TABLE 3.
Employment characteristics of Texas nurse-midwives (N = 141)
| Characteristic | n | % | Characteristic | N | % |
|---|---|---|---|---|---|
| Employment Status | Primary Responsibilitiesa | ||||
| Full-time | 91 | 64.5 | Antepartum | 90 | 63.8 |
| Part-time | 17 | 12.1 | Intrapartum | 86 | 61.0 |
| Per diem | 4 | 2.8 | Newborn | 25 | 17.7 |
| Retired | 17 | 12.0 | Gynecology | 73 | 51.8 |
| Unemployed | 7 | 5.0 | Primary Care | 46 | 32.6 |
| Other | 5 | 3.5 | Clinical MW education | 26 | 18.4 |
| Clinical Practice-primary | MW educational program | 5 | 3.5 | ||
| Yes | 103 | 73.0 | Administration | 15 | 10.6 |
| No | 38 | 27.0 | Research | 7 | 5.0 |
| Primary Employment Site | Other/NA | 6 | 4.3 | ||
| Hospital | 30 | 21.3 | Clinical Hours/week | ||
| Military/Federal | 5 | 3.5 | <10 | 6 | 5.4 |
| Health Science Center | 7 | 5.0 | 11–20 | 6 | 5.4 |
| Community Clinic | 3 | 2.1 | 21–32 | 11 | 9.9 |
| NFP Clinic | 3 | 2.1 | 33–40 | 44 | 39.6 |
| HMO | 0 | – | 41–60 | 38 | 34.2 |
| Self | 7 | 5.0 | >60 | 6 | 5.4 |
| Physician practice | 25 | 17.7 | Prior Clinical Experience Required for Employment | ||
| Midwifery group practice | 12 | 8.5 | Yes | 31 | 22.6 |
| State government | 1 | 0.7 | No | 67 | 48.9 |
| Educational institution | 19 | 13.5 | Don’t know | 9 | 6.6 |
| Other | 15 | 10.6 | N/A (self-employed) | 3 | 2.2 |
| CNM Salary (with experience) | N/A (not in midwifery practice) | 27 | 19.7 | ||
| <$50,000 | 3 | 2.2 | CNM Salary (no prior experience) | ||
| $50,001–60,000 | – | – | <$50,000 | 5 | 3.7 |
| $60,001–70,000 | 5 | 3.7 | $50,001–60,000 | 5 | 3.7 |
| $70,001–80,000 | 7 | 5.1 | $60,001–70,000 | 6 | 4.4 |
| $80,001–90,000 | 23 | 16.9 | $70,001–80,000 | 16 | 11.9 |
| $90,001–100,000 | 32 | 23.5 | $80,001–90,000 | 35 | 25.9 |
| $100,001–110,000 | 16 | 11.8 | $90,001–100,000 | 21 | 15.6 |
| $110,001–120,000 | 2 | 1.5 | $100,001–110,000 | – | – |
| >$120,001 | – | – | $110,001–120,000 | 1 | 0.7 |
| Unknown | 25 | 18.4 | >$120,001 | – | – |
| Income from CNM Practice (gross) | Unknown | 22 | 16.3 | ||
| <$30,000 | 5 | 3.6 | Hospital Staff membership | ||
| $30,001–50,000 | 3 | 2.2 | Medical, full | 12 | 11.4 |
| $50,001–75,000 | 16 | 11.6 | Medical, associate | 12 | 11.4 |
| $75,001–100,000 | 47 | 34.1 | Allied Health | 39 | 37.1 |
| $100,001–125,000 | 30 | 21.7 | Don’t know | 10 | 9.5 |
| $125,001–150,000 | 6 | 4.3 | NA (out-of-hospital) | 19 | 18.1 |
| $150,001–200,000 | 4 | 2.9 | NA (do not attend births) | 17 | 12.1 |
| >$200,001 | 0 | – | Other | 1 | 0.7 |
| NA (not in midwifery practice) | 27 | 19.6 | Hospital Voting Privileges | ||
| Prescriptive Authority | Full, like physicians | 7 | 29.2 | ||
| Yes | 96 | 93.2 | No voting privileges | 12 | 50.0 |
| No | 7 | 6.8 | Don’t know | 4 | 16.7 |
