Scope of Practice of a CNM, WHNP in rural Haiti

For those of you in the health profession in the U.S., it is very important to know your scope of practice- who you are allowed to care for and what care you are allowed to provide with your given degrees, credentials, and licences.

Well, when you’re the only provider staffing a clinic in rural Haiti, scope of practice rules go out the window!  I’m not going to perform surgery on anyone or do anything that I was not trained to do, but I can’t tell the gentleman who just walked an hour or paid a moto taptap to get here that I can’t treat him because he isn’t a woman!

My newly expanded scope of practice makes for exciting days!  There is never a dull moment in the LiveBeyond Clinic!

The first couple of days of the week are always busy because of illnesses and injuries that occurred over the weekend.  So far this week (Monday and Tuesday), my patient encounters have included:

  • the most severe conjunctivitis I have ever seen
  • an itchy bellybutton
  • a dental follow-up (s/p abscess with extraction)
  • eye irritation
  • a miscarriage
  • 8 ob ultrasounds (for FHTs not heard or Size >/< Dates)
  • HTN follow-up
  • high cholesterol
  • bilateral leg pain, intermittently falls or can’t stand
  • presumed kidney stones
  • UTI x 2, UTI follow-up x 1
  • CAUTI follow-up
  • unilateral axillary lymphadenopathy of unknown origin
  • blunt-force laceration to hand
  • scabies
  • pain and wounds d/t motorcycle MVA x 3
  • difficulty sleeping
  • post-viral rash
  • 20-30 routine antepartum visits
  • very large keloid
  • headache
  • stomachache
  • newborn check-up

. . . and probably more that I didn’t write down!!!

This week, I even got to add the role of pharmacist when someone brought me a prescription for Tylenol and Multivitamins that they had gotten from the doctor in town.

It’ll be even more exciting once we start having births (which should be any day now. . . We have around 12 women in the Maternal Health Program who are due any minute.)

So, if you’re ever getting bored with your job, come work a week with me at the LiveBeyond Clinic!  You can sign up at and e-mail me at if you have any questions.


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