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Any CNM's care to advise me on an educational/career move? (I'll take other's opinion's too:)

Last post 11-01-2009 12:19 PM by midwifea. 9 replies.
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  • 10-10-2009 4:52 PM

    Any CNM's care to advise me on an educational/career move? (I'll take other's opinion's too:)

     I am finishing up my ADN RN program.  My goal is to move into a grad program for CNM within the next 5-7 years.  In the meantime, I will likely be working LD/PP/MotherBaby hospital unit.  DH is returning to school and I will be primary breadwinner, plus most programs desire L&D experience. 

    I am wondering if I should pursue a BSN immediately, or if I should study various certifications (i.e. Neonatal Rescuscitation, Fetal Monitoring, ACLS-OB)- and which route would make me a more desirable candidate for a hiring manager?

    Trust me, I am familiar with the predominant birth care philosophy of most on this site. While I also completely disagree with just about everything that happens in the hospital, I have come to terms with the fact that I must walk through this hard place, to get to the other side, and have the legal protection to serve women in the environment and demographic that I feel called to.  

    Thanks for the input!

  • 10-10-2009 6:38 PM In reply to

    Re: Any CNM's care to advise me on an educational/career move? (I'll take other's opinion's too:)

     I'm not sure if it's the same where  you are from, but Central NY area is desperate for nurses to fill positions.  I would recommend that you not waste YOUR money on the extra training because if you get hired, they will provide that training free of charge.  I'm not sure about most hospitals, but in my area they do hire new grads directly to OB.  Twenty years ago, when I first started, I had to interview at 5 or 6 different hospitals to find one to hire me directly to OB.  I felt certain I couldn't stand Med/Surg nursing for a year in the hopes of getting into OB (Med/Surg units don't really like to lose their nurses, so once you're there, you might never get away.) Also, some hospitals will pay for your BSN schooling if you promise to give them 2 years after you complete your schooling.  I'm not sure how long you want to do this.  I couldn't go back to hospital OB nursing, after being a home birth midwife for 10 years now, if you paid me a million dollars. Women, babies and nurses are treated terribly.  And to be the one doing the terrible treatment as the nurse is hard to take.   However, you are young, and motivated, and if you can keep your eye on the goal (not on trying to change the birth environment in the hospital) you will do just fine. As far as the clinical experience I gained by working in the hospital, I wouldn't trade it for anything in the world.  To see women with placental abruptions, placenta previas, preterm labor, preeclampsia, shoulder dystocia and babies with transient tachypnea, those needing resuscitationetc., etc. is so valuable in your training.  It's amazing how often these crises happen completely opposite to what you learn in books.  And if you are lucky, while working in the hospital you will learn very clearly what NOT to do(pretty much everything they DO!).  Good luck, Joyce

  • 10-11-2009 9:32 AM In reply to

    • midwifea
    • Top 10 Contributor
    • Joined on 02-12-2009
    • Kailua Kona, HI
    • Posts 475

    Re: Any CNM's care to advise me on an educational/career move? (I'll take other's opinion's too:)

    Siennagreen,

    Joyce gave an excellent reply.  Nursing shortages are rampant every where. You will be able to continue your education while working in a hospital setting.   Being a traditional homebirth midwife, not a CNM, I can only add that, this is your path, for now.  Wherever you are on the path is where you should be, Make it a positive experience for yourself and the families you serve, Reap the rewards from being in a hospital and serving women.

    Blessings,
    April
    moderator

    "The Voice

    There is a voice inside of you
    That whispers all day long,
    "I feel this is right for me,
    I know that this is wrong."
    No teacher, preacher, parent, friend
    Or wise man can decide
    What's right for you--just listen to
    The voice that speaks inside."
    — Shel Silverstein
  • 10-11-2009 10:31 AM In reply to

    Re: Any CNM's care to advise me on an educational/career move? (I'll take other's opinion's too:)

     Thanks to you both!  One of our considerations for moving is Ithaca, so Joyce's comments were very interesting!  There has been some indication that in some cities hospitals are requesting the BSN for specialty positions.  I appreciate your insights!

