrong and since I have more knowledge as a nurse than a regular stand alone doula I have to help in some way beyond the doula role and the baby or the mother dies...even though I was hired as the doula, had to help beyond the role of a doula because of my knowledge as nurse (even though I am not the nurse in this situation), and was not the midwife

[Thornbird]

In that situation, you would only be expected to recognize what was happening, call 911 and help out as a Good Samaritan because you would not be on duty as a professional nurse. You would not be in a position to take any medical orders. So you could not be expected to intervene at more than layperson level. Only your level of knowledge would be an issue, not skills or procedures. The worst case that could happen would be if you didn't recognize the problem and they could say that as an RN you should have realized earlier that there was a problem and gotten mother to a hospital. There are RN's working as Doulas, hopefully, you can connect with some of them.

[fertile_myrtle]

I am an RN that assists in homebirths in my area. I do not assist in a "doula" role though. I am a birth assistant for the attending CNM. Feel free to PM me anytime.