How Do I Start a Midwifery Practice
The first thing you need to do when starting a Midwifery practice or service is investigate the licensure and regulations process in the state where you want to practice. If you are planning to practice on a state line or in more than one state, you will need to look into each state’s regulatory requirements.
You need to understand how the design of a practice is legally regulated. What are your states regulation requirements for consultation, collaboration, and referral to a higher level of care for clients who need care outside the Midwife scope of practice? Do you license yourself with the State Board of Nursing? The Board of Healing Arts? The Health Department or Public Health Board?
If you’re operating a midwife-owned practice, other essential elements include finding a location. It’s probably going to be based on insurers who are going to reimburse you and assurance you can be credentialed from the hospital at which you want to attend births.
What’s your staffing model going to look like? Solo or with a couple partners? How are you going to run the office and non-medical side of the practice? There are a variety of things to consider just in terms of legal and financial questions.
If you are attending women in a hospital, does that hospital have bylaws that allow non-physician providers to maximize hospital privileges. If they do, what do those bylaws indicate in terms of scope of practice, admission, and discharge: things that are elemental to hospital providers, and delineated in bylaws of that hospital.
Then, is there an understanding of how to create a list of privileges that allows the Midwife to practice the scope that they are trained to do and beyond. Can they first assist? Can they repair a third or fourth degree? Can they use a vacuum extractor? I’ve mentioned things that are all not taught in Midwifery education, but are skills Midwives do beyond their educational training through additional certification programs. How do you credential somebody who wants to first assist in surgery with your patient needing a c-section? How do you know they have the necessary skills and training? There are mechanisms that can be put in place to assure competency.
How to Facilitate Difficult Conversations in the Workplace
The idea is how to approach the problem with some preparation to dispel what you would call “intention invention” or projecting what the other person is doing and why they are doing it.
Try to come up with some ideas, so that you have some kind of empathy. Try to start a dialogue in an open question environment. You will then begin to discover things you might not have found if you stayed mired in the original position.
Facilitating difficult conversations requires the ability to look at things with an empathy to the other side, with some preparation in regards to what you really want, how you want it, and alternatives to how you want to get there.
Good negotiators are civil, well informed, will challenge tresspasses, but be quick to forgive those tresspasses. To train people to deal with difficult conversations is a matter of both an empathetic review of how to deal with conflict, but also raising the bar on what truly is difficult.
In many environments, when you are dealing with one that is in collapse, every issue is so impacted and so layered with “this is what it really means” kind of statements, that almost anything from the whether the birthday cake for the last employee birthday was vanilla or chocolate becomes an issue. If you can figure out how to raise that bar back up, past an adult level and into a professional level of what an insult really is, you can then have conversations that ease those tensions and open up dialogue.
A difficult conversation tries to drill down to a more granular level on both sides of what really are the needs, concerns and points on both sides.
How to Negotiate Mutually Beneficial Employment Agreements
For the most part, a normal employment agreement for a Midwife deals with salary versus how many hours they work on call and in the office, as well as other perks. The way a compensation package is structured in terms of rate and style can help alleviate overwork, feelings of underappreciation, and burnout.
The most common issue that normally happens is that after an employment agreement is entered into, the number of working hours increases substantially. There are also questions related to the realities regarding malpractice coverage, non-compete agreements, and a host of other legalities.
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