Experience to Enter CNM Program - page 2

Hello! I'm a senior nursing student in a BSN program and graduating :mortarboard: this coming May (Woo HOO!). I am planning on entering the CNM program at The Ohio State University in the coming... Read More

  1. by   LAW79
    There have been some great, thought-provoking points here! I thought I would share my plan with you, because I am in a Master's Entry CNM program. I will get my RN in May and begin my master's specialty coursework in September. I have decided to do that portion of the program in 3 years...while working FT as a L&D nurse. The first year of classes will be theory (more patho/pharm, etc.), and clinicals won't begin until the second year of school, at which time I will have a solid year of RN experience under my belt. I, too, agree that the experiences of each person are individual and what is right for me may not be right for someone else. I did find it quite helpful to learn about what was right for others, which influenced my decision. In the end, I decided that I really want to work as a RN. I think it will be extremely helpful in developing my confidence and competence. And, I realized that working part-time as a new L&D nurse would not cut it for me. I need to do it consistently for a while. Best of luck to you!
  2. by   nizhoni
    Thought I'd weigh in with an opinion on this interesting thread. My hospital-based background is in L&D, Postpartum and Nursery, but I have been a direct-entry midwife attending homebirths for 30 years. I am ANCC-certified in perinatal nursing.

    I have something of a different "take" on this subject because I have taught direct-entry (non-nurse) midwives for about 15 years in a three-year format, with the professional goal of preparing students for competent out-of-hospital midwifery practice as licensed midwives (LMs) and/or certified professional midwives (CPMs). With only a few RN exceptions, our students have had no formal health education prior to coming into the program. Ultimately, however, they must acquire the same knowledge base and skills sets as a CNM, sans prescriptive privileges (though they still must know their meds as any RN, since they administer abx, anti-hemorrhagics, etc.). I do think our RN students have an advantage over the non-RNs in terms of initial comfort level with the skills and didactic material in our program, but all the students must be able to function competently as midwives by the time their programs are complete. Clinical training for out-of-hospital birth is conducted under the direct supervision of Licensed Midwives/CPMs and CNMs and the profession has required competencies that are equivalent to those of CNMs and WHCNPs. LMs must be able to perform to the same standards as other mid-levels. In addition to being grounded in allopathic pharmacy and IV skills, the students must be knowledgable re: alternative pharmacy, since they cannot actually prescribe allopathically (and ladies planning out-of-hospital births generally prefer complementary medicine).

    Occasionally we have had students go out of the country at their own expense to obtain high-volume hospital-based clinical experience. Sad that we can't accommodate that here, but of course, professional liability issues are a problem.

    These students are highly motivated and perform very well clinically. Their textbooks include both nurse-midwifery (including Varney's Midwifery and British texts) and direct-entry midwifery texts (chiefly by Frye). The majority of students enter private or group practice upon completion of their program and some end up partnering with one of their precepting midwives. In some states, licensed midwives work in physicians' offices in the same role as a CNM or NP (though again, sans prescriptive privileges).

    So that's it in a nutshell. It's also the reason I feel qualified to say that, while it's terrific for RNs to have clinical experience prior to entering a nurse-midwifery program, it's not really necessary in order to develop competency since it's within the ability of non-RNs to do so.

    All the best to you in your midwifery path, MUOStudentNurse!
    Last edit by nizhoni on Oct 28, '06
  3. by   MUOStudentNurse
    Thank you so much for everyone's input! I have so many decisions to make and having the support and advise of some of those who have been through it or have personal experiences helps more than you know! I really hope I get to where I want to be, and hang in there!! :-) Thanks again and best of luck to all of you as well!
  4. by   lovingpecola
    Nizhoni, thanks for your post!!!

    I always wondered how similar the programs were (I'm in grad-entry CNM).

    And your last comments are right on point! I always wonder (when people say we need nursing experience before becoming CNMs) what about all the NON-NURSE midwives, are we saying that they're not *great* midwives, even without RN licensure or experience?!

    Anyway, I digress, but thanks for your post!

    LP
  5. by   nizhoni
    Thanks, MUO and LP. I'm always excited to meet midwives who are enthusiastic about multiple routes of entry into the profession.

    I should mention that, with regard to direct-entry midwifery practice, the standards of midwifery practice that I mentioned in my previous post are typical when the midwives are either CPMs or LMs who must acheive the CPM credential in order to obtain licensure. Certification as a professional midwife is quickly becoming the entry-level standard in states that are moving to license direct-entry midwives.

