Hello everyone, I am a nursing student and I would like to specialize in L&D. Some of my instructors have said that ALL students should start with Med-Surg directly out of school. Would you agree? What is the best start? Also, can anyone recommend a source of information on L&D certifications etc.? Thanks, Amber:D

I have seen so many come here and ask this. I am always happy to tell people who do that I graduated nursing school 6 years ago, having secured an L and D job 2 months prior to graduation. Yes, I started in L and D right out of nursing school. Now before you think otherwise, understand, I am NOT saying starting in Med/Surg is NOT a good idea because it IS! You would get a VERY solid foundation on which to build any nursing career, spending that first to second year out of school in Med/Surg nursing. And it was what I had planned to do.

However, the L and D manager at the local hospital had gotten my name and called me for an interview one day, and I was NOT going to say "no" to the job of my dreams. I felt like fate had stepped in to guide me. But let me warn you; I had a ROUGH first 2 years. There is A whole LOT to learn and FAST. L and D nurses HAVE to learn and possess excellent med/surg skills (cause labor patients can have complications that come up quickly, and you are treating TWO patients, not just one). You have to be an excellent communicator as well. Confidence is vital to practice in OB. But it can be done. 6 years later, I am what I would honestly call a very skilled L and D, Newborn and GYN nurse with a vast amount of experience behind me. I still love what I do.

As far as information regarding L and D nursing, your best source is AWHONN. ( http://www.awhonn.org ). This organization sets the practice standards by which US nurses in OB/Newborn/GYN nursing follow. It is a good start to visit there and as graduation comes closer, perhaps join the organization to show your sincere interest. You will also want to have current CPR when applying for work and be aware most places want you to have NRP (newborn resuscitation program) certification fairly soon after starting work, so be sure you tell any prospective employer that is a goal of yours.

While in school, take EVERY opportunity to learn what you can cause that safety net of having instructors behind you wont' be there when you are a Grad nurse and the learning REALLY begins. Be a sponge from the start.

I wish you well. Do like I did---see what happens BUT--- Don't take your eyes off the prize. Good luck.

I hated med surg and went pretty much straight into L&D as well. I have NEVER regretted it for a second. I have oriented new staff and haven't noticed a real difference between those with med-surg experience and those without. The real factors that will determine whether or not you will be a good L&D nurse have more to do with your personality than anything else. You need to LOVE your job, be willing to learn new things, be able to cope in emergency situations, know when to ask for help and be confident in your assessments, etc. If you think that sounds like you, then I see no reason to make yourself take a med-surg job.

L&D is so different from med-surg that I don't think instructors are really right to say it's the best foundation. Med-surg should really be recognized as its own specialty and not a general foundation for all nursing. I personally think post partum is a much better place to start before L&D cause you learn organization, assessments, prioritizing, skills and how to deal with families (basically all the things med-surg will teach you, but much more relevant to L&D).

If L&D is your thing, then go for it. I am so tired of hearing about MedSurg giving you a good background and a chance to use your skills....if you do not want to work there, then don't. Do what you love, and don't worry about anything else.

I graduate in a few weeks, and I have secured a job in OB. After a required 2 weeks of classroom time and 2 weeks of med-surg, I get to start orienting to OB. First, I will be trained in PP and then after so many months trained in L&D. If I hadn't have gotten this job, then I would be applying for med-surg. I really enjoy working med-surg, as well. I also agree with the other posters that if the opportunity comes for you to get that job...go for it. Perhaps you could also look into cross-training....My future place of employment does it with those who request it.