| Prescriptive Authority Required for Employment | NA (don’t provide intrapartum care) | 1 | 4.2 | ||
| Yes | 73 | 70.9 | Admit Patients to Hospital Under Own Name | ||
| No | 15 | 14.6 | Yes | 27 | 25.7 |
| Don’t know/other | 15 | 14.6 | No | 63 | 60.0 |
| DEA Licensure Required | Don’t know | 2 | 1.9 | ||
| Yes | 54 | 52.4 | NA | 13 | 12.4 |
| No | 45 | 43.7 | Professional Liability Insurance | ||
| Don’t know | 3 | 2.9 | Yes | 81 | 77.9 |
| Other | 1 | 1.0 | No | 23 | 22.1 |
| Designated Midwifery Practice Director | Extent of Liability Coveragea | ||||
| Yes | 58 | 56.3 | Occurrence | 61 | 43.3 |
| No | 31 | 30.1 | Claims-made | 49 | 34.8 |
| NA (solo practice) | 5 | 4.9 | Tail | 36 | 25.5 |
| Other | 9 | 8.7 | Liability Coverage Effect Practice Ability | ||
| Service Director Background | Yes | 13 | 12.5 | ||
| CM | 1 | 1.0 | No | 91 | 87.5 |
| CNM | 49 | 49.5 | Named as Defendant for Malpractice | ||
| Registered Nurse | 2 | 2.0 | Yes | 12 | 11.5 |
| Physician | 16 | 16.2 | No | 92 | 88.5 |
| Business/health Admin | 7 | 7.1 | Nature of Physician Consultation | ||
| Don’t know | 0 | – | 1 or more attending | 82 | 78.8 |
| NA (solo practice) | 14 | 14.1 | Residents | 10 | 9.6 |
| Other | 10 | 10.1 | No arrangements | 10 | 9.6 |
| Not nurse midwife | 7 | 7.1 | Don’t know | 2 | 1.9 |
| Collaborative Practice Guidelines | Type of Physician Consultationa | ||||
| Yes | 89 | 85.6 | OB/GYN | 84 | 91.3 |
| No | 14 | 13.5 | MFM | 55 | 59.8 |
| Don’t know | 1 | 1.0 | Family Medicine | 8 | 8.7 |
| Review of Collaborative Practice Guidelines | Other | 4 | 4.3 | ||
| Annually | 58 | 65.2 | Access to Consulting Physicians | ||
| Determined by physician | 16 | 18.0 | CNM employer | 21 | 22.8 |
| As requested by MW | 12 | 13.5 | Employed by same organization | 48 | 52.2 |
| Don’t know | 8 | 9.0 | External to MW practice | 25 | 27.2 |
| Other | 6 | 6.7 | In-house | 20 | 21.7 |
| Quality Review Process | Off-site, available as requested | 9 | 9.8 | ||
| Yes | 71 | 68.9 | Other | 5 | 5.4 |
| No | 24 | 23.3 | Need for Formal CNM-MD Practice Agreement | ||
| Don’t know | 8 | 7.8 | Yes | 35 | 34.3 |
| Nature of Quality Reviewa | No | 54 | 52.9 | ||
| M&M review | 43 | 30.5 | No opinion | 13 | 12.7 |
| External peer review | 25 | 17.7 | Need for MD Prescriptive Authority Supervision | ||
| Internal process | 73 | 51.8 | Yes | 5 | 4.9 |
| Nursing peer review | 14 | 9.9 | No | 87 | 84.5 |
| Risk management | 47 | 33.3 | Undecided | 11 | 10.7 |
| Do not participate | 5 | 3.5 | |||
| Don’t know | 14 | 9.9 | |||
a
Could answer more than one category.
Where numbers do not equal 141, there were missing responses. Percentages may not equal 100 due to rounding.
CNM, certified nurse-midwife; OB/GYN, obstetrician/gynaecologist; MFM, maternal–foetal medicine; M&M, mortality and morbidity.