    At any rate, I have to smile when the members of our local Bridge Club meet. These are CNMs, LMs and students who get together to "talk shop" over brunch on a regular basis. One is often hard pressed to tell them apart and the diversity in the midwives' educational routes and practice sites just reaffirms that midwifery is alive and well as a dynamic profession!
    Last edit by nizhoni on Oct 28, '06
  6. by   traumaRUs
    Playing devil's advocate here, how do you know without any experience that delivering babies is what you want to do for the rest of your career?

    I mean, yes, it sounds all cool on TV and the wonderful little warm bundles of joy that everyone loves to show off, but with the huge liability factor, how do you factor all this in BEFORE any experience doing it?

    I have to say I'm not a baby person - my experience is ER where birthing babies was always an emergent procedure and never ever under any kind of controlled environment...so I guess I feel that if I had no experience, I could never have dealt effectively with these types of outcomes.

    My nursing experience gave me the background info to be able to effectively care for these patients.

    So...my question would be how do you KNOW you want to be a midwife without any experience?
  7. by   MUOStudentNurse
    I think you make a good point, TraumaRUs. As an RN you can only observe their work and as a student that is what I have done as well. It is true that you never really know if your choice is right until it is unfortunately "too late". I think in order to choose any specialty in nursing, you have to base your decision on what you have observed and what you think is the best for you. I am extremely anxious and excited at the same time about choosing a specialty but I guess based on all the different experiences I have had, Midwifery seems like the best fit for me. I guess only time will tell! Thanks for your input and believe me, it is a HUGE decision and it is impossible not to question even your own choices!
  8. by   traumaRUs
    Thanks for sharing your thought process - I appreciate it.

    I don't agree with direct entry advanced practice programs because it does force a decision on students who have little to no first-hand knowledge of what they are getting into. I know for myself, it took me a few years to be comfortable with my nursing abilities before I decided to pursue an APN. I specifically chose a very broad category (adult health) in order not to be pigeon-holed. Plus, it is hard sometimes to predict what jobs will be available and I wanted that flexibility too.

    I will say that my ER experience has been a godsend for my arrest situations at the chronic dialysis units.

    I wish you luck and feel there is enough work for all of us. We don't all have to agree on the educational route - what is important is that we work as a team.

    Take care - let us know how it goes.
  9. by   SebagoLaurel
    Quote from traumaRUs
    Playing devil's advocate here, how do you know without any experience that delivering babies is what you want to do for the rest of your career?

    I mean, yes, it sounds all cool on TV and the wonderful little warm bundles of joy that everyone loves to show off, but with the huge liability factor, how do you factor all this in BEFORE any experience doing it?

    I have to say I'm not a baby person - my experience is ER where birthing babies was always an emergent procedure and never ever under any kind of controlled environment...so I guess I feel that if I had no experience, I could never have dealt effectively with these types of outcomes.

    My nursing experience gave me the background info to be able to effectively care for these patients.

    So...my question would be how do you KNOW you want to be a midwife without any experience?
    Maybe you dont. But I also had no way of being 100% sure I would really like being a nurse when I did a 180 turn at 44 and switched from being an engineer to go to nursing school. My past interests, talking to people in the job, studying about it, etc. gave me some knowledge - but if I had the attitude I should not do something new without trying it first I would not have done it. And yes, I have disadvantage of being older, no health care experience, etc. over others with many years experience - but I have faith in myself that I can become a great NP (mind you - I am talking Family NP not midwife for myself) despite not going the standard route.
  10. by   traumaRUs
    I sincerely wish you well!

    I too went into nursing as an adult in my 30's after 10 years in public affairs in the military.
  11. by   midwifeinthemaking
    I realize many of you wanted to become nurses so please don't take this as a slam but I only became a nurse to become a midwife. I am not very into the "medical model" of our current health care system. I am dreading going to work as an R.N. in the hospital for the 6mo. to 1 year of experience before starting to work on my masters in midwifery. Are there any other options for a new graduate to get experience. I keep putting it off and I realize it is because it is just something I do not want to do. Any suggestions???
    Has anyone else been down this same path?
  12. by   traumaRUs
    Hi midwifeinthemaking....how do you know that you want to be a midwife if you have no experience? Working in the hospital (where at least some of your clinical time will be conducted) will allow you to be more comfortable with the "medical" aspect of the care. Not all deliveries go as planned.
  13. by   midwifeinthemaking
    I'm pretty sure from having my kids at home with a midwife that it is what I want to doand also being part of deliveries with midwifes...but you can never be completely sure of anything until you do it. But I certainly don't think working in L&D will answer that question for me...since most of the way things are handled go against what I believe. Yes I did do my clinicals and a practicum in L&D...I liked med surg better just because I did not disagree with as much........I'm not here to say whats right and wrong...people have choices

close