PRESIDENT’S

ADDRESS

1973

ACNM ANNUAL

CONVENTION

Elizabeth S. Sharp, C.N.M., Dr. P.H.

The next two years represent an important period for the American College of Nurse-Midwives. I imagine that every incoming president feels that her term of office just happens to be an especially important period for the organization, and I, too, share that feeling. Why? Perhaps I can tell you best by sharing with you a poem which has special meaning to me as a nurse-midwife. The poem, written by a physician-poet from Atlanta, Dr. John Stone, is entitled “The Crossword Puzzle Maker.” I t seems to describe how I often feel as a practicing nurse- midwife. Let me share it with you.

When the letters refuse to fit into place, she thumbs her dictionary for words she’s never used: ancient Egyptian gods and planets, Emperors and gnus.

Over my morning coffee I am unaware of her, the blocks and blur of her hop-scotch mind.

Nor can she know, who holds back answers for tomorrow’s paper,

what my world is about,

the comers I have worked myself into, with no words to get me out.*

As a nurse-midwife, I find lots of corners in my professional life, “with no words to get me out.” And from talking with other nurse-midwives, I

*John Stone, The Smell of Matches, New Brunswick, N.J.: Rutgers Univer- sity Press, 1972.

5 1 Summer I 9 73, Vol. XVIII, No. 2

believe we have many corners in com- nurse-midwife can be in the field and mon. I will mention just a few: how to be devoid of the stress. Even students integrate educational programs with and new graduates are caught up in services; how to establish and maintain the problems of developing nurse-mid- supportive and productive relation- wifery, as they are in the very settings ships with nursing; how to work with where nurse-midwives are ironing out physicians - from the obstetrician problems, or trying systems of care, or deadset against nurse-midwifery to the curriculum designs for the first time. residents who are supportive but obliv- Our growth in the number of ious to OUT problems as they concen- nurse-midwives a n d services is trate on their own learning; how to gratifying and reassuring, but it may solve problems related to salaries for be at a critical point. A close knit nurse-midwives; how to COW with group of nwse-midwives no longer legislative matters; and last, but not exists as in the days when every one least, how to cover a tWenty-fOUr hour knew everyone else and commmica- service when nurse-midwives are tion was much simpler. Yet effective scarce. communication channels are essential

to enable nurse-midwives to share their midwives, we have developed to the experiences, the comers they have point where we have an identity. gotten themselves into, and how they Nurse-midwifery has made its mark. have gotten out. By sharing, stress and We are now faced with the dilemma of dismay can be reduced. Despite the how to expand nurse-midwifery in uniqueness of each setting, common- this country with the misfortune of alties in problems pertain across set- having to do so when the health care tings. Through sharing, nurse-midwives system is in such a chaotic state. As learn the pitfalls to avoid, and time we are expanding nurse-midwifery, we and energy are not wasted going down are encountering new situations and futile paths. problems for which we must find the An essential reason for communi- answers. Crossing uncharted waters is cation is to “program for success.” We difficult, and as John Stone implied in are accumulating more and more his poem, no one knows what our evidence about what makes nurse- world is about. midwifery successful. Rather than

Change and new experiences are allowing nurse-midwives to fail in their challenging, exciting, and necessary for endeavors, which is Personally trau- the growth of a profession, but take matic and certainly detrimental for the their toll in stress. As Eric Hoffer profession, how much better it would wrote about change: “It needs inor- be for us to share what works. This is dinate self-confidence to face drastic not to discowage innovation, but change without inner trembling.” merely to advocate that nurse-

Without doubt, stress is synony- midwives venture forth where condi- mous with being a nume-midwife tions are favorable and in a manner today, not in relation to our direct conducive to success. practice but rather in terms of the Communication is a vital part of forces that impinge on our practice: decision-making. We are still in the now and for the future. Hardly any stage where the decisions and actions

Through the hard work of nurse-

Journal of Nurse-Midwifery / 6

of one nurse-midwife or group of There is a need to facilitate com- nurse-midwives establish precedence munication among nurse-midwives in and thus determine the range of order to help in the formulation of possibilities for others. The whole answers for getting us out of our matter of legislation attests to this. comers. We must continue to develop

Although we have many corners which we can and will get into, it is necessary to stress that we already have had experience with how the American College of Nurse-Midwives can be helpful to nurse-midwives who are pioneering in new services and programs. Our Guidelines for Estab- lishing Q Nurse-Midwifery Service, our Approval of Educational Programs are all products of our organization and demonstrate its value.

Why are the next two years critical? Consider what needs to be accomplished in legislation, certifica- tion, team relationships, and prepara- tion of nurse-midwives. Each of us will be involved in different areas on different levels. The pace of change will be rapid and we have to be pre- pared for quick responses, many times in the midst of a busy day; for example, when you receive a phone call from a hospital administrator in your state who wants to know how to employ nurse-midwives and you try to answer his questions as you are about to take a multigravida to the delivery room.

It is important to realize that we are promoting and developing nurse- midwifery through working with and talking to non-nurse-midwives. There- fore, what we think and how clear we are about nurse-midwifery, matters greatly. Furthermore, if we are consis- tent with what others in nurse- midwifery believe, care about, and wish to see promoted, we can move forward with a united front.

our dictionary of answers. We cannot afford to do otherwise lest we bum out our energy. Our own conflicts and dilemmas must be ironed out within the professional organization before presenting nurse-midwifery to others on the health care team. Otherwise we will diminish our effectiveness by going outside our own organization as a “house divided.”

What does all this mean in terms of what the ACNM must have? First of all, strength in membership is vital. Our membership is growing and will continue to do so as the number of certified nurse-midwives increases. But lapsed members, no matter how few, is a concern. It is alarming to have an uninvolved group of professionals out- side the organization possibly influ- encing the course of nurse-midwifery. We need new members and the return of the former members.

The second thipg we must have in the ACNM is members knowledgeable about what is going on. Quickening, the new Journal of Nurse-Midwifery, reports at Local Chapter meetings, the Annual Convention are some exam- ples of sources of information.

A knowledgeable membership promotes the third essential ingredient for a strong organization; that is, each member respqnding to issues and helping, for example, with the prepara- tion of position papers and docu- ments. In reviewing the recommenda- tions from the recent Workshop on Service and Education held in Atlanta, it was encouraging to find that so many recommendations supported

7 1 Summer 1973, Vol. XVIII, No. 2

collaborative efforts among nurse- midwives.

Finally, if the ACNM is viable, and I believe it is, the membership must respect what the ACNM stands for and promotes. As I said earlier, a united front must be presented on the outside. On the inside, however, the profession can and should have differ- ences of opinion; that is how growth takes place. In a nurse-midwifery “call” room on labor and delivery, a sign said;

NEVER, FOR THE SAKE OF PEACE AND QUIET DENYYOUROWN

EXPERIENCE OR CONVICTIONS

- DAG HAMMARSKJOLD

I know that we will continue to find in nurse-midwifery that our differen- ces in education and professional work experience can be used to our advantage.

Nurse-midwives seldom question their potential contribution to family care, but sometimes doubt their abili- ty to effect significant changes in care. I think we can effect changes, by working toward being a vital part of the health care system in order t o pro- vide the care we believe in. To do so means more than getting the word nurse-midwife in the dictionary; it means putting together many words for solving the puzzle of how we are going to expand nurse-midwifery in the next few years to safeguard the future.

Journal of Nurse-Midwifery / 8