CNM vs. PA vs. CRNA

[carmelite]

Heya!

Sorry, this question is a bit far ranging, and I'm not sure if I'm posting it in the right place.

I am about to finish my prerequisites for an ADN program, and am a bit lost about my next steps. My plan was to get my ADN, and then work as an RN while pursuing an ADN to BSN, with the goal of eventually moving on to CNM or CRNA.

A school counselor I spoke to yesterday put some doubts in my mind about this process, though. He said that it will be quite difficult to pursue my BSN and Specialty Master's degrees while continuing to work as an RN, and that opportunities for financial aid at these levels are quite limited. He suggested that I instead pursue a PA degree. I have about 18 more credits left to have an AS in Biology (could finish that by the end of this coming summer), and then I could complete my BS in Biology in 2 more years and apply to PA school. He felt like this would be easier for me b/c I would get to my master's more quickly, and wouldn't have to work while in school as much. He said my grades are good enough to get quite a bit of scholarship money throughout my undergraduate education, and then I would likely only need loans for the 2 year PA process. Basically, he said that I would be working sooner if I took the ADN route (likely finished in about 3 years), but it then might take me many years to work my way through to my masters. and I may get stuck for a long time at the staff nurse level (not that that's terrible, just not my ultimate goal). If I took the PA route, it'd be 4-6 years before I finished, but then I would be done with school and could just focus on my work and family, and, while I was in school, I could just be focusing on school and not on working at the same time.

A bit of background on me: I am 32 years old and I have a 2 year old little boy right now, and am married but my husband makes almost no money (don't ask, this is a whole separate issue). My family is largely living off of Financial Aid money (Grants, Loans, and Scholarships). I am a good student and have made A's in all of my prerequisite courses (had a 102 average in Anatomy, actually:). I was actually a national merit scholar coming out of high school, and chose to not attend college at all at the time, thereby waiving my full scholarship to the University of Texas (once again, don't ask) Oh, the follies of youth! I am attending Austin Community College right now, which has a great ADN program, but school has been incredibly stressful b/c I struggle to get enough childcare and am always running out of money. I am determined to finish and to do well, though, b/c I see no other way forward for my family's survival and for financial independence for myself.

The other piece of the puzzle, besides the time and money involved in achieving my degree, is what it is that I ultimately want to be doing. I started this whole journey with nursing b/c I was inspired to become a midwife and a lactation consultant. I feel most drawn to caring for women during labor and delivery, caring for newborns, and helping women and babies during the postpartum period. I am a bit concerned about the CNM route, though, b/c I have heard quite mixed reviews on job satisfaction from CNMs. It seems like many work quite long hours, have less autonomy than they would like to have, and have difficult schedules overall, especially if they have young families. On the other hand, I have heard from some CNM's that love their work and have found jobs with more balanced schedules. The CRNA route is attractive b/c of the obvious financial benefits. Also, everything I have read says that CRNAs have very high job satisfaction, work with a lot of autonomy, and are highly respected.

To be honest, being a PA seems the least attractive in some ways to me. I know there are a wide variety of choices within that field, but it seems like overall they have less autonomy than CNMs or CRNAs. Also, they make a bit less money (on average) than either of the other 2 fields. The main benefit of the PA route, as far as I can tell, is that it is so flexible. Once you are a PA, you can switch specialties with relative ease. Also, as previously mentioned, if I were to go the PA route I could be finished with my degree quite a bit sooner, and would largely be focusing just on school and family (which is a lot already) and not trying to work, raise a family and go to school at the same time.

I know that's a lot, but anyone got any thoughts? I'm trying to make some decisions before I have to register for Spring classes next week!

[sashamom]

You have an impressive story to say the least! I wish I could offer you some advice but I am a career changer with 2 small kids currently taking my prerequisites here in Houston through HCC. My plan is to get an advanced Nursing degree though I'm not sure which one. I'm most interested in CRNA having spoken with a few about their careers.

i have an MBA and have worked in corporate healthcare for many years and since having kids, have been drawn to a more fulfilling career in patient care.

i would love to hear how your story progresses. Best wishes!

[PMFB-RN, RN]

A school counselor I spoke to yesterday put some doubts in my mind about this process, though. He said that it will be quite difficult to pursue my BSN and Specialty Master's degrees while continuing to work as an RN, and that opportunities for financial aid at these levels are quite limited. He suggested that I instead pursue a PA degree.

That counselor has no idea what he is talking about. RN to BSN programs are desinged for working RNs. many thousands of nurses earn their BSN while working full time.

You won't be able to workl if you go to CRNA or PA school. Many nurses complete NP programs while working.

[btab3]

I agree with the above post. I know many many ADNs that do their BSN while working and even online. Hospitals will even pay for you to get your BSN. Plus you would be working all that time while making money and furthering your career. I believe your choice should be more focused on whether or not you would rather be a a PA or a CNM or CRNA. Be happy with what you want to do in life because you will be doing it everyday!

[Corey Narry, MSN, RN, NP]

I think you should explore the options beyond what the counselor said and investigate the separate fields on their individual merit. There is a CRNA and a CNM forum here but the PA forum is not on this site.

The counselor is right in saying that the CRNA specialty will take the longest out of all three. You would need to get the ADN, work as an RN in critical care while obtaining a BSN before being considered eligible to apply to CRNA programs.

However, he is not quite accurate in terms of the CNM route. CNM programs vary. There are ADN-CNM, non-nurse to CNM, and traditional BSN to CNM programs. L&D experience is not always required. You can search all those options in a neatly organized database on the ACNM website: Midwifery Education Programs.

[carmelite]

Hey! I just wanted to follow up on this post. I can't believe it's been 2.5 years since I posted this. So much has changed. I am in my 2nd year of the ADN program, and should be graduating in December of this year. I am still at a loss to decide on a specialty, with CRNA and CNM still topping my list of possibilities. I ended up ruling out the PA route, and don't regret it at all. Thank you to all of you for your input on that issue!

It turned out, BTW, that the academic advisor who was advising me to go into a PA program had a "relationship" with the 4 year university that he was trying to encourage me to attend. I found out about his conflict of interest when I spoke to another adviser, who seemed pretty upset a the obvious bias her colleague was displaying.

So, just a word of warning! Academic advisers are not always acting solely in the best interests of the students!!

[traumaRUs, MSN, APRN]

Congrats on being in the nursing program.

Moved to the Student NP forum.