L & D experience and CNM -- opinions!

Specialties CNM

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I know this has been asked before, but I need advice! Just applied to a CNM program. I have no L & D experience. I've talked to two midwives in my area non-CNM, who say that I shoudn't try to get a L & D job in the meantime, and one CNM who says the same -- background on her, she also went into her program without experience. I spoke to another CNM with 10 years experience, and she said I should definitely try to get some L&D in!

Here's my issue. My job right now is m-f daylight. I KNOW that I'm going to have to quit this job because it will be too difficult to schedule my precepting hours outside of this. So, I am either going to not work altogether, or I was thinking of applying to L & D, but with the mixed reviews, I'm not sure! I think it would really help -- but I guess what I'm worried about is spreading myself out too thin. I have 2 small children at home, and on top of that I would be trying to learn a new speciality (L&D) as well as learn midwifery course work and precepting. I'm just worried it might be too much, especially because my local L&D is at a women's hospital and most are high risk or have other medical problems. I would love any advice!

Specializes in Reproductive & Public Health.
Hi there cayenne06... I find it very interesting that you have your CPM and are now working towards a CNM. Unfortunately I am a few posts away from being able to PM you otherwise I would have. I would love to discuss your roles as both a CPM and a CNM. I am currently in nursing school working towards an RN and eventually a CNM. I have been volunteering with a few CPMs in their home birth practice and I find myself questioning more and more whether I should continue to pursue a CNM or switch gears to a CPM. Initially I figured that a CNM would be the better choice because I have the option of working in a hospital, I am not limited to which states I can practice, and I am already in nursing school. But, beyond those few things I am not sure if the CNM route is still the best option. I am curious as to why you went back to school for a CNM? Thanks for any advice you can part with. If it is easier here is my email: [email protected]

While I am grateful that I got my CPM first and wouldn't change a thing about my educational path, I would strongly encourage you to get your CNM license first. Once you do that, it is relatively easy to qualify for the CPM credential. The reverse is absolutely not true. http://www.narm.org/pdffiles/htb.pdf

The BEST thing I can say about moving from CPM to CNM is that I have a strong foundation in physiologic birth, which helps me keep perspective while learning in a big tertiary hospital. Just the other day, I helped a dad catch his baby while mom was on hands and knees. No medications, no IV, intermittent auscultation, baby went right to mom's chest, cord cutting was delayed. Bed was not broken, the lights were low. . . it was beautiful. And then just a few hours later, I admitted a GDM patient with pre-e, mag drip, epidural, the whole shebang. Her birth was beautiful and wonderful too :) I wasn't happy with my scope as a CPM. I wanted to take care of women with finanical, psychosocial and/or medical contraindications to home birth. I wanted to provide full scope reproductive care, and I wanted to have full prescriptive and admitting privileges. These are things CPMs cannot do.

I have been an L&D RN for 10 years and am currently a CNM student. My only thing about not having L&D experience is when you are with laboring women day after day and year after year, you have the opportunity to see a LOT of stuff, and not all of it is pretty. When you work in L&D for a long time you have the ability to know when things "just aren't right", and you can glance at a fetal heart tracing and know what you're looking at and what that baby is telling you about what's going on in there. Right now I work with a nurse who has 25 years of nursing experience but this is her first year in L&D and she does not know what she is doing. (She'll get there eventually, but it takes time). If you have a midwife on call who has no labor experience, and a nurse on the unit caring for her patient that has no labor experience, who is going to know when things are going downhill? I personally wouldn't want to be the OB on for backup that night! I've never personally worked with a CNM with no labor experience, so I haven't seen the other side of the coin....

I would love to work in L&D that's my goal !!! Completing my BSN now any advice

Specializes in Reproductive & Public Health.
Right now I work with a nurse who has 25 years of nursing experience but this is her first year in L&D and she does not know what she is doing. (She'll get there eventually, but it takes time). If you have a midwife on call who has no labor experience, and a nurse on the unit caring for her patient that has no labor experience, who is going to know when things are going downhill? I personally wouldn't want to be the OB on for backup that night! I've never personally worked with a CNM with no labor experience, so I haven't seen the other side of the coin....

