MSN/DNP Nurse Midwife

Wasn’t really sure where to put this, but wondered if anyone had recent BSN grads who continued straight from undergrad to an MSN or DNP program?

D26 is pretty sure this is the route she wants to go (Nurse Midwife) and we have been looking at a lot of programs, and focusing on those with no GRE scores or RN experience required, as well as full time in person.

I am struggling to find any data on acceptance rates. All programs list their minimum req’s, but trying to gauge feasibility of acceptance, depending on where her GPA lands in the next two years.

Anyone have any insight? Should she start emailing programs now, or is it too early?

Is your daughter a college sophomore or a high school sophomore? The term D26 is commonly used on CC to denote a current high school sophomore. I know you have a D22 in nursing at Pitt. Is this the daughter you’re referring to? If so, she should be able to do the research if this is the path she hopes to take. I would think that most nurse midwife programs prefer applicants with several years of hospital experience, particularly in labor and delivery.

If this is another daughter, high school class of 2026, it is way too early to look into this.

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Not a nurse (or a midwife) but have several in the extended family.

They all had substantial nursing experience before qualifying as a midwife- and all of them endorse this plan. Not just because it’s what they did- but because they see that in addition to the clinical skills, you need a LOT of experience working harmoniously with other medical staff.

Dealing with an obnoxious OB-GYN. Dealing with a nurse in the delivery room who has 30 years experience and doesn’t want you anywhere near the patient and challenges your decisions in front of the patient. Even knowing how to find an anesthesiologist at 2 am when nobody is answering the page. Knowing how to get a vegan meal delivered to a patient when she’s been in labor for 18 hours, has just delivered and really needs to eat but refuses the salisbury steak.

And if you want to practice autonomously-- even more important. How to arrange a back-up hospital delivery for a patient who is insisting on a home birth despite a few potential medical complications. Dealing with family members. Etc.

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This would definitely be a plan that would make most people nervous and looks like a money making scheme for a school rather than a way to train competent nurse midwives. Sounds like a terrible idea. The best nurse practitioners have tons of experience before they become NPs.

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One of the NP programs where I teach wont even let you apply until you have 2 years direct care experience with that patient population first.

I teach nursing. Id say 75% of my students coming in want to be NPs. Few actually do it. NP jobs are very romanticized yet the reality of healthcare and oversaturation of NPs in certain markets (and subsequent lower salaries for way more extra work and more responsibility) turn many NPs back to working as RNs.

Have her graduate and try to get a new grad job in L&D first. Go from there.

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A few years ago my daughter thought she wanted to be a NP. She was not a nursing major, she was a biology major. She applied to 7 direct entry MSN/DNP and MSN/NP programs, was accepted to all, and chose to attend a direct entry DNP program (MSN/DNP)

After one week she dropped out and is back in school pursuing a degree that she should have applied to originally. The one thing that she found out from recent grads of the MSN/DNP program is that it is hard to get a job as a NP when you have not worked first as a nurse. That is very important to consider, and it makes perfect sense. A few grads said it took them awhile to find a job, wasn’t what they wanted etc.

Is your daughter in a nursing program now?

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I’m an L&D nurse. She definitely needs several years of experience before pursuing her CNM or any advanced practice degree. I’d recommend pursuing a staff RN job in a busy L&D unit at a teaching hospital that utilizes both midwives and physicians on staff, ideally in a state that is well regarded for having skilled CNMs, such as California or Massachusetts.

L&D nursing has a steep learning curve. I would be surprised if any graduate programs permitted direct entry. I’d be equally surprised if she were able to find a preceptor in order to complete her required hours as those are often awarded by professional connections. I agree with others that the advanced practice nursing market is over saturated (at least where I live). I personally know nurses that went back to school for their NP or CNM and continue to work as staff nurses. Good luck to her. Nursing is a great profession.

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I am another supporter of getting at least a few years of L&D nursing under your belt before jumping into a midwifery program. Very few things present as textbook cases and the only way to learn them before having to be the one in charge dealing with them is through hands-on experIence. More so than the CNM clinicals alone could provide. You also need to learn to recognize what you don’t know through experience - and that is extremely important! APN programs were not developed with the brand new nurse in mind when they came into being. They were for nurses who had years of experience and were nursing “experts” (cue Benner’s “Novice to Expert” here).

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Im all for empowering and using NPs to help those in need. But as a nursing professor, I do worry about the rigor of training at many schools. Doctors are trained for 4 years to diagnose and prescribe and then they train for 3 plus or more years under an experienced provider and get many more hours of direct patient care. Meanwhile, np programs are out for money pushing through students and teaching them to diagnose and prescribe in less than 2 years with very few direct hours. Add to that you can graduate np school and Im hearing many new np grads are getting less than a month of orientation. I wouldnt feel confident putting my license and possible patient lives on the line with less than 2 years of schooling.

Schooling to become an RN does not teach you to diagnose or prescribe. You are lucky if you spend 8 hrs a week with direct patient care for 4 semesters.

