CNM post MSN-FNP

[calijaz]

I'm just finishing up my MSN-FNP program. I've become particularly interested in women's health, OB, alternative medicine, fertility, etc. lately and have begun looking at CNM programs. My concern is that all of my experience as an RN is in critical care and procedure areas (cath lab/IR). Also, I currently live in AL where CNMs can do virtually nothing (I thought they did not even exist here until today). This makes the distance programs impossible for me as I don't think there would be anyone I could work with here. I'm considering moving out of state now to attend a school that would have my clinicals set up for me.

In the meantime, do you think it would be more advantageous to begin working as an FNP or to try to get an L&D job as an RN?? The job market here is tight... I need to move! Haha.

Any suggestions appreciated. :)

[mcnacht]

Though it's tempting for nurses to want to multitask and do EVERYTHING, I really think you should focus on one thing at a time and get really good at that thing (FNP, in your case). Though the L&D stuff may be required for CNM programs, unless you've had a huge change of heart and are PASSIONATE about that, you should work for a few years as FNP and get solid experience with a variety of people before you specialize so much. Once you become a CNM, it's likely that's all you'll do--no time to get the broad experience later. But if you get the broad experience now in a general FNP practice or urgent care, that will make you a better midwife later. Does that make sense?

Good luck!

[pro-student]

I'm in a dual FNP/CNM program and I didn't have any L&D experience before I started. Many programs are realizing RN experience is not necessary for advanced practice and doing away with such requirements. I know of some students who do clinical placements in Alabama but if you have the opportunity to pursue your education in a more supportive environment, that would probably be helpful. I would definitely op for using your APN training rather than pursing more RN experience. I think experience as an APN might even give you more of a leg up. A good Midwifery program (read - any accredited program) will prepare you for full scope practice even if you've never cared for laboring women.

I would also suggest that unless you want to attend labors and catch babies, your FNP scope should cover practicing in women's health and infertility. You could use CE activities (there are some great conferences and programs available) to build up skills and knowledge in these areas. The benefit of attending a CNM program would be mainly if you wanted to increase your scope of practice to include intrapartum management.