Anyone enter CNM with little to no nursing experience?

[misslolalady]

Hi all,

Just curious if there are any people who were accepted to schools with little to no nursing experience. I am going to be graduating nursing school soon, and looking into Midwifery. I know that many schools require L&D (even though I really don't have much desire to work there), however, with the poor job prospects for New Grads in Southern California, I have no idea where I will end up for my first job, or when exactly that will happen. I understand that experience (in pretty much any area) would be advantageous.

I am looking at online/distance programs.

Thoughts?

[klone, MSN, RN]

I don't know of any programs that will accept someone with no nursing experience. I think the minimum is 1 year of nursing. Some programs require L&D experience, but others do not.

[arabianeyez83]

I think personally I would want some kind of nursing experience before becoming an advanced practice nurse.

[starryeyed]

I had no nursing experience before starting school. I did a bridge program to become an RN and then a midwife without working as a nurse. I know my school would take students that don't have nursing experience, and most other schools that have bridge programs. I have been working as a midwife for almost a year. I think there are both positives and negatives to not having L&D experience. L&D nursing is really a different role than a midwife. Classmates that had nursing experience had to overcome that hurdle. However, they were familiar with L&D and the hospital setting. I think not having nursing experience makes that transition to midwife a little more challenging, because you don't have the familiarity. My thoughts were I would be a better midwife with two extra years of practice versus to years spent as an L&D nurse.

[starryeyed]

i had no nursing experience before starting school. i did a bridge program to become an rn and then a midwife without working as a nurse. i know my school would take students that don't have nursing experience, and most other schools that have bridge programs. i have been working as a midwife for almost a year. i think there are both positives and negatives to not having l&d experience. l&d nursing is really a different role than a midwife. classmates that had nursing experience had to overcome that hurdle. however, they were familiar with l&d and the hospital setting. i think not having nursing experience makes that transition to midwife a little more challenging, because you don't have the familiarity. my thoughts were i would be a better midwife with two extra years of practice versus to years spent as an l&d nurse.

[fmwf]

I had no nursing experience before starting school. I did a bridge program to become an RN and then a midwife without working as a nurse. I know my school would take students that don't have nursing experience, and most other schools that have bridge programs. I have been working as a midwife for almost a year. I think there are both positives and negatives to not having L&D experience. L&D nursing is really a different role than a midwife. Classmates that had nursing experience had to overcome that hurdle. However, they were familiar with L&D and the hospital setting. I think not having nursing experience makes that transition to midwife a little more challenging, because you don't have the familiarity. My thoughts were I would be a better midwife with two extra years of practice versus to years spent as an L&D nurse.

I really do appreciate the balance that starryeyed brings to this question that many ask. Some are very adamant about this, I can understand what the emotional value could be for a preceptor who has the task of bringing someone along who has had no L&D (or nursing).

However, in our understanding of midwifery and yes nurse-midwifery, L&D culture is decidedly different--an auxiliary to the obstetrics model.

Midwifery one the other end of the maternity services spectrum is so much more than intrapartum and childbirth. Cliche, but it is holistic. It is not an elevated L&D nurse or a physician-extender. So much so that in all fairness we could eliminate special folks who have the midwifery trait/calling/goal/bugg from the equation by stipulating that folks have the coveted highly competitive L&D experience. And doing that we forget that we need people who can do a lot more than just the L&D part--like building community programs and approaches, promoting lactation, postpartum, essential caring and education, adolescent services, international health....etc. I really hope that this "must have L&D experience for midwifery school" thing is rethought or at least modified. It can be done. It can think of a few ways to do it. In fact there are advantages to doing this. There are schools that make this possible. I like the idea of putting in your extra work on the midwifery end instead of the L&D end.

[CNM2B]

I agree with you and believe that everyone who becomes a CNM with some sort of life-experience (which we all have!) brings something valuable to the table.

However, I do have to say that experience as an L&D nurse (or any type of nurse, for that matter) is a lot more than simply going through the motions of assisting with delivery. I worked as an RN in critical care for several years and have now spent 6 months in L&D. I now see that intangible strength that experience can bring--those gut feelings that can't be learned from a textbook or during clinical experiences. Those wise nurses I work with who have done it for years and years give me a ton of insight that I am so grateful to get--insight learned from years on the job and assisting with thousands of births. Insight that I am slowly developing on my own as well.

