Scope of Practice for CNM's?

Dayray, RN · Jul 1, 2005

Your just starting your carrer so why limit your self?

Just go to Nursing school and work for a while and then decide. after school you can get a job in maternial child and then you'll get to see it from that side. you might like OB nursing or you might still want to continue to CNM school either way you'll figure it out on the way.

As for CNM's going away, I dont see it happening. CNM's are struggleing at the molment but not so much becuase of lack of schools. CNM's have diffaculty becuse of insurance companies and the AMA forcing them to be under the thumb of MD's. The general public does'nt know what CNM's are so they also struggle with misunderstanding of what they are and can do.

Just go to nursing school and leave the CNM issue until you get to that point. Who knows you might even find out that you like another area of health care more then OB. Nursing school teaches you allot about yourself so there is no telling what things might look like after you graduate.

WorkofHeart8 · Jul 7, 2005

thanks! anyone else?

BETSRN · Jul 7, 2005

Can someone list the things CNM's are NOT allowed to do?
I'm starting to think I should become an OB/GYN :chair: instead because I dont want to be limited in the things I can do and I wanna care for my patient no matter what the risk instead of having to send her to an OB. But medical school is soooo long, I'd be spending my whole life in college! LOL I realize the 2 careers are different, but I dont think I'll ever decide which one I want to do. I do know I'm going to nursing school no matter what. Anyways, I'm scared that as a CNM, when a complication arises that needs an OB, I wont know WHEN and when not to call an OB. Or that it'd be too late and the mother and/or baby dies - I'm not meaning to sound disrespectful to midwives, especially since I used one for the most part of my pregnancy (had to switch to an OB a couple weeks before birth cuz of switch of insurance, and he didnt even make it to the birth, the nurses delivered her, go figure).
Anyways I have no clue what I should do, and I dont see how TIME would make a difference considering I'll just go back and forth between the two until I get my BSN. What I like better about CNM's is that they spend more time getting to know their patients and being with them and labor and that they focus more on the natural side of things (I know that not all do) which is just like me (I love aromatherapy and herbs and homepathy and things like that). I guess I'm scared because the school I was dying to go to closed their program (Boston University, I really want to move up there) and I'm scared that more will close and the CNM numbers will drop and/or no one will want to go to them anymore despite the research that they have better outcomes. And I figure OB/GYNs will always be needed cuz of complications.
Okay enough rambling (for now)

You clearly have NO idea what a doctor does as opposed to a certified nurse midwife. Nursing and medicine are two totally separate and completely DIFFERENT fields. Instead of just asking on this message board, why don't you actually go and shadow an OB/GYN and the CNM (and also a regular RN) and see the differences.

I will tell you one thing. If you choose to become a physician (particularly an OB) you better be ready to pay well over $100,000/year for your medical malpractice insurance. In some areas in the south, that figure is more like $200,000. That is money off the top before you even begin to think of making any money for yourself. As an RN, I pay less than $100/year for my malpractice and I am also covered by the hospital as well.

I don't mean to sound rude but go do some research and then come back and ask questions. The 6 year medical programs (like the one Boston UNiversity had) are even more rigorous than the more traditional med schools. Take a look at the entrance requirements for med school. Are you up for that? Nursing school is no walk in the park, either.

As a nurse I can honestly say that I wouldn't be a doctor for anything. There is no way that I want to open myself up for the liability that physicians face.

WorkofHeart8 · Jul 7, 2005

Um, wow. I DID say I know the 2 careers are different, did I not? Excuse me for asking a simple question.

smk1, LPN · Jul 7, 2005

You clearly have NO idea what a doctor does as opposed to a certified nurse midwife. Nursing and medicine are two totally separate and completely DIFFERENT fields. Instead of just asking on this message board, why don't you actually go and shadow an OB/GYN and the CNM (and also a regular RN) and see the differences.
I will tell you one thing. If you choose to become a physician (particularly an OB) you better be ready to pay well over $100,000/year for your medical malpractice insurance. In some areas in the south, that figure is more like $200,000. That is money off the top before you even begin to think of making any money for yourself. As an RN, I pay less than $100/year for my malpractice and I am also covered by the hospital as well.
I don't mean to sound rude but go do some research and then come back and ask questions. The 6 year medical programs (like the one Boston UNiversity had) are even more rigorous than the more traditional med schools. Take a look at the entrance requirements for med school. Are you up for that? Nursing school is no walk in the park, either.
As a nurse I can honestly say that I wouldn't be a doctor for anything. There is no way that I want to open myself up for the liability that physicians face.

do we have to to be so abrupt and dare I say it, rude to the new students who ask simple questions? :uhoh21: this is an informative site as well as a discussion site. Hopefully some other CNM practitioners or students will be able to give some practical advice to the OP.

WorkofHeart8 · Jul 7, 2005

Thank you SMK1!

midwife2b · Jul 7, 2005

It might be easier to talk about what a CNM can do instead of what she can't do.

A CNM can't do a C-section (but she can first assist).

I know midwives who have learned to use forceps and vacuums, can do circumcisions and ultrasounds.

One doesn't learn these things in the basic program, but you can add skills later.

It really depends on the state you are in and who is backing you up.

A CNM provides healthcare throughout the lifespan for females beginning with adolescence. There is more than just birthing babies, but not everyone realizes that.

You asked a good question. I hope you find the answer you are looking for!

WorkofHeart8 · Jul 7, 2005

Thanks midwife2be :)

Editorial Team / Admin · Jul 8, 2005

I am an OB-GYN nurse practitioner and am limited in the care of my patient. I cannot do C-sections, of course. No circumcisions. Nor do I want to. My malpractice insurance is $35,000/year. A CNM cannot perform C-sections either. As for knowing when to notify the physician, that comes with experience and experience and experience. Even the most seasoned midwife and/or nurse practitioner have an outcome that can be heartbreaking. You need to see the movie and/or read the book,"Midwives". Sissy Spacek plays the main character. It will make you think twice about these professions. Just go to school and when you finish, you should have a clear idea how you want to proceed in your career. Good luck.

WorkofHeart8 · Jul 8, 2005

Thanks Siri :)

SmilingBluEyes · Jul 8, 2005

It might be easier to talk about what a CNM can do instead of what she can't do.
A CNM can't do a C-section (but she can first assist).
I know midwives who have learned to use forceps and vacuums, can do circumcisions and ultrasounds.
One doesn't learn these things in the basic program, but you can add skills later.
It really depends on the state you are in and who is backing you up.
A CNM provides healthcare throughout the lifespan for females beginning with adolescence. There is more than just birthing babies, but not everyone realizes that.
You asked a good question. I hope you find the answer you are looking for!

excellent and helpful response. Thank you!

Also would be helpful to check with the individual State Board of Nursing/Nurse Practice Acts for more specific info on scope of practice in your given State.

Good luck, whatever you do decide is best for you! :)