CNM or NP as next step for a new grad?

[BBeers7]

I've always had a love for infants and have dreamed about being a NP in a NICU at a top childrens hospital someday, but since finishing school and my OB rotation, I'm torn between this or going the Certified Nurse Midwife route. What advantages/disadvantages do you see in each field? And how long would you work as an RN before attempting the next step?

Thank you!

[LibraSunCNM, BSN, MSN, CNM]

Do you want to work with relatively healthy women, or critically ill neonates? The two fields are interconnected but vastly different.

[jalilly]

Hi,

Both are wonderful career options! My best advice is to gain experience as a RN before you make any decisions in graduate school. The exact amount of time you need for grad school depends on a lot of factors, but I think at least 2 years is a good amount of time to become confident in RN skills and gain a variety of experiences.

As a NICU NP, you will work with neonates who are critically ill. You will work with families, but your patients will be babies. NICU NPs work in hospitals.

As a CNM, your focus is on caring for women, not babies. The majority of your patients are healthy. CNMs often work with a group of CNMs in the office and hospital or birth center setting. CNMs also do general well women care for non-pregnant women. CNMs have a holistic view of health and many promote natural birth.

My advice is to work as RN in L&D or postpartum. You will meet CNMs and NPs. Which people do you gravitate towards? Who do you connect with? Which job matches most with your lifestyle?

[jennylee321]

Go get a few years work experience and then come back to this decision. Working in the area you might realise neither of these jobs are for you.

[Jory, MSN, APRN, CNM]

If you want to be an NNP before you can apply to a program, you have to have two years of Level III NICU experience. As part of the NICU team, you'll get to be present for a lot of births and if you are in a smaller hospital, many times NICU nurses are cross-trained to take care of postpartum mothers or couplets.

CNMs actually have a very broad scope of practice. They can take care of women from their adolescent years on up to postmenopause and the scope is full primary care, not just prenatal and GYN. They can obviously take care of women during pregnancy and birth. Over 90% of all CNMs work in a hospital setting. Your scope of practice also includes babies up to 28 days of life and in some very rural setting, the CNM will actually admit the newborn to the hospital and see the baby for the first couple of visits before transfer of care to a pediatrician.

The demand for CNMs is growing and a good program will teach you how to market your skills in an area that may not have very many midwives.