Decisions on CNM vs. FNP

Specialties CNM

Published

Specializes in Neurology/medsurg/PCU.

Hi All,

This is my first time posting on this page. I have long read these posts and am now in need of some help myself. I currently work as an RN in inpatient Neurology medsurg/tele/PCU. I am currently enrolled part time in an FNP DNP program, I am in my 3rd semester. From age 13 to pretty much 21 I strongly wanted to become a midwife, it was the whole reason I went into nursing school. I ended up swearing off this path after my maternity rotation in school because the nurses at my clinical placement were very cold, pushed me away, and seemed fairly uninterested. I instead decided to become an FNP as this would allow me to do a little bit of everything, which I also like.

So here lies the problem. Lately, I have noticed in my FNP courses, all my topics of choice for projects have been women's health focused. I miss this area of interest and long to be imersed in it again. I have begun speaking with a midwife to understand more about the profession and have the idea to possibly switch from FNP to a midwife track, if I am admitted. I am unsure if it is wise to jump in head first to a midwife program and stop FNP all together or if I should finish out my FNP track and then midwifery (I finish FNP in 2024... very long.. but get doctorate) OR if I should attempt to find a dual program in midwifery and womens health NP. Also curious on if I should switch my current job to somewhere maternity related and if so how soon.

I would appreciate any feed back, thoughts and ideas, or questions, especially from nurse midwives or those in school. Thank you all so much in advance ?

WOW!! That’s a long DNP program.

A lot depends on what you actually want your career/practice to look like. If you’re sure you absolutely want to catch babies, then you might want to look into switching to a midwifery program. But if you’re not sure or if you think women’s health (without catch babies) would be a fulfilling career, then I’d stick with the FNP program.

There are some FNPs who work exclusively in women’s health and even if you don’t end up doing that, there is nothing wrong with having a niche or primary interest in women’s health. There is always the option of doing a post-grad certificate in midwifery once you are an FNP.

For now, I would suggest staying with your program unless you are absolutely sure you want to catch babies and really have no interest at all in primary care for men and kids. FNP is great in opening up lots of possibilities but it’s only worth it if you could see yourself taking advantage of those possibilities. I would also encourage you to try to shadow a midwife and/or explore whether you can get some experience working in L&D/post-partum. I hope that helps a little.

Specializes in Neurology/medsurg/PCU.

Thank you both so much for your input. I was actually mid set up to shadow 2 midwives in the Boston area this Spring but my plans were a bit thrown due to COVID. I have been able to talk with 3 midwives the past 2 weeks, 2 of whom teach in my FNP program which has been super helpful but still not the full in person experience. At the moment I am leaning towards finishing my FNP DNP degree and transitioning to a labor and delivery or maternity based job in the next year to gain a better understanding. After this is finished, pending I feel the same as I do now, I would like to attain my post graduate certificate in midwifery. Hopefully this will allow for time to grow, flexibility in the future, and a solid educational understanding of both areas. Thoughts? Is there benefit to having both FNP and CNM?

That sounds like a great plan. I think there is tremendous value in being both a CNM and FNP. There is an increased emphasis on midwives also being primary care providers but this has been a more recent change so many current midwives/midwifery faculty haven’t been trained in primary care and may not be comfortable with it. Unfortunately, finding a job that allows you to utilize the full skill set can be a real challenge. I did a dual CNM/FNP program because I wanted to provide full spectrum family healthcare (like the traditional family doc who did womb to tomb including attending deliveries). I think there is a place and definite need for this type of care but it’s becoming less common even for family physicians to do full scope family medicine and most dual trained FNP/CNMs practice primarily as one or the other. But even without practicing both at the same time, there is a lot of value each can add to the other.

Specializes in Neurology/medsurg/PCU.

Thanks so much for sharing :) I am so excited for the future. I am so glad you mentioned you are CNM and FNP, I actually have not met anyone with both before. Which degree do you primarily use? I can imagine it is hard to find a job to utilize both. What are your experiences like having both? Would love to chat more

Happy to help! PM me and I'd be happy to talk more specifically.

1 Votes

Hi!