Although the holistic approach to midwifery is SO IMPORTANT, at that moment when I experience my first shoulder dystocia or other emergency, I'm going to go back into this current experience for strength. And while strip reading isn't so important when you are in a birth-center or assisting with home births (since women aren't continuously monitored), it is super important in a hospital setting. Learning to read strips is, again, an artfrom that takes years to master. The basics can be learned in a few days, but the experienced nurses can look at a strip and tell a whole lot more about the labor than is initially apparent to a new nurse. I have a year-and a-half until I finish my CNM program and I am SO GRATEFUL for this time working on L&D. I'm certainly not saying that it should be a requirement, but it also shouldn't be discounted as a valuable tool.

[elkpark]

My grad school offered a direct-entry MSN CNM program, so all those students entered with no nursing experience at all (in many cases, no previous healthcare experience, period). There are a number of those programs around the country -- so, obviously, there is a sizeable group within TPTB that feels that no nursing experience is necessary (ditto for all the other direct-entry advanced practice programs).

[allthemadmen]

Midwifery one the other end of the maternity services spectrum is so much more than intrapartum and childbirth. Cliche, but it is holistic. It is not an elevated L&D nurse or a physician-extender. So much so that in all fairness we could eliminate special folks who have the midwifery trait/calling/goal/bug from the equation by stipulating that folks have the coveted highly competitive L&D experience. And doing that we forget that we need people who can do a lot more than just the L&D part--like building community programs and approaches, promoting lactation, postpartum, essential caring and education, adolescent services, international health....etc. I really hope that this "must have L&D experience for midwifery school" thing is rethought or at least modified. It can be done. It can think of a few ways to do it. In fact there are advantages to doing this. There are schools that make this possible. I like the idea of putting in your extra work on the midwifery end instead of the L&D end.

Well said. I have many years of OB self-education and work as a doula/childbirth educator in all settings, and my nursing experience will be in critical care. I am not sure I could work L/D nursing for long. :\ However, I would also value the experience CNM2B reports- I just haven't always found L/D to be the most welcoming place for those with alternate experience.

[CNM2B]

I just haven't always found L/D to be the most welcoming place for those with alternate experience.

Now THAT is very true. I find myself in the minority a lot of the time and do have moments where I am appalled/shocked/stunned/saddened at some of the routines on a L&D unit. I try to extrapolate the good stuff and remember the bad for when I'm in a position to make some changes.

[misslolalady]

Thank you all for the insight. I was just curious as to what others thought of the L&D experience requirements.

I can definitely see advantages to having some experience (in any specialty, really). However, I think that some schools should be a bit more flexible when it comes to the L&D requirement. It does seem as though L&D is a completely different animal when compared with Midwifery. This is part of the reason too that I feel I would have a difficult time working in L&D. I feel it would be difficult to tell the patients, "No, you can't move around as you please, as it interferes with the monitor". "No, you can't get up to use the bathroom, I'll straight cath you". Directed pushing, continuous fetal monitoring.... etc. etc. I especially think this is true because I am currently pregnant with my first child, and I am in the care of midwives, and it is incredibly liberating to not only be allowed to do what I feel is necessary to feel as comfortable as I can birthing, but to be encouraged to do so!

I know that I will get to my ultimate goal one way or another...just trying to figure out which schools will be best for me to apply to!

Thank you all for the great advice and viewpoints!

[allthemadmen]

Thank you all for the insight. I was just curious as to what others thought of the L&D experience requirements.

I can definitely see advantages to having some experience (in any specialty, really). However, I think that some schools should be a bit more flexible when it comes to the L&D requirement. It does seem as though L&D is a completely different animal when compared with Midwifery. This is part of the reason too that I feel I would have a difficult time working in L&D. I feel it would be difficult to tell the patients, "No, you can't move around as you please, as it interferes with the monitor". "No, you can't get up to use the bathroom, I'll straight cath you". Directed pushing, continuous fetal monitoring.... etc. etc. I especially think this is true because I am currently pregnant with my first child, and I am in the care of midwives, and it is incredibly liberating to not only be allowed to do what I feel is necessary to feel as comfortable as I can birthing, but to be encouraged to do so!

I know that I will get to my ultimate goal one way or another...just trying to figure out which schools will be best for me to apply to!

Thank you all for the great advice and viewpoints!

I agree with your feelings on this, but on the other hand, just as nursing schools have to prepare entry-level nurses to practice in any environment, so do nurse-midwifery schools have to prepare CNMs. Most babies in the US are born in hospitals, so familiarity, indeed comfort, with hospital L/D practices- especially cesarean birth- is not necessarily an unreasonable expectation.