Ive had several students want to be nurse midwives who couldnt even get new grad jobs in ob. Many students dont even get an ob rotation!

I love being a nurse and love the flexibility. But too often students put the cart before the horse. Get into nursing school and graduate first.

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Is your daughter a current nursing student? I

I am an NP. I love my job, and would recommend it to anyone, BUT - as others have said, it is not a good plan to go directly from an undergraduate BSN program directly to NP without work experience. NP programs were designed for nurses with experience. Although there are some programs that will admit students without experience, she will have to get that experience somewhere. The amount of time and clinical hours required for an NP is just not enough to graduate ready to practice independently. Honestly, I would not trust my care to an NP who had just graduated without any experience. If your daughter feels very strongly about this route to education, Vanderbilt has a program that is highly regarded, but she should expect to seek out a fellowship or additional training after graduation, and realize that NP education does not compensate for lack of clinical hours and experience - there really is no shortcut.

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Hi All,

I have been away from the computer for a few days, so apologies for my delayed reply. Yes, this is for my Sophomore BSN student at Pitt. Sorry for the typo! I agree in practice 1000% with everything you all are saying regarding RN experience, and will definitely discuss with her. She has great advisors and professors to speak with as well. Pitt does start clinical hours earlier than many programs and requires more hours than most; this semester is 5 weekly, next semester Soph year is 12, and it continues to grow. Not saying that is in lieu of experience.

I won’t remotely pretend to have better insight than someone in the field, but regarding graduate programs…Both Pitt and UPenn have direct entry (with a BSN and license) Nurse Midwife programs without work experience. No GRE required. Pitt is a DNP, UPenn is an MSN with dual certification as a CNM, and Women’s Health NP. Not at all to say this is ideal from a “starting your career” perspective, but I don’t know that she honestly would work full time for a few years, then go back. Hard to know. And she’s 20, so who knows if her plan will stick in the coming years.
We looked into Vanderbilt as well but it seems their clinicals can be as far as a 4-hour drive from campus while still having 3 classes a week in between. That sounds brutal. Definitely more research to do!!
I appreciate all the feedback and insight into why this may not be a great plan, and will share the concerns you all have expressed, much appreciated!

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Those are good programs that you listed and I know that many on here respect the names, but I still don’t agree with jumping into a CNM or NP program right after getting a BSN. Most new grad nurses still don’t even know what field of nursing they like yet, never mind having to choose a population they will be restricted to work with after grad school.

You will run into NP’s and CNM’s who obviously went through those programs as new grad BSNs and they will have the argument that nursing does not teach you how to be a NP so getting work experience first is not warranted. Believe me when I say these are the ones who don’t know what they don’t know. I fall back on my ER and cardiac nursing experience nearly every day. It’s that sixth sense you develop as a nurse that helps when you become a NP or CNM.

Best wishes to your dd as she progresses through nursing school. I’m sure she will find a rewarding career no matter which path she decides to take.

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I am shocked to hear this, as the newborn and post-partum populations are included on the NCLEX. Do you mean they never had the clinical experience or didn’t even have a semester-length course in OB?

Yes ALL take an ob course. However, not all nursing students get actual hands on experience in OB. And if they do, it is often short (8 weeks).

If she truly wants to be a midwife, then she should be applying to work in OB now as either an assistant or extern/intern. She should also be going to the health system websites directly to watch how often and how many new grad L&D positions are available.

My daughter’s program had ob clinicals - some students are lucky enough to be in a delivery room at the right time. But it was certainly not as much time as med surg and even mental health.

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I know several nurses who trained as doula’s and/or lactation consultants prior to an NP program. It is very, very difficult to get a job in L and D as a new grad without any experience. Sometimes the post-partum floors will start someone and they can then move to L and D.

Fortunately, at Pitt, they have rotations in L&D at Magee Women’s Hospital right on campus. And it’s nice that it is first semester Junior year so she can get a good sense if she loves it.

Fall Soph: FOUNDATIONS OF NURSING PRACTICE 1 CLINICAL

Spring Soph: NURSING MANAGEMENT OF ADULT WITH ACUTE/CHRONIC HEALTH PROBLEMS CLINICAL

Fall JR: NURSING CARE OF MOTHERS, NEWBORNS AND FAMILIES CLINICAL

NURSING CARE OF CHILDREN AND THEIR FAMILIES CLINICAL

Spring JR: NURSING CARE OF CLIENTS WITH PSYCHIATRIC MENTAL HEALTH PROBLEMS CLINICAL

ADVANCED NURSING MANAGEMENT OF THE ADULT WITH ACUTE/COMPLEX HEALTH PROBLEMS CLINICAL

Fall SR: COMMUNITY HEALTH NURSING CLINICAL

ADVANCED CLINICAL PROBLEM SOLVING CLINICAL

Spring SR: TRANSITION INTO PROFESSIONAL NURSING PRACTICE CLINICAL