     

  • 10-11-2009 12:19 PM In reply to

    Re: Any CNM's care to advise me on an educational/career move? (I'll take other's opinion's too:)

     April, it was interesting, your choice of words and how I heard them a different way than you meant them for siennagreen.  You said, this is your path now...  In my situation, I chose the CNM path because I didn't do my homework and knew of no other way.  Now, after practicing for 10 years as an OB RN then 10 years as a Home Birth Midwife, I practice less like a CNM and more like my DEM counterpart (only we two practice in a large Mennonite/Amish community).  After my first year in practice I decided not to have a practice agreement with an OB--it seemed wrong and it didn't work for the women I cared for.  I still have a license.  I initially thought the CNM/license was so important.  No, it's the care of women that is important.

  • 10-15-2009 6:22 PM In reply to

    • midwifea
    • Top 10 Contributor
    • Joined on 02-12-2009
    • Kailua Kona, HI
    • Posts 475

    Re: Any CNM's care to advise me on an educational/career move? (I'll take other's opinion's too:)

    Joyce,

    you are so right, it's the care of women (each other) that is so important.  All the licenses and job perks and stature are irrelevant.  What we do has meaning, deep meaning. 

    This week is hard for me, I had a mama who called and had not felt movement for a couple days at 23 weeks, she came over early the other morning and I tried for half an hour to get a heartbeat.  To be the one to say, your baby has passed, and then hold another woman for an hour while you both cry is not really in any midwife job description. To wait for labor, plan to say hello and goodbye after birthing, plan to bury baby after a washing and singing ritual and making a cast of baby's feet and hands and be the tree of strength for your couple so that they can carry on is not in our job description either.  This is not a career, it is a calling.  The true moments of absolute heaven we experience regularly has it's price.  It has it's price.

    Blessings,
    April
    moderator

    "The Voice

    There is a voice inside of you
    That whispers all day long,
    "I feel this is right for me,
    I know that this is wrong."
    No teacher, preacher, parent, friend
    Or wise man can decide
    What's right for you--just listen to
    The voice that speaks inside."
    — Shel Silverstein
  • 10-15-2009 7:04 PM In reply to

    Re: Any CNM's care to advise me on an educational/career move? (I'll take other's opinion's too:)

    Siennagreen...

    You are one step ahead of me in the process.  I am contemplating returning to school after many years to become a midwife.  Like you, I feel like I need to walk down a rough path to come out the other side, and I really appreciate the comments made about what value there is in learning those emergency situations in a hospital settings.  I know that I want to be a homebirth midwife, but that it will be many years until it will happen for me.

    Siennagreen... do you have a BS in another area?  Some of the MSN programs require a baccalauriate in any discipline.

    My plan is (I think but this changes daily) is to do what you have done... ADN RN as I have a BS in another area, and then work to pay off the ADN before doing the MSN thing.

    Good luck in your path.

     

    Carol
    childbirth educator, Hypnobabies instructor, and doula PLUS an aspiring midwife and mom.
  • 10-28-2009 1:09 PM In reply to

    Re: Any CNM's care to advise me on an educational/career move? (I'll take other's opinion's too:)

    I too am choosing to wlak through that "hard place" 

    and I appreciate CBECAROL for sharing a real life experience that so passioantely differenitates career versus calling.

    For me "the calling" requires dual response:

    CPM because the model of care and spirit of practice seems most like what I've personally experience and desire to offer other women.

    CNM( and eventually PhD) because I got a boat load of student loans to repay and the feds only do loan repayments for Certified Nurse Midwives.

    Having an education in public health and experience working in public health clinics I feel confident that as a CNM serving an underserved population I will be able to bridge the healthcare disparities gap with a model of care that honors the women I will serve. The experience will also be invaluable as I seek to forge a path internationally while simultaneously opening a birth center ( again requires a CNM at least in the state I may choose to live). Also by having contractual employment and loan repayment on the front side of my career I will be in a better financial position personally to simply barter or offer a sliding scale option for women who choose prenatal care and home birth outside of the clinical/hospital setting.

