vimmie

I did a similar job in NYC in the Spring and Summer, worked as a nursing assistant while finishing school during the surge. Now I’m hired by the unit as a RN. Definitely worth it!

If you’ve been there 5 years that’s plenty of time at one job. When I was burnt out at my job , the best thing I did was get out of there and find something more fulfilling. Good luck!

Absolutely take it! Happiness is the most important thing and loneliness is the worst. From what you’ve said it seems a no brainier to me. How long have you been in your current position? If you are happier you are more likely to progress and make more money in the long run too.

No problem! Good luck with everything. I just checked on the ACNM website and it says: "In order to take the exam that is offered by the American Midwifery Certification Board (AMCB), which leads to the credential CNM or CM, the individual must have a graduate degree from a US midwifery education program that is accredited by the Accreditation Council for Midwifery Education (ACME). This means that most midwives educate abroad will need to take at least one additional course from an ACME-accredited program."

Hi Maria! I hope I can help you out a bit. I think that your Spanish nursing qualifications will probably transfer to the US. The best way is to have your qualifications evaluated by an organization in the US. Hopefully a nursing agency will be familiar with one they would recommend. They’ll probably charge a few hundred dollars for this and you’ll have to send all your transcripts from nursing and midwifery to them. Then you will have an idea if you are all good to go (once you have sponsorship) or if you need to do any other qualifications to become a US RN. The NCLEX is the national exam that all US graduates of nursing take. It’s pass/fail and you’ll probably also have to do this to get your RN license. Yes you could definitely work as a L&D nurse as you get your CNM licence. I work as a postpartum nurse while getting my CNM. You are basically working as a L&D nurse in the UK. L&D nurses just have less responsibilities as they don’t (usually!) catch the baby or suture afterwards. Good luck with your journey! Let me know how you get on.

Hi there. I did all my pre-requisites for nursing school living in London through John Hopkins online. I know at the time, not all programs accepted online pre-requs but this year they are probably not as strict. John Hopkins were OK, were fairly expensive though from what I remember. Maybe there are some cheaper ones that the colleges you want to go to would accept? You just need a decent internet connection. I know I didn't have to be online at a certain time. Good luck! I understand your frustration but your MPH will be useful in nursing school later on down the line.

Hi there! I've just been hired by NYP and was wondering if it qualifies for public service loan forgiveness? This might be a silly question. Anyone know? Thanks so much

Happy to reassure you. Most CNMs work in hospitals and work closely with physicians to achieve the best outcomes for pregnant people whether they have a completely blank medical/obstetric history or if they have had complications previously or ongoing. CNMs definitely support interventions, medications, epidurals,cesarean births when it’s appropriate. Unfortunately there is a lot of interventions/medical care that’s unnecessary for low risk women. However, due to your personal experiences for example CNMs would be highly supportive of the collaboration with the widely medical team. What CNMs do is look at the person from a holistic point of view and have a more equal decision making relationship than a traditional doctor patient set up. Hope that helps! Good luck with your application.

For example- Columbia has a 15 months masters to get an RN (so you're not repeating your bachelors which is nice) and then the DNP midwifery is 2 years straight after that. Good luck with your search!

It’s got to be better than some of the regular/renal/cardiac trays I’ve been seeing! Get more plants to those patients

Lemme send you a private message!

No problem at all! Hope it helps. You can definitely do it cheaper but I wanted to get back to work quickly. So it’s over $100k for an Ivy League school on their accelerated 18 month program. It ain’t cheap! But the teaching is very good and pay over here is much better once you start working. As I said you can do it much cheaper. University of Minnesota is very well respected. You could also be a CPM (a homebirth midwife) but the integration between home and hospital maternity care is very poor. You wouldn’t be able to work in a hospital as a CPM and they aren’t allowed to practice in all 50 states. Good luck with your move. Let me know what you choose to do!

Don't worry- it is super confusing! So prior to like 2000 or so all UK nurses were 'general' trained. My aunt for example as part of her nursing did every large specialty (maternity, pads, adult, mental health). So it is easy for those nurses to qualify as RNs in the US. But because our direct entry course is so specialized in maternity we don't have the broad scope that US RNs do. Adult trained UK nurses are the only ones that have the scope to take the NCLEX (the exam that you need to take to be a US RN). But often adult trained UK nurses are deficient in maternity and pediatrics. There is no bachelors prepared midwives. All certified midwives or CNMs have to have do a masters. Certified midwives are only licensed in ~5 east coasts states so you need to be a nurse first if you want to practice as a hospital midwife in Minnesota (then take a masters or doctorate to be a CNM). The scope of practice of a CNM is so much larger though (teenagers- post menopausal) you do well women gynae clinics and you'd have full prescriptive authority. It's kinda like a UK version of a RM/junior SHO/GP (that specializes in women's health). Anyway- I'm still learning how it works! But yeh that's my plan accelerated nursing masters for 18 months and then a two year midwifery doctorate. Then back to work! Re. NMC pin- my move to the US is permanent so this year I was due to revalidate but didn't. Just took myself off the register from the end of this month.