I too went straight to L&D after graduation and I don't regret it for a minute, I now have been out 2 years and I absolutely LOVE what I do, I did NOT even work post-partum until I took a travel nursing job a year and a half after working as staff in L&D, I say go for it, if it's really what you want to do!!! I worked as a scrub-tech/CNA in labor and delivery while I was in nursing school and BOY did I learn a lot, I attended deliveries, placed catheters, put patients on monitors, scrubbed for c-sections, vital signs, learned about the dynamics of L&D it was valuable experience that I built my nursing practice upon. GOod luck with whatever you decide

Thank you all so much for your replies. Right out of H.S., I started in a 4 yr. nursing program but changed to Education. I worked as a teacher for years. I helped coached my best friend through the birth of her son and had a front row seat. It corfirmed every want that I had had to be an L&D nurse. At the moment, I decided to go back to school for nursing. I am so anxious to begin, I prefer L&D would would also like to work PP and help with breastfeeding and newborn care. I am interested in becoming a lactation consultant in the future. Do many of you get the opportunity to "cross over" in those fields: L&D, PP, newborn nursery? As I said, several teachers told me to start in Med-Surg. I just finished an entire semester in Med-Surg and I will have to spend 7 more weeks in Advanced Med-Surg this fall. I just DO NOT like Med-Surg! I think I would be happy ANYWHERE else! The problem with L&D in my area is, we have two hospitals, one is the Univ. of Va and the other is a nice private community hospital. I have heard that it is nearly impossible to get into their community hospital but if you want to try, you should start in the Women's Center, which sounds pretty cool. Or you may be able to get into the UVA L&D and eventually transfer as an L&D nurse. Any opionions as to which would be best?

If you want to do Labor, Delivery, Postpartum and newborn care, you can try a midsize to smaller hospital. Where I work I do them ALL. We are a 22-bed unit that has 10 LDRP's and 12 general/surgical beds. ( smallish unit like mine that does 65-70 deliveries a month is ideal to me cause it's not a "factory" atmosphere). This is a great way to go cause you can follow a woman thru labor, delivery and her postpartum periods. You help her initiate breastfeeding/bonding and take care of her and her family throughout the course of her hospitalization. I have never had to "crosstrain" working this way, because when in a unit this size, I have become oriented to ALL areas at once. I also take care of GYN surgical patients to include those who have suffered losses such as ectopic pregnancy or miscarriage/fetal demise. I also have done level-2 newborn care (Not NICU but special care nursing for sick newborns). I do it all, really, except NICU, which is fine by me.

In a larger hospital, L and D and PP/Mother-baby are separate units and it's likely you would be oriented to PP/mother-baby nursing FIRST and then L and D nursing some months later on. That is how it usually works in the larger hospitals in my area, anyhow.

I agree with you; you have to take what gets your foot in the door, so if you can more easily "break" into OB nursing at one hospital over the other, then by all means do what you can to make it happen. There IS always transfer later on as an option, as you pointed out. Sounds as if you would more likely get in at the bigger university hospital. That is OK---you will learn a LOT there, believe me!

First, you have to get through nursing school! You will do clinicals there (OB, med-surg, Peds, Ortho, Community Health, Home health, geriatrics) and will see more clearly what may work for you. I wish you the best, whatever happens. I am a 2nd-career RN myself, so I know it can be done when you are determined and having maturity like we do (as well as experience in other careers) helps a lot! PM me if you would like, I am happy to help any way I can!!!!!

I too just graduated and i have been taking a crazy ride like a rollar coaster on this med-surg, LD, med-surg-LD.

i have not yet decided what to do. i figured after i pass BOARDS, then i will just apply for PP and MEDSURG, and just see what happens...

my thing is what if i move. is it easy fpr a LD/PP nurse to transition to a MEDSURG floor? how marketable are you as a LD nurse?

It's ---It is VERY easy to get into med-surg nursing virtually EVERYwhere. Med-surg nurses are in GRAVE shortage...as are ER and ICU nurses. You ARE marketable as an L and D nurse; don't sell yourself short. Plus: many hospitals offer residencies in different areas such as med-surg, ER, peds and ICU, as well as many other areas. And an experienced nurse in another speciality would be welcome in shortage areas if he/she is motivated to learn the ropes and jump in! So, do NOT sweat your marketablility! Good luck!