The best thing about working as a nurse midwife is sharing in the most monumental moment of a family’s life in the delivery of their children. My patients come back for well woman care we continue our partnership in their care. This continuity of care is a very rewarding part of my career.
About Julie Stembridge, MSN, CNM: Julie Stembridge is a Certified Nurse Midwife at WakeMed Physician Practices, where she provides full-scope midwifery care and primary health care services to women across the lifespan, from adolescence on through menopause. Her daily primary care responsibilities include conducting primary care health assessments, providing reproductive health consultations to women across the lifespan, and advising on and providing birth control. As a CNM at WakeMed, Ms. Stembridge also sees patients in the hospital setting, attending deliveries and providing care to pregnant women before, during, and after the birth of their child.
Prior to her role at WakeMed, Ms. Stembridge worked as a Clinician at Community Health Clinic, and as a Certified Nurse Midwife at Women’s Health Practice. Ms. Stembridge earned her Bachelor of Science degree in Neuroscience and Psychology from Allegheny College in 2004, and subsequently enrolled in a Bachelor’s to MSN program at Vanderbilt University, where she received her MSN in 2006.
[OnlineFNPPrograms.com] Could we please have an overview of your academic and professional path in nursing and nurse midwifery?
[Julie Stembridge, MSN, CNM] I studied Neuroscience and Psychology at Allegheny College for undergrad. After realizing I had a love for women’s health, I researched the philosophies behind advanced practice nursing and physician assistant careers. After several years as a hospital volunteer and countless hours of soul-searching, I realized my heart and interest was in nursing–more specifically, nurse-midwifery. I enrolled in the Vanderbilt MSN bridge program for non-RNs where I earned by RN license and then continued on to specialize in Nurse-Midwifery and gain my MSN.
While in graduate school my clinical rotations included a private practice with deliveries at a small community hospital near Atlanta, labor and delivery at Vanderbilt University Medical Center and Nativiti birth center. Since graduation I have worked at Women’s Health Practice, a small private OB/GYN practice in rural Illinois doing full scope midwifery, at Community Health Clinic providing women’s health and family planning services, and for the past five years with WakeMed Physician Practice OBGYN, a hospital owned group in Raleigh, North Carolina.
[OnlineFNPPrograms.com] Could you please describe your role and responsibilities as a Certified Nurse Midwife (CNM) at WakeMed Physician Practices? What kinds of medical conditions and challenges do your patients face, and how do you help them manage their conditions?
[Julie Stembridge, MSN, CNM] As a CNM, I share in the management of our antepartum, intrapartum, postpartum and GYN patients with the other CNMs and MDs in our group. My responsibilities are split between time in our outpatient office and time on call at the hospital. In the office I see women of all ages before, during and after pregnancy. I may see a young woman who is concerned about her periods followed by a middle aged woman who is starting menopause. Our pregnant patients are also seen in the office for their prenatal and postpartum visits.
During my work with patients, I review a patient’s history, perform an exam, order testing and initiate a plan of care. A typical day in the office includes prescribing medications, procedures like ultrasound, Nexplanon and IUD placement. In the hospital I am responsible for seeing all of the patients from our group. This can include laboring moms, postpartum patients, pregnant patients with complications or postoperative gynecology patients. In the hospital I perform exams, order testing, interpret testing and perform procedures such as ultrasound, normal vaginal delivery, laceration repair, neonatal circumcision and assisting the MD in cesarean section. Our team at the hospital includes physicians, nurses, surgical techs, neonatal nurse practitioners and respiratory technologists. The majority of my patients are pregnant or recently postpartum.
At WakeMed the neonatal team provides care immediately at and following delivery. Some nurse midwives deliver newborn care for the first month of life depending on their clinical arrangement. As a Nurse-Midwife, I specialize in the care of normal healthy women but I’m also trained to recognize deviations from normal. Should a patient develop a high risk problem, I will be able to continue to participate in her care with MD collaboration. I’m fortunate to work with a great group of providers who all strive to deliver individualized care based on our patients’ desires.
