[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.

[SebagoLaurel]

Originally Posted 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?

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.

[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.

[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?

[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.

[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

[midwifeinthemaking]

sorry I spelled midwives wrong

[lovingpecola]

Trauma, I don't know if your question was to any one particular person at first, but as a direct entry advanced practice student, I'll answer for myself:

How did I know I wanted to be a midwife?
There are a million reasons, here are a few:

I have three generations of midwives before me, I know what midwives do and I have deep respect for it and a passion to follow and add to the profession.

I've worked in the doula capacity, without certification, so I know the basics of how to support a woman in labor.

I shadowed bedside RNs for a semester before making the decision in undergrad to go this route.

I shadowed wonderful CNMs for months before entering the program.

I was the director of a women's resource center and so I know about sexual and reproductive issues faced by women, social and political issues faced by women, and have the relative communication experience with women.

I've volunteered at a community health clinic ran by RNs (in manager capacity), CNMs and OBs, which is a good way to make a comparison between the roles of each.

And, although YOU may not value these "ways of knowing," they are valued by others, including those who are in the profession:

I have known since I was a very little girl that this is what I was going to do, although I wasn't sure if it was going to be through the RN entry route.

I eat, sleep, and breath midwifery and women's issues including their interaction with other people.

I am intrigued by the political issues surrounding midwifery and women's rights in this country and globally and make the committment to be involved

I read tirelessly about all of the issues that come my way about the profession and I think critically about policy, autonomy, the physical work itself.

I have always, simply, known.

--------

I understand the basic logic behind people's "how can you be an *ADVANCED-PRACTICE* nurse with out any practice to begin with" comments. But I have to say that Midwifery is a little different in that there are multiple routes of entry, RN entry is just one of them.

WHAT ABOUT ALL THE MIDWIVES WHO ARE NOT RNs? THEY DON'T HAVE, NOR WILL THEY EVER GET RN EXPERIENCE, ARE THEY NOT GOOD MIDWIVES?

And by your logic ("how do you know without experience") one wouldn't know if they wanted to be a midwife until they actually caught a baby. Surgeons wouldn't know they wanted to be surgeons until they cut somebody open, etc. But do we allow them to do any of this until they make the decision and get the education and training? NO. In my opinion, APRNs are doing the same thing: They made the decision, and they're getting the education and the training. They'll get better over time, just as in any other profession.

There many different ways to do a given thing, any thing. But it requires open-mindedness to accept this.

My advice to future practitioners on this board is to ask advice (as you are doing), sit down and *really* think about what YOU want, then make the decision and be proud of it. Once you make the decision, don't let anyone make you feel inferior, or otherwise incapable based on the path that you choose. Seek out experiences that will strengthen your weak areas and reach out and help someone in those areas that you feel confident. I've worked with some wonderful nurses so far. They have a lot to teach, but I have also taught them a thing or two. It's a reciprocal relationship, but it only works well when people are open to it.

Good Luck with making your decisions!

LP

[ibambamama]

Wow - I've been needing to read this for awhile! (of course, nursing school itself has been keeping me pretty busy!
I am also a student in a direct-entry master's program - I will finish my RN in May and begin my midwifery classes in June. I have continually been going back and forth as to whether or not I should take a year off in-between and get some nursing experience before starting my master's- and I still haven't made a final decision. I can definitely see the value of working as an RN and really honing those skills that we are just getting a taste for in school; but, for mostly personal and financial reasons, I feel very pushed to just go straight through my program and become a CNM. An idea though that I have been playing with, and that I would love to get some feedback on, is this - what about finishing up all of the schooling (BSN and MSN) and then working as an RN for awhile before taking (or getting!) my first midwife job. I live in NYC and have heard that midwifery jobs are pretty hard to find here, so I have been thinking I will probably have some downtime anyways between graduation and finding work - but of course, there is also the concern that I will forget everything I have learned and trained for in midwifery school if I don't work as a midwife right away.
Any thoughts?

[midwifeinthemaking]

"lovingpecola" thanks for your imput, your lucky some of us have to go on a little less but I am hoping I love it as an occupation as much as I love being in the room when those babies are born. As for midwifery I would be an advocate whether I wanted to be one or not and I wasn't lucky enough to be raised in an atmosphere that nurtured it. Most everyone I knew thought I was crazy for having my kids at home and yet it was one of the most wonderful experiences of my life. I feel like I have been going against the grain of society to get here...just for once it would be nice to be in an environment that truly supported it.