Simplyroses

I watch with dismay as nurses accept admission to and attend universities that cannot be bothered to arrange clinical rotations. This disturbing trend does not serve the students and it certainly does not serve the reputation of the profession. Attend an accredited university that has an established faculty practice or has already established relationships with local practices. No medical school or PA school would require the students to find their own clinical rotation sites.

If I was 22 years old with a bachelor's degree, looking ahead to 3.5 years for a DNP, I would just apply to medical school. Some medical schools are going to 3 year programs. More hard-core learning and less fluff. More respect, more income.

Choose references that can speak about your ability to: A) function professionally in a healthcare environment and B) think critically during high-stress situations, and C) handle the academic rigor of graduate school. I have never had an MD provide my references, even when applying for hospital privileges. All of my references have been RN's, CNM's, ARNP's, or Doctorate level faculty.

I specifically chose NOT to apply for the scholarship because I could not relocate my kids during their teen years. The placement sites for scholarship awardees can be very limited and located in BFE. I am working for a FQHC in my hometown but prior to entering the program I did not know that they would have an opening for a CNM when I graduated. I plan to apply for the federal nurse loan repayment annually to see if I can get it. Still, after 10 years of minimum payments the balance of the loan will be forgiven.

Try the NICU. Patients are 10 lbs or less!

Choosing a graduate program is very individual. Some programs are on-line and you must find your own preceptors. That can be stressful and challenging if you do not have a great support network established prior to entering the program. In some areas of the country, the preceptors that accept Frontier or on-line program students have a wait list of 1-2 years. The on-line classwork can be great if you have family/job challenges to work around. Some programs have a faculty practice and you rotate through the clinic and L&D call with faculty who are very used to precepting students. Many of these programs will not allow you to contact your preceptor independently if you want to set up your own site. They require that the school contacts the preceptor first so that they can vet the preceptor and verify credentials, as well as establish a professional relationship with the preceptor. That being said, any program that is accredited by the ACME (the Accreditation Commission for Midwifery Education Accreditation Commission for Midwifery Education (ACME) | ACNM ) will be a rigorous program that will fulfill the minimum requirements for you to sit for your AMCB certification American Midwifery Certification Board . Check out this list: ACME-Program Accreditation Information Then make a list of criteria that is important to you for your graduate school experience. Are you looking for out-of-hospital experience? Waterbirth? Do you want a small, close cohort to study with or do you want to study independently? Do you want a site that finds your preceptor for you or do you want to find your own? What is the cost of the program? Where in the country is it located? How long does the program last? Is it a MSN or DNP? What is the cost of living? Can you work while you are in the program? Is there a part-time option if you need to work? What percentage of their students pass the boards? Good luck researching!

I completely agree! The programs seem to be getting away from "translating research into bedside" practice and moving towards administrative/leadership classes for the DNP. I'm sure academia thinks this is a great idea, but academia is quite often far removed from patient practice. Now a fellowship to become an expert in one area might be worth the time...

Has anyone read this text: The ASAM Essentials Second Edition I also see there is a board certification in this specialty. Any thoughts? Certification and MOC

Can I ask what school you attended for your graduate degree?

I'm very sorry to hear that! It can be frustrating and feel defeating. There are two other review courses on the AANP website: AANP - CE Opportunities You could also attend a live review course: APEA - Advanced Practice Education Associates Live Course Review Don't give up. Try again.

[h=6]Pathways | IBLCE Per the IBCLE website: A minimum of 1000 hours of lactation specific clinical practice that was obtained within the 5 years immediately prior to applying for the IBLCE examination[/h] [h=6]This lactation specific clinical practice must have been obtained through paid or volunteer work as a [COLOR=#089bc3]Recognised Health Professional[/COLOR] and/or [COLOR=#089bc3]Recognised Mother Support Counsellor[/COLOR].[/h] [h=6]Volunteer recognised mother support counsellors who primarily provide in-person group or individual breastfeeding support receive 500 hours of lactation specific clinical practice for each full year of volunteer service. Only full years of service are credited.[/h] [h=6]Volunteer recognised mother support counsellors who primarily provide telephone, email or web-based breastfeeding support receive 250 hours of lactation specific clinical practice for each full year of volunteer service. Only full years of service are credited.[/h]

That is possibly not the most useful question to ask. What is their graduation rate? What is their pass rate on boards? Does my state allow Frontier/distance program or will I have to relocate? Can I find my own preceptor or do I want a school that already has established preceptors and will place you? How invested are the faculty in your education?

My background: I've worked in L&D and NICU for 19 years. Many of my adult patients have suffered from addiction to substances, and many of my neonates are born addicted to substances or have had exposure to substances. This year I transition to a new role as a Certified Nurse Midwife at an FQHC in my hometown. I have a special heart for women addicted to substances during their pregnancy. I can also guarantee that I will now be the provider for many of them in my community. There is a methadone clinic in town and some physicians are starting to prescribe Suboxone. Questions for those of you involved in addiction nursing: What classes, if any, would you recommend as a baseline knowledge for this population (ie psychopharm)? Are there continuing education seminars that are helpful? Are there resources not to be missed? Any advice from the trenches?

Have you considered Psych Mental Health Nurse Practitioner? It would enable you to diagnose and prescribe in addition to the good work you currently do.

Actually, Oregon is one of the best states to practice as a midwife. There is great autonomy and independent practice opportunities. The Board of Nursing must really see midwives as nurses first, and then midwives. Many midwives do not identify with nursing at all. You might be right about the CM designation. It isn't recognized out here in the West.

