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CNM vs WHNP vs Having Both

CNM   (7,582 Views 29 Comments)
by JennaSnow JennaSnow (Member)

978 Visitors; 18 Posts

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I am interested in CNM and WHNP and would love to do a dual program in the future. I am in the NY/Long Island area. Does anyone know if there are any dual programs around here?

Also, I know CNMs can see patients for well women care......what is the real benefit of pursuing the WHNP in addition to CNM? What can the WHNP do that the CNM cannot? Is it worth the money for school to do both? I know they complement each other nicely.

Any input?

Thanks for any replies!

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klone has 13 years experience as a MSN, RN and specializes in Women's Health/OB Leadership.

3 Followers; 113,862 Visitors; 13,161 Posts

The CNM has a broader scope of practice than the WHNP. They can do everything the WHNP can, plus do deliveries. If you're wanting to do deliveries, then IMO, getting a WHNP also is redundant.

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978 Visitors; 18 Posts

That's what I was thinking, but I've been reading different threads about doing both. Didn't really understand why though.

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LibraSunCNM has 10 years experience as a MSN and specializes in OB.

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I've been a midwife now for four years and literally the only reason I've come across yet that people get both certifications, is that they reach a point where they want to do just outpatient work, no deliveries, and malpractice insurance is cheaper as a WHNP, so they use that certification to save money. Otherwise, as klone stated, it is completely redundant.

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2,190 Visitors; 26 Posts

Oh, I just answered this in the Georgetown thread...

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KatieMI has 6 years experience as a BSN, MSN, RN and specializes in ICU, LTACH, Internal Medicine.

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From my contacts with both durign the last semester...

- CNMs: do deliveries, school is more pointed, more rigorous and more difficult to get into, they are generally more busy (lots of calls, deliveries around the clock, etc), insurance costs more, usually (but not always) prefer Ob over gynecology, pre-program, "side specialties" strictly within the area (uro/gyn, gyn/onco), Ob experience is mandatory.

- WHNP (de-facto, FNPs): experience is not mandatory, schools can be easier to get into, more gynecology, no deliveries, interesting cross "side specialties" (like gyn/geri, gyn/peds, gyn/HIV clinic) are possible, less chances for call, paid (again, usually but not always) a bit less.

More than one CNM confessed that they envied me with my future FNP degree because they were either already seeking quieter waters or thinking about the time when being always on call and rushing in L&D in all hours would be too much for them.

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LibraSunCNM has 10 years experience as a MSN and specializes in OB.

24,634 Visitors; 1,167 Posts

From my contacts with both durign the last semester...

- CNMs: do deliveries, school is more pointed, more rigorous and more difficult to get into, they are generally more busy (lots of calls, deliveries around the clock, etc), insurance costs more, usually (but not always) prefer Ob over gynecology, pre-program, "side specialties" strictly within the area (uro/gyn, gyn/onco), Ob experience is mandatory.

- WHNP (de-facto, FNPs): experience is not mandatory, schools can be easier to get into, more gynecology, no deliveries, interesting cross "side specialties" (like gyn/geri, gyn/peds, gyn/HIV clinic) are possible, less chances for call, paid (again, usually but not always) a bit less.

More than one CNM confessed that they envied me with my future FNP degree because they were either already seeking quieter waters or thinking about the time when being always on call and rushing in L&D in all hours would be too much for them.

Not to nitpick, but not all CNM programs require OB nursing experience. In fact, some require no nursing experience and encourage students to go straight through. Whether or not this is a good thing, it's definitely becoming more common.

I'm also not sure why a CNM would "envy" you your FNP degree when, as we've been discussing, CNMs can do all aspects of outpatient care. Did you mean that they had decided they wanted to be able to see men, children, geri, etc?

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KatieMI has 6 years experience as a BSN, MSN, RN and specializes in ICU, LTACH, Internal Medicine.

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Not to nitpick, but not all CNM programs require OB nursing experience. In fact, some require no nursing experience and encourage students to go straight through. Whether or not this is a good thing, it's definitely becoming more common.

