Hear me out, I need some advice

Specialties CNM

Published

Hello nurse fam! So Im struggling with a dilemma about which way I want to take my nursing career. A little background info: I've always thought I wanted to be a neonatal NP. My final semester I precepted in Labor & Delivery Summer of 2014. After having a horrible rotation in labor during nursing school I thought I would hate it but turns out it went great! I graduated Aug 2014, and landed my first job in a NICU. Now I have been here 6 months now and wow I am grateful for the opportunity to have started in what I thought was my dream career Ive realized that this isnt something I want to do long term. I love infants however sometimes the acuity of their illnesses is tough. Its nothing how labor was, everyday (generally) was a good day filled with excited new parents and families welcoming a new baby, as opposed to how the NICU is not always such a happy ending. So I was comsidering applying to my local Peds NP program and although I wouldnt mind taking care of kids all ages my heart is with infants! The school also has a program that offers a dual CNM/Peds NP program. Now here is my dilemma, although I loved my labor rotation, Im terrified of deliveries because of a story I read online about a dr accidentally decapitating a baby during the delivery process :( True Story. Ever since Ive read that story it has completely terrified me of being responsible for delivering a woman's child safely. I know that may seem silly but it really did change my entire perspective. Ive also heard sucky things about the on call you have to do as well as not being compensated enough, also horrible horrible midnights, but aside from my fears I think the birthing process is a wonderful thing! So as I was in the process of brainstorming my ideas for the Pediatric NP program's essay, I realized that a lot of my goals are related to the occasional maternal but mainly infant population. I love the aspect of teaching parents, especially on how to care for their infant. & anyone who knows labor knows that the birthing process involves lots of teaching and reassurance as well as the post-partum period. A coworker of mines told me I was "too good with talking to people to only work with babies". My question is should I consider the dual midwifery/Peds NP program or stick with Peds NP? I would appreciate any feedback! Thanks guys :)

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You can Always use your skills of talking with parents about their infants as a PNP. I think with your experience you should stick with PNP. A dual midwifery/PNP is a lot. I'd prefer to be an expert in either of those, not both, but that's my opinion. Good luck on your journey!

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Being a Neonatal Nurse Practitioner is kind of a niche specialty. Only a few hospitals in each state would even hire you. If you are unsure if you want to do NICU long-term, then definitely don't do NNP, because they work in the NICU.

Being a PNP, you could practice in the hospital or in a clinic.

Being a CNM opens doors to work women's health, gyn, do full-scope with deliveries, etc.

Think carefully about the role you want to take on in health care. If you are a practitioner, your liability and responsibility increases. You can be a bedside nurse or an office nurse or a school nurse or a community health nurse. All of these positions have you interacting with families, without the time/cost/liability of a practitioner role.

It's okay to be an RN for a while - even your whole career. Why is it that you feel driven to become a practitioner?

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Midwifery is calling. It necessitates that you believe birth and labor is a normal process in a woman life. If you want to work with mothers during this time you have to be able to reassure them of the normalcy of pregnancy. This is hard if you don't truly share this as a value.

I understand what you are saying about the NICU. I am not sure of the hospital situation that you are currently working in. I spent about 3 years level II/III/IV NICU and decided it was not for me long term. While I am in CNM school, I have spent my time working in a level 2 nursery at an outlying hospital. And it's so much better! I go to deliveries as the transition nurse. So I still see the premies, but we stabilize them and ship them to the big hospital (where I used to work). I also spend more time with healthy happy babies and families. This has been great. I was getting too caught up in the NICU and ethics behind my actions and all that is involved.

I do not know the 'right' answer for you but just think long and hard about midwifery. Stay a nurse until you have a clearer picture of what you are going for. Level III/IV NICU isn't for everyone. Sometimes level 2 is where a lot of amazing teaching can happen. We have NNP's that help out in our level 2 and that also work for the peds offices doing all of their newborn checks. Follow your passion!

Also, I will say that working in a specialty takes about a year or so to get comfortable with, until then there is a lot of anxiety and fear. Maybe giving things time will help you see things clearer.

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Ria- I hadnt thought about that but is a very good point, thanks for responding

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Simplyroses- Now after having worked in our NICU I know that being an NNP isnt for me. I do think it would be nice to work in a NICU follow up clinic or being PNP thag works with the Maternal Infant Health Program. I want to become an NP because honestly as a nurse I feel like Im not putting the bigger picture together, having the time to really sit and think how one thing effects the other and completely learning the disease process, my day is full of busy tasks and I would like to actually be able to go deeper into the care.

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Lmac0202- i do believe that the birthing process is a beautiful, normal experience. I think my fears are getting the best of me. I also think that a level II nursery may be a better fit for me. Or even a nicu follow up clinic. I know for sure I want to work with infants, and be able to provide the educational aspect for parents. Thats the best part of my job is showing a nervous mom or dad how to care for their infant (aside from seeing a baby be able to go home). So I know thats the environment I want to be in just not sure what the title of that would be. Good luck with CNM school :) & thank you for responding.

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Specializes in OB.

Just curious, which school is it that you mentioned offers a dual CNM/PNP program? I've never heard of this but that's pretty cool.

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