Is is possible to be a bad nurse and a good midwife?

NayRN · Jun 17, 2012

First, you have only been working for a year and a half. You can't possibly know everything after only a year and a half. Give it some time. Second, why do you say that you are a bad nurse? You may not know everything, but if you don't know, are you able to ask for help and learn from that? Are you able to think critically? Have you made some serious mistakes or what?

Your concerns seem quite normal for a new grad to me (yes, you are a new grad if you have only been working for a year and a half)

subee, MSN, CRNA · Jun 17, 2012

Hi All, Hoping I can get some insight here and some unbiased advise.
(And please read - I am not asking here if you can be a midwife if you 'hate being a nurse' - that is not how I feel at all and, quite frankly, it saddens me to see midwives - or potential midwives - who feel that way!)
I have been a nurse now for almost 5 years (well, I graduated 5 years ago, have only worked in the hospital for about a year and a half) and my plan all along has been to eventually go back to school and become a midwife. I have applied for programs for next fall but am starting to have my doubts.
All of my hospital experience has been on L&D and I really love it. However, I have recently moved from working in a very large teaching hospital in a major metropolitan area (about 8,000 deliveries a year, just L&D) to a small community hospital in a rural area where I work in an MCH dept (L&D, post-partum, NICU, and peds, combined - although I just do L&D and PP). I am only working per diem at this new hospital, which I am very happy about, but, since starting here, I have felt really insecure about my skills and knowledge as a nurse. The level of autonomy for nurses at this little community hospital is so much greater than it was at my old hospital - and quite frankly the care is much better and more thorough! - but I feel like I am nowhere near as good a nurse as most of my colleagues!
I am still terribly nervous at most deliveries, I panic when there is an emergency, and even in the day-to-day things I feel like I am just not thorough or thoughtful enough to be good. Plus, there is so much that I still don't know, but I feel like I should by now.....I don't know, it just makes me feel like I have no business going back to school to become a midwife if I can't even get down being a good nurse!
Anyone have any advise or been through something similar?

No, it is not possible to be a bad nurse and a good midwife. You need more experience so that you don't panic in emergencies. Give yourself another year.

caliotter3 · Jun 17, 2012

Maybe you will feel better if you just give yourself another year or year and a half of experience before returning to school. Sounds like you will gain good experience from this hospital position if you just allow time to take its course. Go with the flow.

EricaSAFJAF · Jun 17, 2012

I think a good nurse is someone who realizes they have room for improvement and is concerned that they can always do better. We are not perfect, but the mark of a good nurse is someone who cares and strives to better the care that they give.

tothepointeLVN, LVN · Jun 18, 2012

I think your instinct is correct that you need to give yourself some more time and experience and gain that confidence that you need then you'll feel much better pursuing your goal.

You don't sound like a bad nurse only that your aware of your weakness and limitations.

aspiringmidwife76 · Jun 23, 2012

I agree with everyone else's comments. You are not giving yourself enough time. Maybe after another year and a half you will have enough confidence that you won't panic in an emergency. My advice to you is to stay put, learn as much as you can off of your senior nurses and buy maternity nursing books. I have worked in a high risk L&D unit for six years, and now I feel ready to take on my CNM degree. I have always wanted to be a CNM, but being able to function in an emergency is a must. You never know if you will be delivering a baby who becomes a dystocia. Good Luck, keep it up and you will succeed.

NewYorkMidwife · Jun 30, 2012

Hi purple,

I believe that when you changed to our new job, you had already learnt how to be a nurse in big metropolitan setting, so you may feel intimidated with these new skills that you didn't learn in your first job. I would not worry because all those skills will be taught to you when you are in midwifery school. lady partsl exams, baby care, all of those will be part of your training. I wouldn't worry at all. Good luck.

purple_sage · Jul 1, 2012

Thank you all so much for the responses and the advice. I think it definitely is a good idea to be a nurse for longer - more time and experience would certainly help with some things (i.e. lady partsl exams!!); and my plan right now is to pursue school very part time while I continue working at my local hospital.

But I guess my question still remains a bit, as some of what I am worried about is not so much about feeling inadequate because of inexperience but rather because of my own personality.

I am, in general, a rather high-strung person. I am a fierce worrier (in all aspects of my life, which can sometimes be helpful actually, but of course, also has its' pitfalls!) and a generally anxious person. I constantly doubt myself, even when I am right.

Yes, some of this would get better with more experience, but I fear that some of it would not - and that those things might make me a very poor midwife. (BTW - it amazes me, especially in NYC - how many midwives I knew who never worked as nurses and even came from radically different backgrounds - music, art, architecture - how did they know they would be any good at this?!)

I guess what I'm saying is - is it possible to just have the wrong personality for this? I have wanted to be a midwife for so long and, quite frankly, can't imagine doing anything else with my life - but what if I'm really not cut out for it?!

jt43 · Jul 1, 2012

I personally would run from a midwife who was "anxious "and "high strung". You may get better about that over time but having a baby is stressful enough. You don't need your caregiver adding to the anxiety and tension imo. Maybe you can find some ways to address that part of your personality...stress management, meditation, yoga, etc.

mrshurstnurse · Jul 3, 2012

Hey There!

So I'm a new nurse and sounds like we have a lot in common. I work on a renal/metabolic med-surg floor and on-call at a water birth center. I LOVE my job at the birth center. I struggle with my job at the hospital.

Although I am nervous at times, I never show it to my patients/clients. I make the decisions I NEED to make when I need to. I second guess them at times, but I'm growing more confident.

For me, nursing has been a roller coaster of a career choice and I'm keeping my options open for now.

At the birth center we've had a cord prolapse, nuchal cords, distocia's and our share of the anxiety filled events. We've never lost a mom or baby & all outcomes have been well thanks to our midwife's insight, competency & proficient work. & God's grace of course. (Also, birthing centers are only low risk pregnancies) :)

However, the midwife is the one making the BIG decisions... with NO SLEEP! lol Of course this is a private owned business, but it is the baby business. She works long hours. It's a 5 day week followed by midnight call-ins, false alarms and late labor alarms. Followed by another 5 day week. CNM's have opportunity for different work hours depending on employment.

Here are some things that make the midwife I work with a great midwife:

1. She has learned and mastered the skills needed to do her job well.

2. She is Confident in the skills she learned & when people question her skills does not intimidate her. (She sticks to her guns!)

3. She is constantly critically thinking

4. She is always multitasking.

5. She remains calm in a crisis.

6. She is life-long learner.

Those are a few I could go on, but are you seeing a trend? Its the same qualities that make a great nurse. :)

I believe skills can be mastered with experience, confidence can be strengthened with time, anxiety & worry overcome when the root cause is discovered and addressed, critical thinking is practiced and learned: All of these things make a great midwife and great nurse.

My advice: Learn your skills like the back of your hand, we live and die by the vital signs & assessment, your new confidence motto: fake it 'til you make it.

If you have always wanted to be a nurse-midwife do it. Just be sure your not making it more romantic career in your head. The struggles you have as a nurse you will have as a midwife. Your weaknesses will still be your weaknesses and your strengths still your strengths.

Good luck! :)

colleenmc · Jul 17, 2012

I would recommend working full time for at least another year. repetative experinces will help your anxiety. once u have been doing ob for a while you will will be able to trust your instincts. even though not every situatoin is the same, there are limited number of things that will most likely go wrong at a low risk hospital. if you have enough exposure, it will become second nature.