I was in the same boat as you not too long ago, except I am currently in the CNM DNP program and wanted to either switch to FNP DNP or get the certificate after I finish my CNM degree. While in nursing school I got into a 2.5yr FNPDNP program and I got into a couple of CNMDNP programs and decided to go for CNM because that's what I wanted to do, and was told that the FNP market is so saturated, and that I should go for the specialty, especially if it's what I want to do.

My final decision was to go for CNM and go for FNP afterwards. I also wanted to see if I needed to obtain experience as an L&D nurse and I've heard from all of the midwives that I have reached out to that it is not necessary. What is necessary is to understand and appreciate the role and responsibilities that L&D nurses hold, although having that experience would help with learning about fetal monitoring and more. I am currently and urgent care nurse and I feel like I am getting an ample amount of experience as a healthcare provider in general and will have broad experience before I dive into a specialty career.

This is just my experience from what I have heard from people but ultimately it's up to you! Either way, I think you will be okay! :)

Specializes in Neurology/medsurg/PCU.

Thank you so much for your comment! It is good to know someone else is in a similar situation. It’s interesting you were told to do cnm instead of FNP for saturation as I was actually told the opposite! I was pushed towards FNP with people saying how there is an increased demand for this role (but my heart is really in cnm). I am seriously considering switching to an L&D job but want to make sure It is a good fit as I love everything about my current job... besides patient population. How are you liking cnm school? Where do you go?

Hi!


I am a currently practicing FNP, and I really do like it. In undergrad though, the plan was to go into L&D and then onto CNM. However, I ended up at an awesome pediatric facility and eventually in an FNP/DNP program after several years at the bedside. I still hold onto the eventual dream of post-grad midwifery certification, after we finish up having our own babies and get them all into school! I think FNP skills will translate well into the CNM role (though my specialty at this point is men’s health, with a healthy sprinkling of primary care)— I’ll already be well settled in the APP role and comfortable with a good number of the normal complaints! I joke that I think I’d make a great asset on a team of CNMs— I’ll treat all the rashes and streps and tummy bugs, etc. I obviously can’t tell you the outcome of these plans, because they probably won’t come into fruition for another decade, but I love seeing like minded people discussing this. I see midwives first my own care and love picking their brains. Receiving care from them totally brought all my old dreams of baby catching back to life!

Kelsey

1 Votes
On 6/10/2020 at 11:51 PM, Steph Knepper said:

Thank you so much for your comment! It is good to know someone else is in a similar situation. It’s interesting you were told to do cnm instead of FNP for saturation as I was actually told the opposite! I was pushed towards FNP with people saying how there is an increased demand for this role (but my heart is really in cnm). I am seriously considering switching to an L&D job but want to make sure It is a good fit as I love everything about my current job... besides patient population. How are you liking cnm school? Where do you go?

Hey sorry for the delay! That's interesting, every single person I have come across (including practicing FNPs) have told me to go into a specialty first. But it probably is the location you are in that makes the difference. If your heart really is in CNM, maybe you can shadow a midwife? Even if you stay in the FNP concentration you can still continue to make all your projects women's health focused and go for a women's health NP job after you're finished and do the CNM cert afterwards if you don't want to make the switch.

I am actually going into my 4th semester of DNP school soon (time flies!) and won't be taking any specialty courses until fall 2021. I go to West Virginia Wesleyan College mostly online (until clinicals and some on-campus residencies) but will be taking the specialty courses at a partner school. I'm doing full time but only 2 classes per semester so I can work, which has been steadily busy and crazy busy at times. If you have any questions feel free to pm/inbox me!

Specializes in Neurology/medsurg/PCU.

Thanks so much to both of you! I actually just started my 3rd semester of DNP FNP schooling so I completely understand. I also agree that it is nice to hear from others who have like mindsets. Currently, I have decided to finish out my FNP schooling then after do a dual certification as a CNM. I am working on deciding when the best time to change to a L&D job would be, I’m hoping within a year but now is not the best time to change jobs. Also have to factor in being able to get A JOB without maternity experience... anyhoo that’s me!

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