Well. The CNM would have PLENTY of labor experience after completing midwifery school! I agree with you to a certain extent though. Of course the more experience you have with a situation, the easier it is to pick out variations from normal. And it can be disorienting and sometimes overwhelming to provide labor support when you are new to L&D. I know I felt really awkward during my first year or so, trying to figure out how to meet each woman's individual needs during labor. ESPECIALLY since I don't like anyone to so much as talk to me while I am in labor! There is definitely a comfort level that comes with spending years and years doing labor and delivery.

Specializes in L&D, Trauma, Ortho, Med/Surg.

I know this is an old, old thread - hoping my comment will *ding* ya'll and you can give me an idea...

I am a new grad. I have been a doula and childbirth educator since 2001 and 2003 respectively. I have been a midwifery assistant to three different homebirth midwives over the years. I raised my kids - they are all school aged now, and I went back and got my RN (woo!). CNM has been my dream goal for a while now. I was at the top of my class. I am organized, I love to volunteer, and I surely have a nurses and midwifery heart. I really wanted L&D job straight out of school. I was one of the first people in our class to get a job interview. I am going to be honest and vulnerable here: I bombed the interview. I seriously had no idea of how rough it was going to be for me. In hindsight, I did not prepare at all. None of my friends had had interviews yet, and I had no idea what to expect. When I got in there and was asked questions, I had a panic attack (this has never happened to me before in my life). I could not think clearly. It was awful. For a day or two I was really in a cloud - I think it was panic attack leftovers or something. I finally stepped out of my cloud and researched how to answer behavioral questions. In the mean time I had an opportunity to apply for a L&D job. Our market is saturated with new grads, so it is pretty competitive. However, I keep being turned down (by this company) for all the new grad jobs. I can hardly blame them since I freaked during the interview. Again, lesson learned. I feel prepared now - sometimes life happens that way - I get it.... sooo...

My question is - how do I step into a med/surg interview with a drive to GET the med/surg job when I WANT my L&D? Also - tell me again that med-surg can land me the CNM school??

Specializes in OB.
I know this is an old, old thread - hoping my comment will *ding* ya'll and you can give me an idea...

I am a new grad. I have been a doula and childbirth educator since 2001 and 2003 respectively. I have been a midwifery assistant to three different homebirth midwives over the years. I raised my kids - they are all school aged now, and I went back and got my RN (woo!). CNM has been my dream goal for a while now. I was at the top of my class. I am organized, I love to volunteer, and I surely have a nurses and midwifery heart. I really wanted L&D job straight out of school. I was one of the first people in our class to get a job interview. I am going to be honest and vulnerable here: I bombed the interview. I seriously had no idea of how rough it was going to be for me. In hindsight, I did not prepare at all. None of my friends had had interviews yet, and I had no idea what to expect. When I got in there and was asked questions, I had a panic attack (this has never happened to me before in my life). I could not think clearly. It was awful. For a day or two I was really in a cloud - I think it was panic attack leftovers or something. I finally stepped out of my cloud and researched how to answer behavioral questions. In the mean time I had an opportunity to apply for a L&D job. Our market is saturated with new grads, so it is pretty competitive. However, I keep being turned down (by this company) for all the new grad jobs. I can hardly blame them since I freaked during the interview. Again, lesson learned. I feel prepared now - sometimes life happens that way - I get it.... sooo...

My question is - how do I step into a med/surg interview with a drive to GET the med/surg job when I WANT my L&D? Also - tell me again that med-surg can land me the CNM school??

To clarify---did you mean to say that you have an opportunity on a med/surg floor? If so, brush up on your NCLEX review book's med/surg chapters, remember not to mention straight out of the gate that you want L&D and will eventually leave to become a midwife, and you should be fine. Yes, med/surg can land you in CNM school, considering that people with NO nursing experience make it into CNM school all the time.

Specializes in L&D, Trauma, Ortho, Med/Surg.
To clarify---did you mean to say that you have an opportunity on a med/surg floor? If so, brush up on your NCLEX review book's med/surg chapters, remember not to mention straight out of the gate that you want L&D and will eventually leave to become a midwife, and you should be fine. Yes, med/surg can land you in CNM school, considering that people with NO nursing experience make it into CNM school all the time.

Yes, that is what I meant, thank you for clarifying.

I will plan on not mentioning the L&D (uhh, but my resume is all full of that for the past 15 years so hopefully that matters not a lot). This organization is notorious for asking "where do you see yourself in 5 years..." I plan on saying graduate school - and glossing over the "undecided" if they probe as to specifics. Do you think that is appropriate?

Thanks for your response.

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