CPM Bound Glitch? (what do i do?)

[cali4niachef]

ladies i think i've changed my mind from wanting to be a CNM to CPM.<lj-cut> i've decided this because the laws in Delaware do not vary from CNM to CPM, you must have back-up to be "permitted" in the state of Delaware. if that's the case i don't think it will be any easier getting back as a CNM doing homebirths or operating a birth center; therefore why not be a CPM. 4 of the 5 distance learning CNM programs are master's programs, they are costly and it would be 5-6yrs before i would complete all my education, not including the year of nursing experience required.

if i decided to become a CPM i don't need nursing experience (does a jig) and it would take less than 4-5yrs, including the 4 semesters it will take to get my AA as an RN. it is far less costly too. i prefer the curriculum of the CPM program's vs. CNM programs.

after baby#2 comes along i still plan to use my GI Bill and get my AA in Nursing and take the RN exam. then i plan to do distance learning through National Midwifery Institute(vocational) or National College of Midwifery(degree). since my local community college is so expensive a months worth of payment from my GI Bill will pay for the entire semester, so i can bank 3 months of payments. which i can use toward my midwifery education and i may still have more GI Bill money left. the student loans i will have to take out should be fairly minimal.

i am planning/hoping to meet with ALL the CPM's in the state and talk with them about how it has been for them to practice in Delaware, what issues have they encountered(prosecution, malpractice insurance,etc.), pros vs. cons, etc. i met the only permitted CPM in DE when i was interviewing midwives for this pregnancy and i am hoping she will meet with me so i can find out how she obtained back-up (had the same back-up for 25yrs). i also want to learn why the other CPM's have not been able to obtain back-up, either by choice or physician refusal.

is there anything else i should ask them? i am certain i will develop a list of questions.

i would like to get a degree in midwifery but i know a degree isn't necessary to be a good midwife. however what are the pros of having a degree as a midwife? would i have more leverage?

i think being an RN in addition to being a CPM (i hope) would make it easier for me to get back-up, but i am not holding my breath. i mean i will be a certified midwife and a registered nurse, essentially a CNM (though i can't be credited through the ACNM), so i think as an RN & CPM i will have the best of both worlds - and i won't have to get my BSN, just an AA to be an RN.

anyways just wanted to let you know where i am on my journey to becoming a midwife. i feel in my heart i am making the best choice.

on the midwiferytoday.com forum a CNM brought up this....

I'm glad that you've found your path! The one thing I would advise checking into however, is your plan of being an RN and a CPM. When you become an RN, you are required to stay within the "scope of practice" as defined by your state's 'Nurse Practice Act'and enforced by your state's Board of Nursing. Catching babies is not within the scope of practice as an RN. When an RN becomes a CNM, her license changes through the Board of Nursing to an "advanced practice" license--so catching babies would fall within her scope of practice. If your state does not license CPM's, you may not be able to hold an RN license and catch babies, since that would not fall within the scope of your nursing license. Does this make sense? I would check into this carefully before pursuing an RN and a CPM--just to be sure you can legally be an RN and work as a CPM at the same time. Maybe there are some others on this board who can speak to this issue?
Also, Delaware is one of the states that recognizes CNM's as a licensed independent practitioner --the language was changed from "physician medical direction" to "collaboration and consultation." Only 5 states still enforce the "medical direction" rule.

Just some "food for thought" as you begin your exciting journey! Good luck!

now what do i do? crap.


p.s. my GI Bill covers Frontier

[momileigh]

Just curious as to why you want to be an RN at all. Is it as a "back-up" in case midwifery doesn't work out? Or because you want to use your gi bill for something?

[birthdancedoula]

As I was reading your post I was thinking the same thing the MT poster said...when you're an RN you are bound by your state's nurse practice act. If you are found catching babies and putting yourself out there as an RN (regardless of your CPM status) you are in jepaordy of having your nursing license revoked. I'm sure this varies from state-to-state but this is what I have found in my own research. I know in some places you have to surrender your RN license if you want to practice as a CPM.

