mom2michael

And mine came almost 30 mins. late....LOL. Questions are run of the mill - why do you want to be a Midwife, what life experiences do you have that contribute to your decision. Can you meet the demands of grad school. What life sacrifices are you willing to make (ie, job hours) to ensure you finish school. It was a piece of cake really. NOTHING to be nervous about at all.

100% of my PTO paid out when I changed status.

I think they are awesome, wonderful, fabulous people. I work in a facility right now that doesn't support women's choices very often, including doula support and my moms have told me in confidence that so and so is really doula, but they tell everyone else it's a sister or mom or friend. Remember this is YOUR birth and not theirs. Congrats and good luck to you!!!!!

GN 1-2 months in PP then they move them to nursery where they get 2-3 months in there. Experienced nurse WAY less, about 5 weeks total for both areas. We do not do mom/baby care, we have PP nurses, nursery nurses. Each job is separate. We pair our new employees with a seasoned nurse. They are 1 RN in our staffing (not 2). Usually everything goes while in orientation. If it's a skill or a procedure yet to be done then you do it with the help of your preceptor.

Do the research on the facility you want to deliver at if need arises. Talk to your midwife. Get all the details, the good and the ugly. My current job does not support Midwifes, Doulas, Birth Plans or anything of the sort. The doctors do not support it, the staff does not support it. They are catty, mean and hateful to those who present with a birth plan. They will shred a patient and her Doula. It's horrible. I'm quitting this week because I can't in good conscious continuing working in an environment that is so catty, nasty and disrespectful to their patients. Not to mention, they are so reactive rather than proactive. However, I'm going to be starting at GREAT facility that supports moms wishes (with in reason of course). So they exist. Just make sure everyone is on board with your plan. BTW, congrats

75,000+ metro population in the area in which I work. We do it all. You might labor a patient one shift, next shift take care of her PP and the next shift take care of her baby in the nursery if it's gone to Level II status. You just never know what you'll do when you come to work. We are a small OB unit in comparison to our competition and counterparts. There are 6 hospitals in the area that deliver babies. We deliver 70 or so babies a month.

It seems your mind is already made up about returning to Tele. Don't let the NRP class get in your way. Can you talk to education about maybe just paying for the NRP class yourself? Perhaps call the birth center and your preceptor/friend there and see if they have some suggestions on NRP. If money is an issue, put aside a bit each pay period until you have enough to take the class. Maybe pick up an extra shift before school starts to help pay for it. Surely there has to be a way to get the NRP class w/o being an L&D nurse. My NRP class had maybe 2 L&D nurses, the rest of us were ER, Nursery, NICU, L&D PACU and RT. Very diverse group of people......... The work schedule also seems to be a bit more conducive to your school/life schedule. Nothing wrong with that either. Nights work for some, others need days. If your manager is willing to let you do 75%, weekend days, then I would say go for it. It will be a pretty darn perfect schedule during school. You start school in Jan. and you are in a for a very long, very wonderful journey. You need to be able to focus on that journey without the constant stress of work getting in the way. Oh and don't feel guilty about anything. You are a month into it. You've tried it, it wasn't for you. No shame in that. L&D isn't for everyone thats for sure!!!

Our sections go to PACU, so I don't know what their protocol is. We check once upon admission to our floor and then we check with our shift assessment. We have the option to check more if there is a clinical indication to do so. However, we do have 2 doctors that specifically write no fundal checks after a C-section and if there is a concern, page them and they'll come in and see the patient. Their rationale is that after major abd. surgery we do not need to be poking and "messing around" with their work. SVD we do fundal checks Q15 mins for 2 hours. At the 2 hour mark we try and get the patient up and ambulating around the room, to the bathroom, etc.... and then we check again. As long as it stays firm after the first trip around the room, we go to checks with our shift assessment unless there is a reason to do more.

