Curriculum Foundations in Recent Years

Curriculum Foundations

In recent years the medical field has transformed from authority-based to consumer based. Whereas once patients followed their doctor's orders and always listened to their advice, modern patients question care and have a higher expectation of time and explanations in all areas of healthcare. Those that are not satisfied with the services of the traditional medical field, seek alternative treatments, moving away from hospitals and doctors. Nowhere is this need more obvious then labor and delivery. Starting in the 1960's a movement arose for patients seeking reform in the childbirth process and desiring more control over the entire process. This social trend of consumer style of birthing has led to a divide between hospitals and patients. The only way this divide will be met is through modification of the childbirth education courses offered to nurses and labor and delivery staff to keep the staff apprised of the current consumer trends in childbirth.

The program I have investigated is the labor and delivery education program through Scottsdale Regional Hospitals in Scottsdale, AZ. The hospital services an upper class area of Arizona where patients are predominately white and Latino and are highly educated. Because of the higher level of education, many Arizona families are becoming critical of typical nurse-related labor and delivery practices and are questioning the standard of care interventions used by the hospital.

In Arizona, the growing social trend is for a natural, non-intervention birth. In fact, many families are opting for hiring a doula to avoid the use of unprepared nurses (Sargent, 2009). To fix this problem, nurses entering the labor and delivery ward should be required to complete a birth techniques class that teaches acceptable non-intervention techniques for those mothers who wish to utilize them. Techniques such as having women labor on their feet, minimizing the use of monitoring, avoiding cervical checks, and encouraging the use of water should become familiar to the nurses (Zwelling 2006). Additionally, nurses should be educated on proper communication and education techniques for their patients. These techniques allow the women the ability to make an informed decision and studies have show, will be more satisfied with the outcome (Simkin, 2007).

The three external frame factors that will effect this improvement in curriculum over the next five to 10 years are the political climate, need for the program, and demographics. The political climate within the United States is one moving away from conventional medical practices and moving toward alternative medicine. With President Obama's healthcare reform bill, it was made clear that costs within healthcare and the liability from certain procedures is unacceptable. Educating nurses in natural birthing techniques saves hospitals the excessive expenses associated with interventions and results in a happier and less likely to complain patient. Very few hospitals within the United States open support natural birth techniques. In fact, most nurses at the hospital were unaware of different birthing positions, the advantages of walking while in labor, or the advantages of water during labor. This ignorance will only result in a loss of patients who will seek out those hospitals with educated staff. Finally, the demographics within the hospital I observed demand better care. The families entering the labor and delivery floor were educated upper-class families who expected the nurses to be fully educated and helpful.