What don't you like about CNM programs you've seen? I struggled with this decision for 8 years and finally decided to pursue the CNM. I dragged my feet mostly b/c I didn't want to go for my BSN (I have an ADN). I am currently in Frontier's RN-MSN program which bypasses the BSN. While I'm not doing midwifery stuff right now, it is so much better than taking 2 or 3 more years to get my BSN.

All of my babies were caught by CPMs so I'll always have that in my heart. It just made more sense for me (time and money wise mainly) to go ahead and bite the bullet to get my CNM.

Best of luck on whatever you decide!!

[cali4niachef]

Originally Posted by momileigh

Just curious as to why you want to be an RN at all. Is it as a "back-up" in case midwifery doesn't work out? Or because you want to use your gi bill for something?

i want to make sure i use my GI Bill, all of it or as much as possible. i can NOT throw $21,000 of money for education down the drain. my GI Bill was the ONLY good thing i got out of being in the military for 4 LONG years. i have to use it.

i just called the GI Bill and i got some individuals names and numbers to call to see if i can get these CPM distance learning colleges approved for the GI Bill. from what i understand it isnt difficult, i just need to get the college to submit info to the VA GI Bill, it takes a couple months and then i can use my GI Bill for that college. that would be AWESOME if that worked out!!!

[cali4niachef]

Originally Posted by birthdancedoula

As I was reading your post I was thinking the same thing the MT poster said...when you're an RN you are bound by your state's nurse practice act. If you are found catching babies and putting yourself out there as an RN (regardless of your CPM status) you are in jepaordy of having your nursing license revoked. I'm sure this varies from state-to-state but this is what I have found in my own research. I know in some places you have to surrender your RN license if you want to practice as a CPM.

What don't you like about CNM programs you've seen? I struggled with this decision for 8 years and finally decided to pursue the CNM. I dragged my feet mostly b/c I didn't want to go for my BSN (I have an ADN). I am currently in Frontier's RN-MSN program which bypasses the BSN. While I'm not doing midwifery stuff right now, it is so much better than taking 2 or 3 more years to get my BSN.

All of my babies were caught by CPMs so I'll always have that in my heart. It just made more sense for me (time and money wise mainly) to go ahead and bite the bullet to get my CNM.

Best of luck on whatever you decide!!

i guess the only thing i don't like about the CNM programs for distance learning is that 4 of the 5 are masters programs and are expensive. however knowning i can use my GI Bill for Frontier is VERY VERY comforting and appealing. as for the Frontiers ADN Bridge to MSN, do you need nursing experience prior to that?

[Rockies5]

I totally agree with getitng the RN degree, even if you don't use it. I mean, education ONLY opens doors and gives experience.

I'm going the RN route myself, though just at the very beginning.

I want to know as much as possible about health and birth in all areas..just because I don't like the style of hospital birth doesn't mean I should (or anyone should) cut off searching for any wisdom in the medical model of birth.

I'm a UCer in my own life. I teach homebirth classes, and I attend UC and hospital births as a doula. I got a toe in it all. It's all part of life for me I try not to be blind to any part.

For me, it's a personal choice and a stepping stone. The health insurance and other benefits I get from working as an RN will allow my family to function. The CPM route doen't offer that.

[birthdancedoula]

Originally Posted by cali4niachef

i guess the only thing i don't like about the CNM programs for distance learning is that 4 of the 5 are masters programs and are expensive. however knowning i can use my GI Bill for Frontier is VERY VERY comforting and appealing. as for the Frontiers ADN Bridge to MSN, do you need nursing experience prior to that?

The most direct route to the CNM credential is a Master's. Sure they have Master's completion options or post-Master's options. Really the only way to the CNM w/o a MSN is a certificate but that, from what I understand, is falling out of favor. I had also heard that the ACNM is moving away from that.