I'm also not sure why a CNM would "envy" you your FNP degree when, as we've been discussing, CNMs can do all aspects of outpatient care. Did you mean that they had decided they wanted to be able to see men, children, geri, etc?

CNM with no previous experience fresh from BSN?? Oh, good Lord :nailbiting:

And, yeah, some of CNMs I spoke with would like to try things like urology, incontinence or fertility clinics but, for obvious reasons, employers want someone who can see any patient regardless of gender. So they hire FNPs, even with zero background.

IMH(umble)O, it is ridiculous when a CNM with 20+ years of Ob experience cannot get job in small "critical access" rural ER which has very high Ob/Gyn caseload (Mennonite settlements nearby, 10 kids per family being kind of local norm) and has to get FNP postmaster's certificate while FP MD who did whole one month Ob/Gyn rotation and one more in outpatient gynecology during residency is running the said ER and sees everybody and everything there.

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Ohm108 has 1 years experience.

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This is a question that I have asked before as I researched CNM programs so thank you to everyone that has provided answers.

I know that the thread is old but I wanted to add that in CA where I am from some hospitals won't hire you as a midwife unless you have both the CNM and WHNP. Part of the reason might be cost of insurance (as stated previously) another might be (whether rightly or wrongly) you put on your CNM hat for inpatient hospital births and your WHNP hat when you are in an outpatient provider setting in a clinic.

I do plan on being dual certified even though as many people have told me, a midwife's scope of practice does encompass everything a WHNP does. The only exception that I can possibly see is if you want to see the women's gero population after menopause. Then you might need the WHNP since this sub group of women might be outside a midwife's scope of practice.

Feel free to correct me if anything I have posted is incorrect. I learn a little more about my future profession everyday.

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klone has 13 years experience as a MSN, RN and specializes in Women's Health/OB Leadership.

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The only exception that I can possibly see is if you want to see the women's gero population after menopause. Then you might need the WHNP since this sub group of women might be outside a midwife's scope of practice.

Feel free to correct me if anything I have posted is incorrect. I learn a little more about my future profession everyday.

No, that is not correct.

With regards to insurance costing more for a CNM - I have a few midwife friends that are not "full scope" (they only do clinic), thus, they are able to get around paying the full CNM insurance rates. If they don't have hospital privileges, then they can't practice in the hospital, and their insurance would reflect that.

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Ohm108 has 1 years experience.

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No, that is not correct.

With regards to insurance costing more for a CNM - I have a few midwife friends that are not "full scope" (they only do clinic), thus, they are able to get around paying the full CNM insurance rates. If they don't have hospital privileges, then they can't practice in the hospital, and their insurance would reflect that.

Noted. Midwives can also see the women's gero population post menopause. Will add to my notes. Thank you!

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LibraSunCNM has 10 years experience as a MSN and specializes in OB.

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This is a question that I have asked before as I researched CNM programs so thank you to everyone that has provided answers.

I know that the thread is old but I wanted to add that in CA where I am from some hospitals won't hire you as a midwife unless you have both the CNM and WHNP. Part of the reason might be cost of insurance (as stated previously) another might be (whether rightly or wrongly) you put on your CNM hat for inpatient hospital births and your WHNP hat when you are in an outpatient provider setting in a clinic.

I do plan on being dual certified even though as many people have told me, a midwife's scope of practice does encompass everything a WHNP does. The only exception that I can possibly see is if you want to see the women's gero population after menopause. Then you might need the WHNP since this sub group of women might be outside a midwife's scope of practice.

Feel free to correct me if anything I have posted is incorrect. I learn a little more about my future profession everyday.

Yeah I'm a little confused by what you consider a "CNM hat" vs. a "WHNP hat" and how they're different. I know nothing about California so you may be absolutely right about hospitals wanting both credentials, although it seems odd. As I said before it only really makes sense if you're only doing outpatient.

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