What a tough decision to make. You are gonna make an awesome CNM when you finish school!!! It's just getting to that point and not making yourself crazy, believe me, I know. It's really OK to have Tele experience and Critical Care experience as a CNM. I actually think it will make you a very well rounded CNM. And I think it's awesome you are going to be a birth assistant. Perhaps that is the balance you need. I'm gonna try and stick it out a year. I don't know that I'll make it, but I'm going to give it a shot. I'm about to come off orientation which I think is going to help and when I come off orientation I'll be mainly PP/Nursery and the 2nd L&D nurse which is fine by me. I've also gone to nights, which has helped out TONS. It's a bit more relaxed on nights. No more endless line of Pit inductions, C-sections, etc...... I don't know that I'll make it the full year but I'm gonna at least try. It's been tough though because my ER job is actually still open (she never found anyone to fill it) and they now have another ER job open and there is going to be some shifting around of staff so it might be even better hours/days than my previous job. It's been REALLY tempting to come back lately. I miss my coworkers, I miss the doctors and I miss the ER sometimes. Good luck and keep me updated on what you decide to do!!!!!

In all the ER's I worked in (3 total) we always removed the sutures, free of charge, in the triage room. We would have the doctor look at the site on a as needed basis. I'm not a billing expert, but I understood it to be in the bundled billing charge for the suture placement.

We have a group of docs that don't care at all. Whatever you want after ROM is fine with them. We have another group that doesn't let them move from the bed after ROM and 99.9% of the time as soon as soon as we have ROM, then it's off to IUPC's and FSE's anyway. I wish we could send them home and let them stay at home but if a patient presents to our triage with ROM, they WILL have a baby in 18-24 hours period. If that means a C-section then so be it. If we have a ROM >18 hours, the baby is started on ATB of the Peds choice, even if the CBC is normal and baby has a normal (and stable) temp. Preventive care measures they call it.

Contact St. John's or Cox Health Systems. Both have RN programs associated with them (I think they are both BSN now) and they used to have programs that if you worked for them post graduation they would pay a portion of your tuition. You will need to call them directly though to find out the status of their programs. I've worked for both systems. No complaints. Missouri also currently participates in the Health Forgiveness Loan, you can obtain information from the Missouri Department of Health website (look under Health Professionals near the bottom of the page). Good luck!!!!

Thanks, that was a wonderful pick me up tonight before I head off to work!!!!

Oh, I would like to think I'll be a more open minded, less intervention kind of gal than my OB counterparts, otherwise I'm about to waste a lot of time in school for nothing. But seriously, I'm going to take a gamble here and say, it probably has to do more with what type of facility you are working in than anything else. Just like with every aspect of nursing and healthcare, there are some great places to work and some not so great places to work. I have some great hope though after reading some posts. There are still great OB departments in the world and that makes me happy.

This is exactly what my husband thinks. Our patients come in and don't know any better. Whatever the doctor or RN says must be right. Informed consent is a joke. They aren't informed. If they are on the fence about anything, believe me, any of the RN's where I work will be glad to swing them to the side of THEIR comfort and ease, not mom's comfort. I try and educate my parents the best I can but it's a long, long, long process that should've started with their first OB visit not when they are in L&D, getting ready to have a baby and so excited they can hardly stand it and they have an attention span of a 3 year old on a 4 day sugar rush. A lot of the RN's I work with play that card against the parents. You can convince someone to eat a onion if you sell it like an apply ya know???? And I also agree with a previous poster that some of the patients not only expect it, they demand it. Of course, it's their labor, their delivery and their life choices they have to live with, not mine. This is one area I know I struggle with.

Frontier requires 1 year of experience in any field before applying. You said ASN program, so I'm assuming you are applying to the Bridge program. Word to the wise, that is a very competitive program from what I hear so they'll take that 1 year experience pretty seriously, along with your GPA, references, etc.... Does that experience need to be in L&D. Only you can decide that. I was forewarned by several students though, it may not hinder you during your schooling and during clinicals BUT it could come back to haunt you post graduation. There are many jobs that will take a new CNM grad, with experience in L&D as an RN as a stipulation. There are several threads on this forum alone that address this issue in particular. I compare this to the age old analogy do you need M/S experience before you dive into a speciality when you graduate? Probably not. But does it hurt you to have M/S experience before you go into a speciality field? Probably not. I wish you luck - you can read thru some of my trials and tribulations as well as some others and decide if it's worth it to you to get L&D experience. If I had a chance to do a "do over" I would not get the L&D experience. I would stay put, right in the ER where I had a great job, great hours and great co-workers. Don't need the added stress of my nutso OB job along with school right now.

