[ksc0723]

I am trying to decide between Family nurse practioner direct entry program and CNM direct entry program. What are the differences, benefits, disadvantages to both?

What about salary differences, job outlook etc.?

Do CNM have prescriptive authority?


Thanks

[CEG]

Well, there are a lot of differences- they really don't have much in common.

A CNM provides routine well-woman care, prenatal care, and catches babies in a hospital, birth center or home.

An FNP takes care of families in a clinic or hospital setting. They provide a spectrum of care for all members of the family.An FNP wouldn't catch babies (unless they are also a CNM). Most of the FNPs I know work in public health clinics.

Prescriptive authority depends on the state- I believe CNMs have authority in all but a few states now and probably similar for FNPs.

I am in a direct-entry program for midwifery. I have a background as a doula and I enjoy being with women through birth and providing education and support.

My personal recommendation is to chose a career path that you really have a passion for. There are a few people in my class who chose to become nurses because it is a good financial choice. I can see them changing careers again in a few years- it's pretty hard work if you don't love it.

On the flip side, if I couldn't be a CNM I would enjoy being an FNP so I can definitely see being interested in both but I would go where your interest really lies and not where you would make the most money or have the best prospects.

[beckinben]

[quote=CEG;2312383]Prescriptive authority depends on the state- I believe CNMs have authority in all but a few states now and probably similar for FNPs.
QUOTE]

CNMs (as of last Friday, assuming the PA governor signed the legislation) now have prescriptive authority in all states. You can find NP prescribing information on Medscape - http://www.medscape.com/viewarticle/440315

I think it can be hard to make the decision if you have not had experience with family practice or with pregnant women. How flexible is your program going to be if you go part way through and decide you don't like catching babies or you don't like seeing lots of hypertension and diabetes in a family practice setting? I had two students in my CNM program (both direct entry) switch to women's health NP because they didn't like doing deliveries. It's a risk with the direct entry model - it's harder to get a good feel for the different areas of advanced practice without some type of healthcare experience.

If there is any way for you to get some exposure to pregnant women - like being a doula - before you have to commit to one track or the other, it could help with the decision. I, personally, had enough exposure to family practice that I wouldn't want to be a FNP. I like my normal, healthy moms and catching babies.

[ruralnurs]

Hi,
It may depend a bit on the state, states can have different laws. However the biggest difference (in relation to OB) is that a CNM can diagnose pregnancy, care for a woman throughout her pregnancy, doing all of her prenatal exams, do post post partum care, yearly (pap, etc.) care, they usually do not care for the baby, they do manage labor and deliver (catch) the baby. I believe they have prescriptive rights everwhere (they should anyway!).

An FNP can also diagnose pregnancy, care for her for all of her prenantal exams, but NOT manage labor or deliver the baby, can do the post partum care and care for the baby.

Currently I am an FNP that continues to do OB as an RN at my small rural hospital (because I love it). I can do prenatal exams (usually covering for one of the docs) as an FNP, and then as a RN I can manage labor (under a doctor's order) but not catch the baby (unless the doc does not make it and that has happened).

If you really just enjoy the women's health and pregnancy part, then go for CNM. If you would like to care for the whole family from birth to death, go for FNP.

Good luck.