Discovering the role of the labour and delivery nurse

Abstract

Midwives are becoming accepted as legally sanctioned health care providers in Canada. In Manitoba, the impact of midwifery on the role of the labour and delivery (L&D) nurse is unknown. The role expectations of the midwife are well described in the literature. The role expectations of the L&D nurse have not been as well described--indeed, the role expectations of the generic nursing role are not well understood, within or without the profession. The purpose of this study was to describe the perceived role expectations and role performance of L&D nurses in Winnipeg, and the perceived factors affecting role expectations and performance. This was facilitated through the use of the conceptual frameworks of role theory and organizational culture. L&D nurses had clear views of their role expectations and role performance; there was no role ambiguity. Role expectations demonstrate considerable overlap with midwife role expectations in the literature. Perceived role performance emphasized the importance of psychosocial support to women and families. This is contradicted by other research. Factors affecting role expectations and role performance were many, including staff relationships, health care reform, and nursing administration. The philosophical model of birth L&D nurses described was more of a medical model than the midwifery model. This may prove to be the greatest source of conflict between midwives and nurses.