Scared of being an RN in a hospital but need the experience

[wannabmidwife]

I recently decided to become a midwife with the birth of my last child. My experience with a midwife was amazing. I have started reading a great deal about midwifery and a book titled "Born in the USA" about all the unneccessary interventions used in a hospital. I have learned that the best route into midwifery is to become an RN first but that is not a step that I'm really too excited about. This would be a second career for me and the extra time and schooling is scary for me. I have 4 kids and I'm not too crazy about all the aspects of nursing. My question is how painful was the hospital experience before becoming a midwife knowing that the interventions were unneccessary? What are your thoughts in this matter? I'd really love to know.

[bebeleche]

Thanks Travduck. I also went into nursing because I wanted to become a CNM. At the time I was fairly young and had a sense that I needed both more maturity/life experience and also a greater sense of the pregnant woman as a whole person beyond the reproductive aspect. I really felt it important to understand all the body systems and get general experience first, then specialize from there. I ended up becoming a FNP for those reasons. The experience is great. I know as a midwife I could care for pregnant patients w/ diabetes, hypetension and other health problems, not to mention the babies. The sick patient is the well patient at different times in life. For me, it was important to be very holistically minded in that way. The only disadvantage is that I am still waiting for the right time to go back to school and in some ways have gotten side-tracked. I have to remind myself that it's about the journey.

[fmwf]

I know as a midwife I could care for pregnant patients w/ diabetes, hypetension and other health problems, not to mention the babies. The sick patient is the well patient at different times in life. For me, it was important to be very holistically minded in that way. .. I have to remind myself that it's about the journey.

Quick naive question...is it within the scope of practice to care for women with these health issues as a midwife (CNM) I kinda don't remember anymore... anybody?

fmwf

[bebeleche]

You are probably right that care of pregnant women with uncontrolled DM or HTN are outside the midwife's scope, however, that does not mean you won't ever have to deal w/ them. There are many places in the US and elsewhere that you may be the sole provider. If they don't have you, they have nobody. Not every pregnant women w/ a chronic disease has access to an OB/GYN, sadly.

When I was a new FNP completing my NHSC scholarship committment in Rural, USA, I provided prenatal care to high risk patients all the time. Was I comfortable with it? No, especially not at first. Was I practicing outside my scope? Perhaps. Did the patients have anywhere else to go? Oftentimes, no. These are poor women with no resources, no insurance, who don't speak English or have transporation or many of a myriad of other barriers to care. Ahhh (deep sigh).

That was actually one of the reasons I chose to leave the job. I do like my license. But you see where I'm going with this. It behooves us as clinicians to gain as many skills and as much knowledge as we can, cuz we never know when we'll need it.

[travduck, BSN, RN, CNM]

CNM's are able to care for women thru the entire spectrum of care from menarche through menopause and now perhaps after. You may have total care of the patient with chronic problems or you may do collaborative care, or split care, or transfer care until -if ever- a severe problem is resolved. Ideally, (in the olden days), the CNM cared for the normal and the physician cares for the abnormal. With "health" care (and legal and financial risks) the way they are, often you care for higher and higher risk patients; and patients who are considered liability risks for events such as little to catagorized "no" care.