RULE 067.00.94-003 - Chapter 6 - Nurse Midwife Regulations

RULE 067.00.94-003. Chapter 6 - Nurse Midwife Regulations

INTRODUCTORY PROVISIONS

A. These regulations are adopted and approved by the Arkansas State Board of Nursing under the authority of the State of Arkansas.

B. These regulations govern the educational and experience requirements and practice standards for nurses practicing in the expanded role of nurse midwife as defined in Arkansas Code Annotated, Section 17-86-502.

C. Pronouns indicating gender refer to persons of both sexes.

SECTION I DEFINITION OF TERMS

For the purpose of this chapter, the following definitions apply:

A. BOARD- the Arkansas State Board of Nursing.

B. NURSE MIDWIFE (NMJ)- a person possessing the qualifications for a registered nurse in the State of Arkansas who is certified as a nurse midwife by the American College of Nurse Midwives (ACNM) or the equivalent as defined by the Arkansas State Board of Nursing.

C. CERTIFIED NURSE MIDWIFE (CNM) - a person educated in the two disciplines of nursing and midwifery, who possesses evidence of certification according to the requirements of the American College of Nurse Midwives, and holds current licenses as a registered nurse and as a certified nurse midwife in the State of Arkansas.

D. NURSE MIDWIFERY- the management and monitoring of care of essentially normal women and newborns: antepartally, intrapartally, postpartally. This occurs within a health care system which provides for medical consultation, management, and referral and is in accord with ACNM Standards for the Practice of Nurse Midwifery.

E. HEALTH CARE SYSTEM- any place where a nurse midwife is practicing.

F. GUIDELINES- written documentation outlining the protocol to be followed by a nurse midwife for handling a particular medical situation or resolving a medical problem.

G. CONSULTATION- the process of collaboration.

SECTION II SCOPE OF PRACTICE

A. NURSE MIDWIFERY

The practice of nurse midwifery means the performance for compensation of nursing skills relevant to the management and monitoring of the woman and her newborn infant throughout the course of a normal maternity cycle, including pregnancy, labor, spontaneous birth and six-week postpartum period, in consultation with a physician licensed under the Arkansas Medical Practices Act who has obstetrical privileges in a hospital.

B. SERVICES AND RESPONSIBILITIES

The extent of services, responsibilities and required supervision of nurse midwives, and the accompanying responsibilities of consulting physicians, must be defined by each agency or clinic in a policy statement, job description, or other appropriate document.

C. DELEGATED DUTIES

The consulting physician may delegate to the nurse midwife those procedures in which she has demonstrated competence.

SECTION III GUIDELINES

A. The certified nurse midwife shall practice in accordance with written guidelines developed with a consulting physician. These guidelines shall be in compliance with the statutes of the State of Arkansas and approved by the Board.

B. The written guidelines shall be developed in consultation with a physician licensed under the Medical Practices Act who has obstetrical privileges in a hospital. These guidelines shall include:

1. Established procedures for the management of common medical problems associated with antepartal, intrapartal, and postpartal care.

2. The scope of practice as defined in these regulations.

3. The degree to which supervision and collaboration are required, including when medical determination to administer a particular treatment is indicated.

4. Joint review at least annually and revision as necessary.

C. An agreement shall be on file in the Board office prior to practice.

SECTION IV LICENSURE

A. REQUIREMENTS FOR LICENSURE

Documents required to support an application for licensure to practice as a nurse midwife shall include the following:

1. Proof of current licensure as a registered nurse in Arkansas.

2. Proof of current certification by the American College of Nurse Midwives or the equivalent as approved by the Board.

B. USE OF NOMENCLATURE

Any person who holds a license to practice as a nurse midwife in this state shall have the right to use the title "Certified Nurse Midwife," and the abbreviation "CNM."

No other person shall practice, advertise as, assume the title of, or use the abbreviation "CNM," or any words, letters, signs, or figures to indicate that the person is a certified nurse midwife.

C. RENEWAL

The Board uses a system of staggered biennial renewal of licenses (odd-even years by birthdate).

1. A nurse midwife who does not receive a renewal notice from the Board by the first of the month of the expiration of her license should contact the Board office. It is the responsibility of the licensee to keep the Board informed of any change of name and address.

2. Any nurse midwife who allows her license to lapse may be reinstated by making application for renewal and paying the renewal fee plus a penalty.

D. TEMPORARY PERMIT

1. The qualifications for a temporary permit to practice as a nurse midwife are:

a. Current licensure as a registered nurse in Arkansas.

b. Proof of application for or awaiting the results of the initial ACNM examination for certification.

c. Determined by the Board to be otherwise qualified.

2. The fee for the temporary permit shall be in keeping with other temporary permit fees required by the Board.

3. The permit to practice as a nurse midwife shall become invalid upon notification to the applicant of the results of the initial certifying examination.

E. REVOCATION, SUSPENSION OR REFUSAL TO LICENSE

1. The Board may revoke, suspend, refuse to license or renew the license of any nurse midwife if the Board finds evidence that the person fails to meet the requirements stated in these regulations.

2. The Board may refuse to issue a license, certificate or registration to any applicant if the license, certificate or registration of such person has been revoked or suspended or placed on probation and not reinstated by the jurisdiction which took such action.

F. FEES

The Board shall charge initial and renewal licensing fees that are in keeping with fees charged certified registered nurse anesthetists and registered nurse practitioners.

SECTION V BOARD REVIEW PROCEDURES

A. The Board may review the guidelines governing the practice of any nurse midwife upon request.

B. In the event a nurse midwife is brought before the Board for a hearing, a member of the State ACNM Chapter shall be notified.

SECTION VI PRECEPTORSHIP

These regulations do not prohibit a student in an ACNM approved nurse midwifery program from serving a preceptorship provided:

A. The student holds a current license as a registered nurse.

B. The student is in the presence and under the direct supervision of a currently licensed certified nurse midwife preceptor or a licensed physician with obstetrical privileges in a hospital.

C. The midwifery care is confined to the educational requirements of the course.

(2/28/1994)

The following state regulations pages link to this page.