Bree124

What do folks think about jumping into a specialty like OB right away, vs doing med-surg for a year or two?( there is an opening at the hospital where I go to school and they are willing to accept new grads) Do it!! I went straight into L&D, and I don't regret it at all. I had a few years of high-risk L&D experience as an RN before graduating as a CNM, and that experience was amazing. I was lucky enough to work in a hospital with several CNM groups delivering there, as well as being a tertiary care center with a level 3 NICU and lots of pretermers, HELLP, etc. It was a great mix and really built my confidence, because I was able to see so many different things. Plus, the experience of working in L&D makes CNM school easier, in my opinion. Is anyone familiar with working with midwives in the hospital setting, and if so could you shed some light on your experience? This can vary so much. Midwives in some hospitals work very independently, and in others not so much. I think shadowing a few midwives would give you great insight into how things work in your local hospital/s. For the practicing midwives out there, could you offer any advice to someone in my situation? Older student, with family, etc. How do you balance home and work life? It can be tricky. I would not be able to do this job without an understanding and supportive partner. Depending on the age of your children, taking a job with call wouldn't work if your husband is out of town frequently. However, I know people who have graduated in midwifery, then took a job doing women's health care in the office without doing much prenatal care and not catching babies at all. This might work for you until your kiddos are older and can be alone at night, then you could try to find a position doing full scope prenatal care and taking call. Good luck with your decision making!

Right, the exact same reason you are a nurse and not a physician, right? Get a clue.

Generally if you "pass" the HR interview, you are considered eligible to work at that facility or organization. If you are turned down for a position by a nurse manager after the second interview, it just means you weren't a good fit for that unit - you should still be eligible to apply for other units and positions within the same organization.

If you can find a midwifery/woman friendly place to work as an RN after graduation, I would definitely recommend a year of experience. I have been working as an L&D nurse since '09 in a tertiary care facility that also has a high percentage of midwife-attended births. It is the perfect blend for me, because I have everything from super low tech births (no IV, mom in whatever position she wants, intermittent monitoring, etc.) to high risk (severe HELLP). I do really believe that someone can be a good midwife without L&D experience (especially if that experience is only in a medically-oriented facility), but I think the experience can also be very beneficial. Good luck with whatever you choose!

International Board Certified Lactation Consultant. OP - I am sorry, I don't know how much they make. Can you find it on Salary.com? Our facility has three IBCLCs employed, solely in that role. They do not work as L&D or PP RNs. A few of our RNs have done the lactaction specialist training (far fewer hours than an IBCLC), and have not had an increase in pay.

Our pharmacy used to mix the bags and stock 6-10 in our pyxis, with an expiration date around 72 hours after being mixed. Now we get them premixed from a manufacturer, and they don't expire for several weeks.

Our facility does not allow elective inductions until 39 weeks, and then only with a favorable Bishop's score (no cervical ripening agents are allowed for elective inductions). If the score is not favorable, elective inductions are not allowed until 40 weeks 5 days. I think this policy change is great, but we have definitely seen an increase in "medically necessary" inductions - current favorites being resolved IUGR (???), "IUGR" (with baby measuring at 20%), and of course, the all time favorite - "preeclampsia," with a BP of 115/50 and absolutely normal lab values. Very frustrating, and I think it reinforces the mentality to patients that if they act like a pain in the butt and annoy their providers enough, they will get preferential treatment. The rationale for not doing these inductions is also very hard to explain to patients who are having their fourth or fifth baby, and were induced around 37 weeks with their other kiddos. If the provider hasn't broached the topic during the pregnancy, having the nurse or midwife tell the patient in triage that we're not going to admit her for an induction just because she is 38 weeks always comes as a surprise. I always try to explain the latest research, and how it is so much better for baby to be inside unless there is a reason to be out, but moms are just sick of being pregnant and don't seem to care. Many have even said to me that they don't think it would be a big deal if the baby had to go to the NICU for a few days. Ugh!!!

Thanks for the clarification. I am not yet a midwife (in my last year of school), but I would not feel comfortable attending a home birth for a woman who was only 34 weeks. However, many women walk around several cm dilated for weeks before delivering. Hopefully she will either make it a few more weeks, or choose to go to a hospital if she does kick in to active labor soon.

Are you asking for advice, or just wondering about the situation? From what you posted, I am not sure entirely what you are asking. Most women who deliver with a certified nurse midwife deliver in a hospital. Only a small fraction of CNM births occur out of the hospital setting. Her advanced dilatation at 34 weeks probably does not risk her out of a CNM birth, unless the hospital has a specific policy that says so. Anyway... as always, we can't give any sort of advice on this board, but I am unsure of why she would no longer be a good midwifery candidate based only on the fact that she is 4 cm at 34 weeks.

We don't open, or even pull anything. As Elvish mentioned, your likelihood of a repeat comes from failure to progress, not uterine rupture. However, we also have our own ORs and in-house attending OB coverage at all times.

Tulip34- When you are searching for a job while in the MSN phase, does the college of nursing help you find work? No. You will need to search out job openings and apply on your own. Are there many people who have trouble finding work as an RN? No. However, keep in mind that you may not be able to find a job in your area of interest, or even in an acute setting such as a hospital. This really depends on how long you are willing to search for a job, as well as what hours you are willing to take. L&D is particularly hard to get into as a new grad, but I am unaware of anyone in the Milwaukee area who was truly unable to find a job as an RN after diligently searching (AKA, not just applying to three day positions and then saying they are unable to find a job :)). When they do begin work, is it usually work in their specialty area (eg, future midwives work as an RN in labor & delivery, etc.?) This really depends on what is available when you apply. I was fortunately able to find an L&D job right after finishing the undergrad DE portion of the program. Others have had to take jobs in med/surg or LTC to get some experience, and then apply to their area of interest (ICU, L&D) after working for a year or more. If you have more specific questions about the midwifery program at MU, please PM me - I am more than willing to answer.

I'm not sure what you mean by "saturated." We have a lot of midwives who deliver at our facility (maybe 25?), and two of them are men. I haven't come across any patients who didn't want them solely because they were male.

We give both hydralazine and labetalol IVP frequently, and do not have the pts on tele. We do frequent BPs and pulse rates, but I think I would be much more comfortable if they were on tele monitoring.

Once you are an LPN, you can do a bridge program to become an RN. I don't think it would save you any time to do LPN then RN rather than just starting from scratch and becoming an RN. One advantage of doing the LPN-RN route would be that you could work as an LPN while finishing your RN, but I don't know if you would have time for that since you are a single mom. Good luck! Hopefully someone will have more advice or information for you.

I had one of those a few years back for my life insurance policy, just got weighed, had my vitals done, filled out some forms, and I think that was it...