I am a New Graduate “direct entry” midwife. Recently, due to staffing shortages at my facility, I have been redeployed to a general nursing ward to work in the capability of an AIN. In that role, I am caring for male patients under RN supervision. I feel unsafe. What should I do?

A “direct entry” or “single registered” midwife holds midwifery qualifications, without prior nursing registration. These midwives are trained specifically in knowledge, skills and practice relating to women’s health, reproductive and sexual health, and child and family health care only. Due to this specific scope of practice, these midwives cannot be responsible for the direct care of general patients, including males.

Rather, as per the Decision-Making Framework for Nursing and Midwifery, “direct entry” midwives can be delegated tasks to assist in the care of general patients, for example observations, medication administration, answering call bells, or any other skill within their scope of practice. They must then report all findings back to their nursing colleague, who will have ultimate responsibility for the patient. This is an example of team nursing/midwifery, where each practitioner provides their expertise collaboratively.

In this situation, it is important that you bring such scope of practice concerns to the attention of the Team Leader, NUM and/or the after-hours manager as soon as possible. This protects not only your registration, but also patient wellbeing.