[OnlineFNPPrograms.com] You were also CNM at Women’s Health Practice, and a Clinician at Community Health Clinic. Could you elaborate on your daily and long-term responsibilities in these roles, and how they differ from your work at WakeMed Physician Practices?
[Julie Stembridge, MSN, CNM] I previously worked at Women’s Health Practice, which was a private practice with deliveries at two small community hospitals. This position was very similar to my current position at WakeMed in that I had both in office and on call responsibilities. There were only two providers doing deliveries at Women’s Health Practice–myself and one MD. In addition to the office and on call responsibilities, I also taught group childbirth education classes for the patients.
Community Health Clinic was very different from Women’s Health Practice and WakeMed in that the clinic was staffed by APRNs and focused on well-woman care and family planning. Since I was the only licensed provider most days, this helped me gain great confidence and independence in my decision making. However, my love for pregnancy and delivery pulled me to WakeMed where I could continue caring for women during pregnancy and delivery.
[OnlineFNPPrograms.com] You also interned at the Nativiti Birth Center and at Vanderbilt University Medical Center–could you elaborate on what you learned about nurse midwifery through these two internships?
[Julie Stembridge, MSN, CNM] I had the opportunity to have clinical rotations at a variety of settings during my midwifery program. I spent time at a private practice in the suburbs, a free standing birth center and a large tertiary care center. My time at Nativiti Birth Center was invaluable in learning the importance of patient education, fostering close relationships with patients as well as the impact of healthy behaviors on pregnancy outcomes. As a free standing birth center, patients were entirely low risk and very motivated to eat well and exercise. Consequently, patients had great outcomes. The majority of deliveries there were waterbirths and required one-on-one support throughout the labor. At Vanderbilt University Medical Center, I worked alongside our program faculty with a population of patients that varied from low risk to high risk. We often had multiple patients laboring at once thereby requiring development of triage and time management skills.
[OnlineFNPPrograms.com] Why did you decide to become a certified nurse midwife, and what professional experiences helped you determine that this area of advanced practice nursing was the right one for you?
[Julie Stembridge, MSN, CNM] Starting in junior high, I worked summers as a hospital volunteer. After several summers I talked my way into an assignment on labor and delivery and saw my first few deliveries. Though I loved witnessing such a monumental occasion for women, I felt as though the relationship between provider and patient was lacking a sense of partnership. I felt there had to be a different way to approach pregnancy and women’s health. Throughout my time in college, I continued to volunteer and research careers in women’s health. I had considered medical school, PA programs and CNM programs. I knew that for me it was important to specialize and know one area inside and out rather than having a basic understanding of many specialties. The more I learned about the nursing philosophy of holistic, education based care, the more I confident I was in my decision to pursue my degree in Nurse Midwifery.
[OnlineFNPPrograms.com] What have been some of the most rewarding aspects of working in women’s health and nurse midwifery? On the other hand, what specific challenges have you encountered in this field of work, and how have you managed these challenges?
[Julie Stembridge, MSN, CNM] The best thing about working as a nurse midwife is sharing in the most monumental moment of a family’s life in the delivery of their children. My patients come back for well woman care we continue our partnership in their care. This continuity of care is a very rewarding part of my career. Any career in the medical field comes with challenges–long shifts, emotionally challenging cases and lives depending on your decisions. I’d recommend that anyone considering a career in advanced practice nursing spend as much time as possible shadowing, talking with and working alongside practicing APRNs so that they can enter the career with a reasonable understanding of the demands.
[OnlineFNPPrograms.com] For current and prospective MSN students who are interested in becoming certified nurse midwives, what advice can you give them about optimally preparing for this field while pursuing their degree?
[Julie Stembridge, MSN, CNM] Students interested in midwifery should spend as much time as they can in contact with patients. Any experience with volunteering, community health fairs and shadowing will be invaluable in cultivating the confidence it takes to educate and effectively communicate. In school, nurture friendships with your classmates; they are the only people who will truly understand the challenges you are facing. Lastly, it is crucial for students and new midwives to care for themselves by eating well, exercising and maintaining a strong support system.
Thank you Ms. Stembridge for participating in our APRN career guide interview series!