384 is definitely a wierd, random number. Yes, it does affect Oregon students. Oregon Health & Science University has an Accelerated BSN-MN in Midwifery program. I just graduated from this program. While this doesn't affect me since I have been an RN for 19 years, 9 members of my cohort went the accelerated route and have not worked as RN's. They are finding that they must either volunteer to gain RN hours, find employment as RN's, or find CNM positions out of state. The Oregon Board of Nursing decision highlights the concept that CNM's are Advance Practice NURSES and as such should have some nursing experience prior to an advanced role. Ten weeks of experience doesn't make much sense, though. It would make more sense if they required a full year or two of experience if they are making the point that RN experience was critical to the role.

Just a heads up: Two years ago the Oregon State Board of Nursing passed a new requirement. In order to be licensed as a CNM in Oregon, you must prove that you have a minimum of 384 RN or CNM hours. This does not affect CNM's or RN's who are currently practicing in other states and wish to relocate to OR, since they will meet the requirement. This DOES specifically affect the people who graduate from direct entry programs and have never logged any RN hours prior to graduation. School clinical time does not count. This means that direct entry CNM's must either practice somewhere else prior to practicing in Oregon, or they must somehow convince someone to hire them as an RN for 10 weeks before they can jump ship to then practice their advanced role as a CNM. Some places of employment are getting around this by orienting people to the practice as an RN, and then transitioning them to the CNM after they have 1) completed their 384 hours and 2) have been granted licensure.

The CNM scope of practice includes women, menarche through menopause, and neonates to one month of age. CNM's do GYN and women's health. The NCC credentials you to be a WHNP. https://www.nccwebsite.org/Certification/Exam-detail.aspx?eid=17 but your educational program must be specific for WHNP, which usually includes more gyn clinical time. The problem I see with being dual certified is that it is a waste of time and money. You need to take extra credits in school, sit for a separate exam, and maintain the continuing education requirements to do both roles. If you know you want to do Women's Health ONLY and never do deliveries, then it makes sense to do a WHNP program. However, your scope of practice, and therefore employment opportunities and loan repayment options, are more limited. If you are a CNM, you can limit your practice to just Women's Health if you choose and can find employment in an office or clinic that doesn't want you to share OB call.

So I ended up taking the position. The offer got better as I discussed the contract with them. They are getting up to 1:7 call, so on the months I work the weekend, I only have two other 24 hour shifts. The months I don't work the weekend, I have 3-4 24 hour shifts. The clinic is an 8 hour patient day, seeing 16-20 patients. If I get called to L&D, the clinic shuffles my patients to other providers (and I will get some of their load when they get called to a birth). They also offer call and delivery pay. $200 for call M-F, $250 for WE call day. Plus, $150 per birth. This brought the compensation to over $105,000 annually. It is also qualifies for federal loan repayment, so they will help me with the paperwork during the next cycle and hopefully I will be granted repayment. I'm pretty excited, and after meeting the team, I feel this is a team I can work with well. Thanks for all the comments!

Just graduated from the Portland area. There, new grads start between $85-95,000. I'm in Washington State. The Bureau of Labor Statistics lists the mean annual wage as $95,860-101,840. That includes all midwives - new grads or 30 years of experience. The median national wage for CNM's is $96,970. Of course, the whole package of benefits is part of the equation. I have 19 years of experience in L&D, Mother-Baby, and NICU. I am a new grad CNM, but taking this job would be a pay cut from my RN wage while doubling my work hours. My question is for those who have taken new-grad positions. Does this offer sound reasonable for new grads?

As I am comparing different job offers for new grad CNM's, I am curious about the working conditions and compensation for other new grads in this field. The offer I am considering taking: Full-scope CNM position in a supportive environment with opportunity to train to advanced skills such as ultrasound, colposcopy, first assist. $89,000 salary, $5,000 signing bonus $2200 continuing education Full paid benefits (medical, dental, life, short/long-term disability) 401K matching after 1 year employment Malpractice insurance with tail coverage Licensure and DEA covered Work 4 8hr clinic days, on-call one 24hr a week (take call while in clinic), weekends 1:5 but the weekend is a 72 hour call shift. My question for others who have taken new grad positions: Does this sound comparable to what is offered out there? The positions my classmates are considering sound like 2-3 clinic days a week, either 2x 12hr call shifts or 1x 24hr call shifts a week, 1:3-1:5 weekend call of 24-48 hours.

Go to the ACNM website and search the job boards. American College of Nurse-Midwives The majority of the job postings require 2 years of CNM experience but will consider a new grad IF you have significant L&D experience. Getting into school and passing boards is not the same as being employable.

Washington is $80,000-110,000. Full-time schedule can be 2-4 clinic days and 48-72 hours a week of call.

Being a Neonatal Nurse Practitioner is kind of a niche specialty. Only a few hospitals in each state would even hire you. If you are unsure if you want to do NICU long-term, then definitely don't do NNP, because they work in the NICU. Being a PNP, you could practice in the hospital or in a clinic. Being a CNM opens doors to work women's health, gyn, do full-scope with deliveries, etc. Think carefully about the role you want to take on in health care. If you are a practitioner, your liability and responsibility increases. You can be a bedside nurse or an office nurse or a school nurse or a community health nurse. All of these positions have you interacting with families, without the time/cost/liability of a practitioner role. It's okay to be an RN for a while - even your whole career. Why is it that you feel driven to become a practitioner?

It is very difficult to give school full attention when you are learning a new job. It takes 1-2 years to become comfortable in L&D. The experience is valuable. It isn't necessary to have the experience to get into grad school to be a midwife. However, hop on to the ACNM's website www.midwife.org and look at the job postings. Most jobs want 2 yrs experience as a full-scope midwife but many will consider new grads with strong L&D experience. Only you know if you can handle a job, 4 kids, and grad school. However, if you are in grad school, plan to spend 40-80 hours a week on class and clinical rotations if you go full-time.