MaineMan88

This is probably the most accurate assessment of CNM salaries you will find. See ACNM 2010 survey below: http://www.midwife.org/ACNM/files/ccLibraryFiles/Filename/000000002053/ACNM_SalarySurvey_2010_FINAL.pdf

What specialty program were you accepted to?

DancingNurse, In one of the posts above you mention that Vandy is a distance program with massive amounts of traveling. The last part may be true, depending on where you are placed; faculty make it clear that you will likely travel outside of Nashville for at least one of your rotations. However, Vandy's midwifery program is not a distance program--or at least not yet. Most of Vandy's specialty programs offer the distance option, including FNP. However, it is my understanding that there are a number of students in each specialty that have classroom spots. If you were to do the NMW/FNP dual-program, you would NOT be a distance student, unless you opted for that in your last semester which focuses only on FNP courses and clinical. In response to your questions, no, Vanderbilt does not require or suggest that students work as RNs after graduation. I know that a lot of the ACNP students have to work as a RN in order to get a job, but from my understanding, this does not hold true for any of the other specialties. The pre-specialty (RN) faculty are supportive of this route and even provide literature that suggests that NPs who start out as non-RN students are better prepared than those with RN experience (although I'm not sure if I completely buy into this). I can send you the article if you wish, just for a different perspective. Here's a blurb from the discussion portion of the article: "Based on the data collected in this study, duration of practice experience as an RN was not correlated with level of competency in NP practice skills, as determined by NP self report. An unexpected finding was that there was a significant negative correlation between years of experience as a RN and NP clinical practice skills as assessed by the NPs' collaborating physicians. Longer experience as a RN was associated with lower rankings of NP skills competency by the physicians.This information can lead us to question longstanding biases that claim that those with little or no experience as RNs are poorly prepared for advanced NP practice." citation: Rich, E.R. (2005). Does RN experience relate to NP clinical skills? The Nurse Practitioner, 30(12), 53-56. My point is not to prove that NPs who enter nursing school without a nursing degree are "better" than those with RN experience--rather, just to reinforce that there are many entry options into advanced practice nursing and that one path is not necessarily better than any other. So to answer your other question, no, I do not think that working as a RN is something that all new graduate CNMs should do or need to do. It might be necessary for some graduates--maybe not for others. I may have done a poor job articulating exactly what I wanted to say in my previous post. I don't necessarily believe that having RN experience correlates to having better NP skills (which goes along with the article I cited)--rather, I would say that having RN experience likely correlates to having RN skills, which will likely by utilized by the NP constantly throughout her career. I guess what I was trying to say is this: To become a NP or CNM, you will first need to become a RN in one way or another. Regardless of the path you take to obtain your RN licensure, that experience will be valuable both in forming your nursing skills and building a foundation of the nursing process and model--both of which will need to be strong in order for you to be a successful advanced practice nurse. Lilacs, I agree with LilyRoseRN that most RNs do not work within the medical model. While there are always those unfortunate exceptions, I think your assumptions are based on outdated stereotypes. In the clinical experiences I have logged working toward my RN, nearly all of the nurses I have worked with have been stellar--intelligent, as autonomous as policies allow, and excellent patient advocates. In other words, most modern RNs do a wonderful job upholding the nursing model. Peace, Nate

Lilacs, I am currently a student in one of the aforementioned "bridge" programs. I just finished my pre-specialty year, and therefore, will sit for my RN licensure exam very soon and will being my nurse-midwifery courses this month. I can sympathize with your situation because I have been there before. I had no interest in being a nurse and viewed nursing as a mere "stepping stone" to bigger and better things. However, I think you will soon find that nursing is not a stepping-stone, but rather the foundation of who you will become as a nurse-midwife. They are one in the same--there is no separating the two. You would not be a good nurse-midwife if you were first not a good nurse, or at least believed in the nursing philosophy. You mention that you don't want to be wiping poop off of the tooshes of angry and frustrated patients. True, you probably won't have to do this often as a nurse-midwife. But many of your patients will defecate as they "push" during labor. How will you respond? Will you call in a nurse and let the patient sit in her own feces until the RN arrives to wipe her butt? Let's say you need a nurse to start an IV and hang a bag of fluids, insert a Foley catheter for a laboring patient, and give an IM Rhogam injection. But let's also say that you are working in a rural area with a nursing shortage. There aren't any nurses to delegate these activities to. As a nurse-midwife, you are ALSO A REGISTERED NURSE. You have been trained to perform in this role and have proved yourself competent. Do you get what I'm getting at here? To be a competent nurse-midwife, you sure as hell need to be a competent nurse. And oh yeah--if you've spent a few years wiping poop off of the butts of elderly men in ICU pods or post-op cardio floors, or at least spent a year doing so in clinical rotations, wiping a little smear of poop away from your laboring patient's toosh will be no big deal. Consider this, keep doing your research, and keep gaining multiple perspectives. If after thorough reflection you still have the same aversion to nursing, I would suggest that you pursue a career other than nurse-midwifery. Best of Luck, Nate

Hey David! I am a CNM student at Vanderbilt, and I am male. Vandy is VERY accepting of men--the program director and another faculty member actually wrote an article in a nursing journal last year about the NEED for more men in the field. When I expressed interest in the program 2 years ago via email she actually called me on the phone and we were in contact over a period of months. Although I have not started the actual CNM portion of the program--I am completing the "pre-specialty" RN portion of the program right now and "bridging" into the CNM program in August--the midwifery faculty have treated me equally and with the upmost respect thus far. Perhaps not coincidentally, the male midwife from Pittsburgh that Nick mentions above actually closed his practice, moved to Nashville, and now works at Vanderbilt Medical Center. Consider Vandy! Nate

Vanderbilt.

