CNM Questions

nurseygurlie · Nov 24, 2011

I have the same plans as you do, so I can't speak from an experienced perspective. However, I have a few views about some of the comments you made in your post.

I recently accepted a job offer at the county/university hospital on the OB-GYN unit. The one shift that I shadowed, I saw many sick people. Some of the things included in my nurse's patient load included two NG's and one foley inserted, one post-op patient, one psych patient with a gaping infected open c-section wound with packing and daily dressing changes, a patient with a nephrostomy and ileostomy, One mediport, one Subclavian central line, and one healthy newborn. I saw more skills on this floor than I do at the Med-Surg floor where I work as a tech. Most of her patients were also on running fluids and IV push meds too.

I think to say that L&D is easy is laughable, I don't think the nurses you are talking to realize what is going on. It is the ONLY unit in ANY facility where one of your patients is inside the body of the other. The level of acuity and critical decision making is very high.

Couplet care is also complex. You have to have assessment skills for the newborn AND the postpartum mom. Very complicated conditions and syndromes can happen postpartum, such as pulmonary embolisms or DIC. Elevated assessment skills, the ability to provide effective teaching, and quick decision making without alarming the patient and their 20 present family members are all mandatory. It's a very specialized unit.

I know some people aren't into it, but I wouldn't work in any other area. You should try shadowing an OB-GYN nurse for one shift and see how enlightened you are at the end. If you can do it at a public hospital, I think you will see even more than you would in a private, just because the moms and women are not all insured and getting adequate prenatal or yearly women's health screenings).

Good luck in your CNM path!!

fromtheseaRN, BSN, RN · Nov 24, 2011

great questions! i am planning on getting my DNP in women's health, or CNM. my concern with the CNM is that i heard the malpractice insurance was not much less that the salary. i'll be watching this post closely for responses. :)

nurseprnRN, BSN, RN · Nov 24, 2011

"i would love to attend frontier because after doing a lot of research on online programs for cnm's i think i'm set on frontier being my #1 school of choice."

:ddon't write this in your application essay.

(what you said was, "i want to go to frontier because after i looked into it i want to go to frontier." this is called "begging the question.")

frontier has a long reputation for excellence in the field. forget online programs. if you can get in, it's among the best.

klone, MSN, RN · Nov 24, 2011

I too wanted to be a CNM and attended Frontier for three semesters before withdrawing and going into a BSN program.

I disagree that being an OB/L&D nurse allows you to lose all your skills. I'm expert at starting IVs, administering IV infusions, and inserting foleys. I'm trained at circulating surgeries. Because most L&D nurses are cross-trained to postpartum, you will also get experience at taking care of post-op patients, and you will deal with drains and surgical wounds. Depending on the facility, you may get patients on insulin gtt's, heart medications, tele monitors, asthma medications, etc. Healthy people aren't the only ones who get pregnant; as an OB nurse, you will probably take care of many women who have comorbidities.

If your dream is to become a midwife, then you don't need to be an expert at vents, trachs, or reading a cardiac strip. But I disagree with anyone who believes an OB nurse isn't good at basic med/surg, or that she loses all her clinical skills.

NurseB_, BSN, RN · Nov 24, 2011

Thanks for your comments!!! It makes me feel a lot better knowing that my skills will not be lost. I've always seen myself being a L&D nurse and eventually a CNM. I'm excited about starting my career path and making a difference. :yeah:

RNLaborNurse4U · Nov 24, 2011

I've been an L&D nurse for over 10 years - and NO day is ever the same! We have low risk and high risk pregnant and newly delivered postpartum women on my unit. We manage a huge range of complications (both medical and related to pregnancy), and I have to say, I learn something new all the time.

I am also finishing my 3rd year at Frontier (bridge ADN-MSN program) towards my MSN in midwifery. It is a very challenging program, but well worth the education. I can apply what I've learned at Frontier into my role as the L&D RN.

As for salary of CNMs, they really do vary, depending on what part of the country you live, and what type of practice you go into (OB/CNM office/hospital, CNM only office/hospital, birth center, homebirth practice, public funded clinics, etc). I'd say that the average pay for a CNM in my state (PA) is roughly 80-85k/year. Of course, the actual range of pay is much wider, and like I said, it really depends on what type of practice setting you are employed in after graduation.

The good news is that midwives are definitely in demand! As the demand rises, the need for more CNMs in a variety of practice settings also rises. Lots of luck to you in your endeavors.

owlRN01 · Oct 3, 2012

It is the ONLY unit in ANY facility where one of your patients is inside the body of the other.

Very true!!!! This made me smile :)