As far as RN experience...they basically look at all your experience. I have been a doula since 2000 and have taught CBE as well. I have lots of birth center experience and HB experience. Also, I've been a LLL Leader for a long time as well. All of this in comparision to my actual nursing experience was what they took into consideration. By the time I was actually accepted into the program I had a year's worth of experience under your belt. A year is not long at all...other nurses will tell you the same. I've been working at a birth center for well over a year now and I have to pinch myself when I see babies who's births I've attended that are walking and talking! Seriously, that year is no big deal and you'll gain so much more perspective on your path.

[cali4niachef]

Originally Posted by birthdancedoula

The most direct route to the CNM credential is a Master's. Sure they have Master's completion options or post-Master's options. Really the only way to the CNM w/o a MSN is a certificate but that, from what I understand, is falling out of favor. I had also heard that the ACNM is moving away from that.

As far as RN experience...they basically look at all your experience. I have been a doula since 2000 and have taught CBE as well. I have lots of birth center experience and HB experience. Also, I've been a LLL Leader for a long time as well. All of this in comparision to my actual nursing experience was what they took into consideration. By the time I was actually accepted into the program I had a year's worth of experience under your belt. A year is not long at all...other nurses will tell you the same. I've been working at a birth center for well over a year now and I have to pinch myself when I see babies who's births I've attended that are walking and talking! Seriously, that year is no big deal and you'll gain so much more perspective on your path.

i've been a breastfeeding peer counselor for 1.5yrs at a hospital on the postpartum floor, i work directly under IBCLC's and with OB nurses. i know a lot more than the OB nurses about pregnancy and birth. would they take that into consideration?

[momileigh]

Originally Posted by cali4niachef

i want to make sure i use my GI Bill, all of it or as much as possible. i can NOT throw $21,000 of money for education down the drain. my GI Bill was the ONLY good thing i got out of being in the military for 4 LONG years. i have to use it.

i just called the GI Bill and i got some individuals names and numbers to call to see if i can get these CPM distance learning colleges approved for the GI Bill. from what i understand it isnt difficult, i just need to get the college to submit info to the VA GI Bill, it takes a couple months and then i can use my GI Bill for that college. that would be AWESOME if that worked out!!!

OK, I get that. I think it would be great if you could use your gi bill for a CPM school.

I'm not *against* anyone who wants to be an RN. And I love CNMs who are into the midwifery model of care.

It is just that none of the non-CNM CPMs I know were nurses or have a nursing credential, nor has anyone I know ever suggested that it is advantageous for a CPM to be an RN first. I was curious to know why you felt like you needed the RN first.

I'm the impatient sort, and I wanted to be actually practicing midwifery as soon as possible. That's why I relocated to go to an extremely hands-on program... but I know that it isn't for everybody!

[birthdancedoula]

Originally Posted by cali4niachef

i've been a breastfeeding peer counselor for 1.5yrs at a hospital on the postpartum floor, i work directly under IBCLC's and with OB nurses. i know a lot more than the OB nurses about pregnancy and birth. would they take that into consideration?

Absolutely! They will look at the whole picture you present to them...not just your experience as an RN.

[cali4niachef]

Originally Posted by momileigh

OK, I get that. I think it would be great if you could use your gi bill for a CPM school.

I'm not *against* anyone who wants to be an RN. And I love CNMs who are into the midwifery model of care.

It is just that none of the non-CNM CPMs I know were nurses or have a nursing credential, nor has anyone I know ever suggested that it is advantageous for a CPM to be an RN first. I was curious to know why you felt like you needed the RN first.

I'm the impatient sort, and I wanted to be actually practicing midwifery as soon as possible. That's why I relocated to go to an extremely hands-on program... but I know that it isn't for everybody!

i thought it would be advantageous to have my AA in nursing for the simple fact to get as much information, knowledge and education as possible. not that i believe a midwife is better if she has a nursing background/education.

the whole thing with the GI Bill is so wacky that i may have to go the CNM route to use my GI Bill. i just can't waste nearly $21,000 of MY money that I earned. i only have until October 2012 to use it.

