CPM to CNM

cayenne06, MSN, CNM · Dec 24, 2014

It will be a HAPPY day when the CM credential is recognized across the country.

biggolp · Jan 26, 2015

It will be a HAPPY day when the CM credential is recognized across the country.

Amen!

wildearth · Mar 15, 2015

I had just finished all the requirements and was about to submit for my CPM when I decided to go the CNM route. I decided not to get my CPM credential because I don't honestly see myself starting a new business while in school full time. Its a much longer path to go CNM, but I think my OOH experience during my CPM training will seriously help me stay grounded in nursing school and beyond.

Also I LOVE that so many of you have said you aren't a nurse at heart, that you're a midwife. I feel guilty sometimes thinking about taking a place in a nursing program away from someone who really wants to be a nurse when I don't want to be a nurse at all.

summersunset · May 5, 2015

It will be a HAPPY day when the CM credential is recognized across the country.

The CM credential will never be recognized across the country. The ACNM is not invested in developing or promoting it. They just use it as an argument against recognition of CPMs. "See, we have a credential for those who don't go to nursing school! We have a direct entry path!" I heard this from a 30 year veteran CNM that is actively involved on the national level of the ACNM. What is it, two or three states that recognize it? And how many schools?

summersunset · May 6, 2015

I am a CPM just starting my ASN to CNM this fall. I am extremely grateful for my CPM training. One thing I can say about those who go straight through CNM is that they seriously lack experience and confidence. I have worked with new grads and those new to out of hospital, they are terrified and have super high transfer rates. It's a different skill set. I am very grateful I went CPM first so I could get the huge amount of clinical hours where I was the one resuscitating a baby, making the calls in dealing with a bleed or freeing a sticky shoulder. A friend of mine just finished her CNM with Frontier and she spent 95% of her clinical time doing pap smears and postpartum check ups (scut work). She was only called into the labor room when baby was crowning. If there were any complications the docs or peds took over. How does that prepare you for autonomous practice? It doesn't. Being able to spend 3 years hands on, one on one, assisting in every kind of scenario is priceless. This is all assuming you have a good preceptor that knows what she is doing.

klone, MSN, RN · May 6, 2015

I disagree that gyn care is scut work.

Frontier requires a certain number of Gyn and postpartum visits to finish clinicals for the very reason that they want to graduate a well-rounded CNM, not a CNM who is only experienced in labor and delivery. However, they also require a minimum amount of births and prenatal visits that comprise more than half of their required clinical hours, so I highly doubt that she spent 95% of her time doing Gyn.

cayenne06, MSN, CNM · May 6, 2015

Yeah I am going to have to disagree with you, summersunset. The high volume, high acuity experiences I got in CNM school prepared me for autonomy in a way that my low risk, low volume CPM preceptorship simply did not. I value my CPM experience, don't get me wrong. But my CNM training vastly broadened my knowledge, my experience, and my clinical skills.

AspiringNurseMW · May 6, 2015

I am a CPM just starting my ASN to CNM this fall. I am extremely grateful for my CPM training. One thing I can say about those who go straight through CNM is that they seriously lack experience and confidence. I have worked with new grads and those new to out of hospital, they are terrified and have super high transfer rates. It's a different skill set. I am very grateful I went CPM first so I could get the huge amount of clinical hours where I was the one resuscitating a baby, making the calls in dealing with a bleed or freeing a sticky shoulder. A friend of mine just finished her CNM with Frontier and she spent 95% of her clinical time doing pap smears and postpartum check ups (scut work). She was only called into the labor room when baby was crowning. If there were any complications the docs or peds took over. How does that prepare you for autonomous practice? It doesn't. Being able to spend 3 years hands on, one on one, assisting in every kind of scenario is priceless. This is all assuming you have a good preceptor that knows what she is doing.

Yea, ummmm no. Frontier requires a specific amount of births to be attended as primary, I worked at a birth center where we had a Frontier student and she made sure she kept pretty open on call so that she could meet that requirement. Your friend may have *felt* that she spent 95% doing "scut work", which if that's all she got out of doing GYN then I think that says more about her or her preceptorship.

We had 2 new grads as part of our practice while I was there, and they actually had the lowest transfer rate among all the midwives once they were practicing solo.

So while I can't deny your personal experience, I wouldn't paint all non CPM CNMs with such a broad stroke.

klone, MSN, RN · May 6, 2015

AspiringNM makes a good point - while it might be the culture of a particular facility to call the provider when the baby is crowning, it is also up to the individual provider to NOT be that provider. The midwife (or SNM, in this instance) can choose to be there, in the room, doing labor support, or making sure she's there as soon as the mom starts pushing.

Also, the clinical experience through Frontier is as vast and different as the clinical opportunities in that person's community - here in Denver, we routinely have Frontier students precept at the FSBC (no docs or peds there) as well as with the one CNM in the community who only does homebirth (no docs or peds there).

claritasd · May 6, 2015

Also I LOVE that so many of you have said you aren't a nurse at heart, that you're a midwife. I feel guilty sometimes thinking about taking a place in a nursing program away from someone who really wants to be a nurse when I don't want to be a nurse at all.

No need to feel guilty. You are NOT the only one. I never wanted to be a nurse, but here I am, halfway through an Accelerated BSN. All the other students are saying "we're halfway nurses!" I think of it as, I'm a quarter way a midwife. I happen to be enjoying my nursing experiences in school, but I still don't consider myself a future nurse. I'm a future midwife who is using nursing as a stepping stone to get where I'm going.

You're not stealing a spot from someone - you need the nursing program to become a CNM, so you're no more or less deserving of that spot than someone else, career-wise. You're there because it will help you reach your goals, same as the other students (just slightly different end-goals!).

cayenne06, MSN, CNM · May 6, 2015

No need to feel guilty. You are NOT the only one. I never wanted to be a nurse, but here I am, halfway through an accelerated BSN. All the other students are saying "we're halfway nurses!" I think of it as, I'm a quarter way a midwife. I happen to be enjoying my nursing experiences in school, but I still don't consider myself a future nurse. I'm a future midwife who is using nursing as a stepping stone to get where I'm going.

YES! I didn't even go to my nursing school pinning ceremony. Last thing I wanted to do was spend 2 hours in an overcrowded auditorium at the ungodly hour of 7pm, when i should be in my jammies.

I am graduating from CNM school TOMORROW, and you better believe I will be there with bells on. I've got an empty spot on my wall above my desk, next to my diploma from CPM school. I've purposefully left it open since 2009, when I decided to go to RN school with the goal of getting my CNM credential. And tomorrow I am going to fill it, finally.

DreamerCNM2b · May 6, 2015

That's so wonderful, Cayenne! Have fun!