Hey, I tried answering your PM but the messaging system kept messing up. I think it ate my first message and I wrote it all out again but the same thing happened. Let me know if you actually received it!

Hey Kate, I was one of the panelists as well, and I think we might have spoken afterward (there were so many people it was hard to remember names!). Bellevue is a nice area for sure. It's pretty out there and you are close to Percy Warner Park and Radnor Lake. However, it's a little bit of a drive (20-25 min) from school and VUMC, which can make a big difference when you need to be at the hospital at 6:15AM on clinical days (and with gas $$)!! I know a lot of people enjoy it out there, but if I were you, I would look closer to the Vanderbilt area since so many of your first year activities are centered in that area. Hillsboro Village, Music Row, and West End are all within walking or biking distance. It all depends on what you're looking for though! Nate

I have been through the same decision-making process that you are going through now, and I know, it's very tough. I am in Vandy's dual CNM/FNP track--my decision was whether to stick with the "dual" specialty or solely pursue FNP. In my experience, what it comes down to is that you have to go with what you feel in your heart. You can get advice from everyone and their mother, but when it comes down it, you have to dig deep down to realize 1) how your skills and characteristics can best serve a population, and 2) what will make you happy. If midwifery keeps tugging at your heart, just know that there are ways to deal with the different hours, the insurance/MD issues, the complications when having a family, etc. All of those things can be managed--but what can't be fixed is living your life knowing that you turned your back on your passion. Don't forget that Vanderbilt offers the best of both worlds through the "dual" program that makes you a FNP and CNM in less than 2 years. Best, Nate

Hi There, I can't really give you a definitive answer of "what they look for"--I suggest contacting admissions and asking them what makes successful applicants stand out. However, from what I can tell, they really look for diversity in demographics and in experience. For example, I am a male in midwifery, which is a rarity, and I did a unique community health outreach project in Guatemala; I think these two things made me stand out the most. Other students have organized and led needle exchanges, have their master's degrees in fields such as clinical psychology and neuroscience, have done medical missions in India and South America, worked as a doula for years, etc. So, I suppose my advice to you is to identify something about yourself or your experiences that makes you stand out, and emphasize that in your application essays. The FNP/CNM option is great--that's my program--but it is true that it may be difficult to actually work as both a FNP and CNM simultaneously in practice. The program was designed for individuals who wanted to work in very rural environments where they might be the only provider for miles and miles. If you were going to work in a rural environment, this option would definitely make you more marketable. It's more questionable if you are working in an urban environment; most likely, you would end up working as one or the other. However, as the CNM director told me, it IS possible to work as both a CNM and FNP in an urban environment if you can be creative in the way that you pitch it to your potential employer. Let me know if I can be of any more assistance. Nate

Okay. Since I am in my pre-specialty year, I cannot tell you much about the actual FNP and CNM programs. However, I have had limited contact with the FNP faculty but a considerable amount of contact with the midwifery faculty and director, and I cannot even begin to communicate to you how wonderful they are. I have spoken to numerous second and third year students, and they have only had good things to say. With that being said, pre-specialty year is just one of those things that you need to "get through" wherever you go, and I think you'll hear that from most students at most schools. It is definitely accelerated. A lot of my classmates have been extremely stressed out, but I have found it to be a good pace. Just depends on how you manage stress. Most of the faculty is great. There are a few that we dread having, but the majority of professors are fun, informed, and especially ACCESSIBLE and INSPIRING. If you email a professor, expect to get a reply within a few hours. Accessibility: My clinical instructor just had a baby, but she is still giving me prompt feedback on my SOAP notes even when a substitute instructor is already grading them for her. Inspiration: A few professors (particularly one of the pediatric specialists who does a lot of the clinical lectures) are straight-up inspiring during their lectures. I just sit there in awe. So awesome. I don't think you should be concerned that it would only take two years to get your masters--however, you said you are a non-nurse, so be aware that if you took the dual FNP/NMW route, it would actually be almost three years total (3 semesters RN; 5 semesters FNP/NMW). If you just did FNP, it would be 3 specialty semesters; if you just did midwifery, it would be 4 specialty semesters. But anyway, I think the reason that Vanderbilt's program is faster than some of the others is that we take classes through the summer. A good friend of mine is in the Yale program, and she has 2 years of specialty work for pediatrics while I will have 2 years of specialty work for both family practice AND midwifery--and this is because she has summers off while we at Vandy will be in class. I assure you that your education/training/preparedness will NOT be negatively affected by the accelerated nature of the program. Vandy pumps out all-stars. Sorry if I've rambled or if this is not totally coherent--I'm pretty tired and trying to simultaneously prepare for lab. Let me know if I can be of any help! Nate

Hey All, Thanks so much for the encouraging words. I am a few weeks into the program--well, the prespecialty RN year--and although I won't start actual midwifery content until next year, I can already tell that I'm in an amazing environment where my gender really will not be much of an issue. I appreciate your support while my confidence was wavering this summer!

Silent Siren, I am currently in the dual FNP/CNM program, but I come from a non-nursing background so I am in the pre-specialty year working on my RN. So, would you be entering Vandy as a non-nurse or as a RN?

Thanks CEG, I will definitely check that out. $50k would not be the cost for the entire program; for the dual-degree it would actually be 3 years at about $50k each year, so I am looking at a debt similar to yours, if not more.

That would be fantastic! I haven't used this site very much so I'm not sure how to personal message you--I'll try adding you as a contact and maybe that will give me the option for a PM.