[MidwifeErika]

Just so you know..... GI Bill will cover Birthingway in Portland. I looked into going there a few years ago and I was planning on using my GI Bill. It isn't distance learning (and I don't know if you would be up for a cross country move), but it is one CPM school that you can use GI Bill for.

[cali4niachef]

Originally Posted by hotwings640

Just so you know..... GI Bill will cover Birthingway in Portland. I looked into going there a few years ago and I was planning on using my GI Bill. It isn't distance learning (and I don't know if you would be up for a cross country move), but it is one CPM school that you can use GI Bill for.

i can't relocate my entire family just to go to school. i have to do distance learning.

thanks for the info though!!!!

[iemaja]

Originally Posted by cali4niachef

i can't relocate my entire family just to go to school. i have to do distance learning.

thanks for the info though!!!!

The advantage of knowing that you could use your GI Bill for Birthingway in Portland is a great piece of information to know when you contact the individuals to see if you can get the distance learning CPM program of your choice eligible for the GI Bill funding. Maybe they'll go with the fact that Birthingway is accredited by the MEAC and so are several other distance midwifery programs (National College of Midwifery, Midwives College of Utah, etc.)

Good luck! I've seen your posts on LJ too, and I think you're getting a lot of great information! Are you going to wait to make a decision until you hear back from the GI Bill folks or do you think you'll still go straight into a nursing program? What is the time frame for which you're hoping to begin school?

[cali4niachef]

Originally Posted by iemaja

The advantage of knowing that you could use your GI Bill for Birthingway in Portland is a great piece of information to know when you contact the individuals to see if you can get the distance learning CPM program of your choice eligible for the GI Bill funding. Maybe they'll go with the fact that Birthingway is accredited by the MEAC and so are several other distance midwifery programs (National College of Midwifery, Midwives College of Utah, etc.)

Good luck! I've seen your posts on LJ too, and I think you're getting a lot of great information! Are you going to wait to make a decision until you hear back from the GI Bill folks or do you think you'll still go straight into a nursing program? What is the time frame for which you're hoping to begin school?

yes it is GREAT info to use when i contact the VA education approval officers in these states to see if i can get these colleges approved for GI Bill funding.

which groups are we apart of? i am not as active there as i used to be. i am more active on cafemom now. i am also all over midwiferytoday forums. i am planning to start school after the baby is born in march/april. i am looking at the summer semester. i am hoping to find out in the next couple months if i can get a distance learning CPM program approved for GI Bill funding; if i can then i will go that route. if i can't then i will go the CNM route. i will get my AA in nursing at a local community college then apply to Frontier(they are approved for GI Bill funding) for the ADN to MSN Bridge program. they only thing i hate is that i need nursing experience. i am thinking of doing a visting nurse postpartum home visits for my nursing experience or at a pregnancy clinic of some sorts.

[mwherbs]

are you going to be living where you are forever?
what RX rights do you have as a midlevel provider? this alone may be of great benefit because you not only could dx a UTI you could write for it if need be- instead of sending your client to another provider. many places CNMs have rules for "consult" or a back-up plan that includes physicians but are not slaves to the relationship and there are other places like Florida where being a CNM is more restrictive than being a CPM-- what exactly does Deleware want from a CNM have you talked to several? and read the rules? many times CNMs who are employed by a practice say that they cannot do something but it is not state regulation that dictates it , it is the practice agreement --
the other thing to think about is finances, having an RN and a CNM can offer greater money opportunities and medical insurance that being a self-employed CPM will not have. There is also the issue of greater social and emotional support- I see that for the most part CNMs are under as much scrutny as CPM no matter the setting but they do realize greater support as well
I am over 50 now and if I could walk into a joe-job part of the has it's allure