I work in a fairly large area, fast growing but our unit itself is pretty small. We deliver about 75 babies a month. Not a large metro area though and our hospital is a far cry from a teaching facility of any sort. We deal with OB's, no residents, no interns, just straight OB's. Family Practice docs were booted out a few years ago, they were a bit too liberal in their thinking. No practicing CNM's anymore because they were WAY to liberal thinking. The staff gives the doctors what they want because that is way they think it works. It's a game. They play the game with the doctor at whatever cost to the mom and the baby. Our manager knows, she claims it's too far gone to fix. I'm totally miserable where I'm at but I really enjoy my PP and Nursery stuff so I stick it out and I hide from L&D where the trolls live. I can give you all stories that would make your cry, believe me, they make me cry when I re-live them. The area in which I work/live has the highest C-section rate in the country. They also banned VBAC's at every hospital in this area. I suppose it guarantees a bottom line. Who knows. It isn't just a doctor or two that believes this - it's all 6 that practice where I work. I've been pretty much shell shocked since coming to L&D, it's a far cry from what I ever dreamed it was or could be. I thought this would be a great stepping stone for me as I started back to school to be a CNM.

what a great place to work It gives me hope that when I graduate from my CNM program I can find a place where having a baby is a normal thing. I know they exist out there. I just knew that somewhere out there one existed......

Yes, you can work in OB when you graduate. Just find the right job and/or facility that meets your needs not only as a new grad but as a new nurse. Those jobs are there, you just have to be willing to look and put forth the effort. As far as shift goes - if you want the job you'll figure out a way to make the "less desirable shift" work for you. Keep in mine though, sometimes DAYS is the less desirable shift in OB and nights is the one that is sought after Always keep an open mind wherever you go in nursing. And just food for thought here - OB nursing can be more than just Labor and Delivery. Some facilities have great high risk units, postpartum/well baby care, a NICU, well baby nursery, peds units, etc.... The focus (at least around where I live) is more of a Women and Children Unit vs. the standard OB floor. Great opportunities though for TONS of experience in a wide variety of areas. Keep an open mind, be willing to learn anything and everything you can and you'll do just fine. Good luck!!!

I did 3-3 and loved it - it was the perfect shift. Got home and in bed by 4, up before noon. Plenty of time to get things done. Never felt drained and/or simply exhausted all the time from lack of sleep the "total night shift" offered.

I wish it was that simple but in my experience the hospital is protecting themselves from the lawsuit happy world we live and work in. So they create 500 pages policies and procedures that medicalizes the birth process to protect their orifice from future litigation. Not only that, they are a business first and foremost, always. An OB department that can crank out the babies is a sure thing money maker. You can not crank out a baby and get mom delivered and home within 24 hours without it being all about medicine (according to them, TOTALLY NOT MY BELIEF!!!!) My parents have ZERO say in what they want. Birth plans are thrown out the window when you come in. You want the tub, intermittent monitoring, walk the halls. Forget it. NOT allowed where I work. Don't want an epidural? Don't expect to find an RN that will tolerate you then because most of the nurses I work with despise the patients who don't want an epidural. Want a birth without Pit? Forget it, it won't happen. If if your doctor doesn't order it, the RN's I work with will eventually start in on their own. Don't want an AROM, forget that too, most of the staff with "accidently" break your water when they are tried of waiting on you to deliver. We used to have a CNM who not only delivered patients but she was the DON there. This was before my time but I guess people used to travel 200+ miles to have a baby there because the quality of care was unbelievable. Parents got what they wanted, what they needed. Then the "medical" people stepped in after one of our 10 or so buy outs in the last 5 years. They told her she no longer had delivery privileges there. Then they started firing on the doctors that went "against the grain". Soon all the great L&D nurses moved on to better things and now it's we are probably one of the worst places in a 4 state area to deliver a baby at. It became about money. I have a very love hate relationship right now with the L&D side of my OB department thanks to the aforementioned items. I guess it's like this pretty much everywhere around me too, so no sense in finding another hospital somewhere else......sigh. So, I really wish it was a simple to say - if you want a non medical birth your hospital will give you one cause I really don't think that's possibly anymore in a hospital, at least not where I live.