    Besides when you are in an area with so few avaialbe CPM's offering mentorship and apprenticing opportunites it seems only logical that I can best effect change by amassing all the education/ credentials I can so I can affect change by providing more opportunites and a paradigm shift in the process.

     





  • 10-31-2009 9:15 AM In reply to

    Re: Any CNM's care to advise me on an educational/career move? (I'll take other's opinion's too:)

     April, how's your lady doing?  I've been thinking of you and your lady.  I agree with your assessment that this is a calling and we truly have to pay the price for the wonderful "job" we do.  You go into this work innocently thinking it's going to be days of bliss, attending miracle after miracle.  But, there are days we truly have to work--to get through these tough times.  Yet, I find those times so, so rewarding, memorable and life-altering.  It's a time I'm truly needed, and with many wonderful births (I think we, as birth attendants) know they could've done it without us!  Hope all is well.  Joyce

  • 11-01-2009 12:19 PM In reply to

    • midwifea
    • Top 10 Contributor
    • Joined on 02-12-2009
    • Kailua Kona, HI
    • Posts 475

    Re: Any CNM's care to advise me on an educational/career move? (I'll take other's opinion's too:)

    Joyce,

    Thank you for asking, I have an interesting story to tell about this birth/passing.  After calling baby's passing, my mama called a friend of hers who is an extremely homebirth friendly OB, this OB had originally given mama my name and number.  She is so homebirth friendly that if a patient of hers ask about homebirth she tells them if she were having a baby she would birth at home.  OB knows all of us and encourages us to birth at home  but she prescribes misoprosotol in case mama does not want to wait for spontaneous labor.  My mama thinks about it and decides to do the miso because she works outside the home, we live in a small community, people would constantly ask her about her baby and not the least reason why, she is 37, this was her first time pregnant and she wants to try again, soon.  Birthing baby sooner than later so her cycles can resume is a forethought in her mind.  She wants me to attend her.  I wholeheartedly agree, we make all the plans for a sweet birth/passing but another one of my mamas, 2nd baby, 39 weeks has begun leaking a little water so I ask her to wait till this baby has been born before taking the miso.  No problem.   Only thing is 2nd time mama leaks fluid for a couple days with no labor!  So, on the third morning 2nd time mama calls and says ok, it's happening this morning.  An hour later mama who's baby has passed calls and says, I took the miso an hour ago!! She has no contrx's or signs of labor and the dose was very light so she agrees to wait to do another dose until after I call and tell her 2nd time mama has birthed.  Off I go to attend  mama and her sweet 8lb. girl who was born outside in the tub with a nuchal hand (hence the leaking fluid and slow to start labor for 2 days) when finally I can check the phone, there are lots of messages.  Other mama got extreme chills and a high fever and papa called me knowing I was at a birth, but a little panicked about his wife and said he was putting her in the car and going to the hospital, 1.5 hours away from their house. I could hear mama in the background of the message, moaning and I know she is also having contrx's.   Next message is mama, calm and serene, saying they had their baby girl in the car (we did not know sex) and they were awaiting my call.  She didn't even make it half an hour away, her fever broke in the car and she had some strong contrx's and her mom and her husband were with her and her mom climbed over into the back seat to help her daughter birth their tiny breech baby.  Papa couldn't even pull over.  She put baby on her belly and kept her damp with a towel so her skin wouldn't peel and told Papa, turn around and go home we'll wait for April.  They got home, mama birthed the placenta, they oiled baby, sang to her, named her Emma, and enjoyed just being in her body's presence for the day.  It was perfect.  When were able to we compare birth times we discovered her baby and my mama's 2nd baby were born at the same time.  Papa told me the whole experience was empowering and made them so strong and closer together. They took Emma to be cremated and she was returned in a little heart shaped silver box.  They cannot wait to try again and want to have a homebirth more than ever now.

    Life is an amazing journey isn't it?

    Blessings,
    April
    moderator

    "The Voice

    There is a voice inside of you
    That whispers all day long,
    "I feel this is right for me,
    I know that this is wrong."
    No teacher, preacher, parent, friend
    Or wise man can decide
    What's right for you--just listen to
    The voice that speaks inside."
    — Shel Silverstein
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