Torn between CNM and NNP

babyNP., APRN · Jul 19, 2017

hey there, welcome to allnurses.

Do you have Level III NICU experience? I do not know of any programs in the US that allow students unless they have 2 years of clinical practice in the NICU, although some fudge it a bit by letting you take didactic theory classes prior to getting the experience and you need it before clinical in school starts. This is unlike CNM school where there are many programs that allow you to enter without clinical experience.

From the neo side, you will be in-patient for the rest of your career in the field- there is some clinic work with NICU follow up care, but extremely rare and most of those have a pediatric NP degree as well (scope of practice as a NNP is 0-2 years old but TBH we are really only equipped to take care of the first 6 months of life). The job is generally 10s, 12s, and/or 24s with the latter 2 being the most common, generally three 12s a week or six 24s a month. CNM as I've read (and please feel free to chime in fellow CNMs) take a mixture of call at the hospital/birthing center with 12-48 hours plus clinic time. Each practice is different.

Pay is better for NNPs as I've found, largely I suspect because we are intensivists who do not do any clinic care. Can't speak for the lifestyle of a CNM, but lifestyle for a NNP for me is great- I do work nights, holidays, and weekends, but I also have a lot of time off.

If you don't have any NICU experience then I would at least do some time there before applying for NNP school if that's what you want to do- you may find that you may not like it at all. I went through a period of thinking I wanted to do CNM after doing my NNP degree because I loved doing the clinic work, but ultimately I don't think I'm going to do it. As much as I loved shadowing a CNM in a clinic, taking histories, and doing fundus measurements and heart tones, I just don't think I'm cut out for speculum exams and repairing tears and being all up in a lady's business. Which...is yeah most of the job. So no go for me (for now).

Best of luck. Keep us posted on what you decide to do.

HighAspirations, RN · Jul 22, 2017

Thank you so much for that thoughtful response!

I do not currently have any NICU experience, but I am planning a move into Philly in about a year with my boyfriend and I am thinking of exploring options for NICU as a new position there as it is not an easy specialty to get into in my area. I am about to finish my BSN and had previously wanted to go right into a MSN program (which I could do with midwifery), but since I am a bit torn I think I'm going to hold off and try to get some NICU experience before making a decision. Choosing between the two paths is quite intimidating at the moment and I want to feel confident in my decision.

I really enjoy the scheduling of the shift work that I have right now and I know an NNP would be similar to that, but the potential for the regular business hours of, for example, a health clinic CNM sounds appealing at times also. However, the acuity of the NICU is something I am really drawn to and in my current position the complicated cases are the most interesting to me. Part of the reason I'm reconsidering the CNM is that I feel like the level of acuity managed by CNMs with , though never be boring, maybe not feel like enough further down in my career. I have all the respect in the world for them and their skill, but there is something about critical care that pulls me in.

Still in the thinking process right now, but again I thank you so much for your response and appreciate the view you offered!