Tuesday, January 17, 2012

Heading into battle. . .

The nursing and midwife license battle continues. . .

The letter in the newspaper brought a quick response on my nursing license, which was quickly followed by a judgment on my midwife license application, too. (In short, for both: no).

It was sometime last month when it hit me—I mean, it really hit me—that I am the only American midwife who is trying—or has tried--to work in Norway. I may not be the first one to have tried. . . but there don’t seem to be any others currently working here, so that leads me to believe that I might be the only one who ever has tried. The magnitude of that hit me. ME. ME. The first one, the only one. The trailblazer. Essentially fighting this alone. No rule book. No advisor. No one (of consequence) on my side.

Completely by chance (and the world of Facebook), I discovered that a guy from my high school (just a year ahead of me) graduated from an American med school, finished his American residency, and somewhere in the process married a Norwegian woman. He is now living and working in Norway, the only American educated physician working in Norway as a physician. Honestly: what are the chance of that??? We come from a high school of, what, 1200 students in a relatively small town in southeastern Minnesota, and it produces the only American physician and potentially only American midwife in Norway???

He, too, faced years of fighting with SAFH over his education, his internship, his residency, his specialty. What finally made it happen for him was that his wife was an advisor to the Prime Minister of Norway, and at some point she met the Minister of Health. “Hey my husband. . . an American doctor. . . can’t work here. . . how dumb is that???” A little this, a little that. . . and his license was approved.

Unfortunately, I don’t have the Minister of Health on my side.

On January 18, Erik and I will travel to Oslo to have a face-to-face meeting with a live human being at the nursing/midwife license (SAFH) office, and discuss the continued disagreements over my nursing education. It’s basically come down to that 15 years ago, I was 2 weeks short on psychiatric nursing clinicals, and a few more weeks short on medical/surgical clinicals, and need to make up that time. (No, 15 years of professional experience doesn’t count). But recently, I’ve spent days assembling page after page of documents (95 and counting) to formally log my complaint on their judgment on my midwife application.  Fight #2. To be fair, my original application did not have pieces of information that would have been helpful—namely, the number of patients I had contact with in a variety of settings as a midwife student, yeh these 9-10 years ago.

In some disturbing ways, I like the process of digging up information, mounting an argument, an assembling the documents; it’s the part of me that enjoyed the research process for my master’s thesis, too. We found a quote in an ACNM (American midwife) document that is golden, my home run of quotes: “ACNM competencies and standards are consistent with or exceed the global competencies and standards for the practice of midwifery as defined by the International Confederation of Midwives”. In short: American midwives are educated according to these international standards, and Norwegian midwives are educated according to these same international standards.

Any dear readers who are still with me. . . bless you.

So while I feel like that should end all squabbling over whose midwives are better educated, and can’t we all just be friends (and colleagues)???—deep down a part of me knows this won’t be good enough. Hence the other 94 pages of supporting documents.

Wish me luck. 


  1. Best of luck! You are a great midwife and I hope things will resolve so that you can practice in Norway!

  2. Best of luck for January 18th, I will be keeping my fingers crossed for you! It's insane that you are still not able to work here. Such a stupid waste of your skills and talent. I have spoken to Aftenposten about my 17 month struggle with the UDI for family reunification and it will be in this Fridays edition. It's important to fight for what we deserve/believe in!

  3. I second Ann. Hopefully all your struggles will help the next American midwife.

  4. My (Norwegian) in-laws always say things like it's "no problem" for Americans/foreigners to find work in Norway, but knowing enough about the system and the culture, I'm (sadly) not surprised to hear of your struggles. I will keep my fingers crossed for you!

  5. Hi Emily,

    Last I commented, I promised to comment more. Truth is, I suck at commenting (though in my defense, I am a *great* pen pal!).

    GOOD LUCK! This kind of hoop-jumping is infuriating ANYWHERE, but to be doing it in not your native tongue/country is just a whole other level of crazy! I am keeping my fingers crossed for you. If you can accomplish all that you have in your short time in Norway, you will accomplish this also, I am certain of it.

    Best of luck to you! We're still planning a visit to friends (who unfortunatly don't have any medical or govt connections) in Oslo over the Easter/Spring break and we'd still love to meet up with you for an afternoon.

    Hang in there Emily!!
    Best, Suzy C.

  6. Emily!

    I can't believe this! I am a doula and nursing student. I am planning to go for my CNM after nursing school. My boyfriend and I have been talking about moving to Norway because he is a wooden boat builder and loves Scandanavian design. I just started researching getting my master's in Norway, but now I am wondering if it will just either A) be a nightmare, or B) easier because you have blazed the trail.

    Anything you'd say to someone in my shoes right now? It's not like we're moving tomorrow, but I don't want to keep on dreaming up this impossible dream for a year and a half from now when I graduate with my RN.

    All the best to you. Sounds like it's been quite the journey so far!

    from the U.S.

    1. Well Kara, I wish I had something encouraging to say to you, but I don't. My situation has been a Nightmare, and I don't anticipate it being any easier for anyone in the near future. One of my mistakes was moving here before I had gotten authorization as a nurse. It had been relatively easy to do before, and we assumed it would continue to be so.

      So, one recommendation I have is 1) get your Norwegian authorization in order before you move. This will require a certain level of language proficiency and very likely some clinical practice time in Norway, although hard to be sure at this point.

      There is only one midwifery master's program in Norway--it is just beginning in Bergen--so the standard for a midwifery education in Norway is not up to US standards. All the other midwifery programs are two year programs, but not a master's degree. I have an American friend who got her RN in the States and her midwifery degree in Norway (she has a Norwegian husband and is planning on living here forever) and she did some of her clinical praksis in the States, and her opinion (among many others I have talked to) is that the training an American midwife receives is superior to that of Norwegians. And, if you would have any plans on not staying in Norway forever, I would recommend getting the CNM, because a Norwegian midwife degree would never get approved in the States.

      Like I said, wish I had something encouraging to say. And it's a possibility that I will have blazed the trail, but there is no guarantee and I wouldn't bet the future of my (or your) career on that. I guess my best recommendation is bide your time, and get your education, in the States while you can, and maybe once you're finished with all your training, Norway will have gotten its shit together.