I was just clarifying the post in which someone misunderstood. I never said I agreed with the statement made, just providing some clarification. I'm all for midwives, regardless of title or education and I think they all have a place in providing excellent quality of care for pregnant women.

The original questions was a bit difficult to understand. The original OP wanted to know if delivering with a midwife was less safe than delivering with an OB. I think what moongirl was trying to say is delivering with a lay midwife wasn't a safe option, delivering with a CNM was a safe option. I may be totally wrong but that's at least how I read the initial post. In regards to the original question, delivering with a professional midwife (regardless of the title but one that is trained to deliver babies however they get trained) is a wonderful, great, fantastic low intervention birth and in my opinion is safer for mom and the baby because of the reduction of interventions. So yes, in my opinion it is just as safe, if not safer to deliver with a midwife than an OB.

per the website: http://www.midwives.org/admissions.asp have a grade point average (gpa) of 3.0 from the most recent degree earned. if gpa is 2.7 - 2.99, the applicant must take either the graduate record examination (gre) or the miller analogy test (mat) and obtain a satisfactory score. click here for the gre website and here for the mat website. minimally acceptable gre scores are either a total of at least 1000 on both the verbal and quantitative sections or at least 500 on either the verbal or quantitative sections and 3.0 on the analytical portion. minimally acceptable mat scores are a raw score of 45 and/or a scaled score of 403-408. please note that an applicant with a gpa less than 2.7 will not be considered for admission. an applicant with a gpa below 2.7 may consider reapplying after they demonstrated success in graduate level nursing courses by successful completion of 9 or more graduate credits with a b or better grade in each course. hope that helps.

Oh my gosh babe, I feel your pain. I'm about month #4 into my orientation and I really don't like L&D. I work in a full service OB department, so I always have my PP and Nursery to go back to when my days of L&D have me down in the dumps. My ideals and desires are NOT shared on my floor and in my unit at all whatsoever. I got a patient up to the rocking chair for goodness sakes, at the bedside, after a AROM (baby's head flat against the cervix so no cord issue). My preceptor came unglued. Why??? Because the baby was down so far we couldn't get an accurate FHT while mom was in a rocking chair. She yelled at me in front of the patient and family and made me look like a total fool. There was no contraindications to a rocking chair and mom did not want an epidural yet (if at all). Hmmm....what about position of comfort for mom??? That goes out the window where I work. The only position of comfort the RN's I work with know about are the 2 positions for an epidural. Side lying or sitting up. This is one of my story of 1000's I could share. We pit our babies/moms to the max and almost always end up in a C-section. Moms who are no where NEAR ready for a sucessful labor are tied down to the bed with IV lines, IUPC's, FSE and every other thing we can shove in an orfice because of what???? The "doctor" is ready for the baby to be born, before 5 p.m. too, cause he has a dinner date with one of the nurses (ok, I'm a bit bitter right now so I best stop). I too thought L&D would be a great pathway to the route of the CNM. It's taught me a lot though, it really has. It's taught me the things I don't want to do when I become a CNM. Its taught me where I want to work when I'm done. I wish I could tell you it gets better. I'm sure there are other places out there where I would be in heaven (a birth center comes to mind) but I'm in this for the short course and just until I finish with school which right now seems to be a million miles away. I regret more often than not leaving my ER job and coming to OB, I really do. I've even contemplated multiple times calling my manger back and begging for my job. But then I go to PP or to the nursery and I fall in love with why I'm there. I remember that when I'm off orientation (hopefully pretty soon) I can start to branch out on my own and start doing things my way (but still following our P&P). I even started taking a Lamaze class so I could better help my moms deal with labor pains before their epidural (or without an epidural). I went to nights because days made me crazy. Nights is a bit better cause there isn't an OB that actually WANTS to induce at night, so most are real honest labors and you have a bit more control over what goes on at night. I tell no one at work about my desires to be a CNM because they don't understand. Why would I want to work with women and do low intervention births when you have the great advances of modern medicine??? Oh, I could go on and on and on, I really could. Please, PM need if you need someone to vent with. I feel your pain!!!!