Hi S1mm1! I'm doing the accelerated nursing masters and then a midwifery clinical doctorate so will end up being a CNM in 2022! Can't wait to be a CNM. It's fascinating seeing the similarities and differences between UK and US maternity care. Both have got their own challenges but I'm excited by the increased scope of practice here in the US. I miss my colleagues in the UK though and I find that obstetric model of care is a lot more prominent in the US. Hopefully in the future there will be more CNMs compared to OBs and the midwifery model of care will be more accepted. That's great you are going to MN! Me and my husband are thinking of moving there after I graduate. ?

It’s easy and fairly accurate to date a pregnancy using a woman’s last menstrual period date. Ultrasounds are also not perfect- estimated due dates have a margin of several days either side. Babies have been weighed at homes and in hospitals for a long time, definitely 1950s onwards. Everyone always wants to know the baby’s weight!

Yes. Definitely there is a middle ground. I come from a country where you have a national health service where there is no billing the patients and no charging insurance companies so people get what they need and nothing extra. In the US you can bill for a range of unnecessary things to cover yourself or it’s more profitable for the hospital/service. You compare the recommendations for cancer screenings in the US compared to Europe or Australia for example. When you allow advertising of prescription medications on TV too people think they need a medicine to solve everything and then go and demand this from their provider. Take circumcision of newborns for example. Completely medically unnecessary and comes with a whole bunch of risks but because it’s profitable for people to do- it’s still done routinely.

Sounds like you are a wonderful nurse. I wouldn’t loose any sleep about it. I tried to figure out the science between the care me and my colleagues provided and the praise we received but who knows?! Some of my most caring colleagues complain that they don’t ever get cards/mentions. Sometimes I wonder if it helps to give just a bit of your own personal story to your patients so they see you more as a well rounded person rather that just a fabulous nurse. Hmmm. Anyone with a background on psychology?!

I can only speak from the UK but we would never separate mom and baby within the first 4 hours (unless in an emergency and one or both was very sick). The midwife (we don’t have OB nurses) would stay with the woman and baby, making them comfortable, providing refreshments, finishing paperwork while STS is on going. If we were happy with both mum and baby we would leave them with the call bell and then go into the room now and then to check on them and go back if they need anything. We do skin to skin in the OR after we’ve dried baby and checked they can breathe ok! Then we transfer to recovery remaining skin to skin. Hope that helps.

Yeh- don’t think you’ll find much because there are very few women that don’t have their spouse/partner in the labor room with them these days.

You could look at women's opinion on their birth experience. Like how satisfied they were with their birth experience or you could look at the rate of c sections or epidurals between different women using different types of support. Tbh, most women have some type of support with them in labor and that support varies a lot, from the partner who sleeps their way through labor in a chair to those that are at their partner's side throughout with water and cold wash cloths. There are several research papers that explore how doula support specifically helps with improved outcomes. Personally, I've found sisters/mothers/aunts some of the best support for women during labor.

Sounds like you are doing the right things, talking to colleagues and supervisor about it. Talk about it as much as you need to. It will take time. Time is a great healer and with time comes perspective too. Unfortunately birth is not without bad unpreventable outcomes, whichever facility you work in. I'm sorry you've gone through this. Everyone who has worked in OB/GYN long enough has been through a similar experience and you constantly question yourself and ask 'what could I have done differently?' It is especially hard when things like this happen in your first few years as a L&D nurse. Treat yourself to something you've wanted for a while or a weekend away. You have done enough. You are enough.

I’m looking forward to comparing the two ways of working but with the two very different healthcare systems I feel it might be comparing apples to oranges. Im looking forward to having full prescription powers as we only have a narrow range of drugs we can give without a Dr prescription in the UK (no abx or pitocin for example) and the range of women we care for is different in the UK (just pregnant women and postpartum for 28 days instead of complete well women care. But it I feel that the barriers to access care are higher for disadvantaged women in the US and the OB/midwife relationship might be a bit less supportive as the midwife numbers (relative to the UK) are smaller and from what I’ve read. Anyway- they are my assumptions before I start. Looking forward to learning a lot from my experience on the other side of the Atlantic.

Nice! Best of luck with the NCLEX. I hear that it’s all in the preparation. Will you go into L&D nursing or another specialty?

Thank you so much LibraSunCNM! I thought it would become apparent when I started clinicals but it’s great to have a rough understanding of the roles. Amvictorious- that’s great! Where are you moving to/moved to? What bought you state side? Sadly, because I’m a direct entry midwife my midwifery degree is not acknowledged in anyway (apart from it being a bachelors level qualification) and I can’t sit the nclex. To give myself full flexibility I’m doing an accelerated masters in nursing and then a three year DNP in nurse midwifery. I’m working at a London hospital currently.

Yes. I’m a UK midwife who is emigrating this year to NY. We don’t have OB nurses, just midwives and doctors on our labor wards so I was just wondering how it all works within the team in US hospitals. I have a place on a CNM program which I’m excited for as it’s more expanded than my role in the UK. But I have a few questions of how the team works together over here. Thanks so much!