[pebbles1977]

Hi all!
This is my first post here. I graduated in 2000 and have worked in GYN Onc since. I have loved it, but it's now time to move on (several reasons that pushed me, but I always wanted to do L&D).
Here's my issue. I have told my boss and made up my mind. But I'm a bit worried about personality differences. I'm pretty laid back. I advocate to my patients well, but take things in stride as well. That's not been my experience with my L&D charge nurse collegues.
Can you guys tell me honestly how it is, and how your personalities mesh? How easy of a transition can this be, going from a pretty much surg/chemo/onc floor to L&D?
Any words of encouragement or discouragement would be appreciated! No really, I just need honesty, since I'll be starting in October.
Thanks!

[ladytraviler]

Let the charge nurse know upfront that while you have been a nurse, that l&d is a change for you. Ask her/him to teach you what they know. This seams to open a door for you and let them know that you are not coming in as a "know it all" type of person. Ask the other nurses to teach you as well. The more willing to learn from the experienced, the more willing they are to teach you. That's what it seems like to me. The personalities may or may not mesh. As long as you are willing to learn and set back and watch how the others interact, you should not have a problem.

[SmilingBluEyes]

HI there and welcome to OB!

I think you will bring with you such valuable experience when you transfer to L and D. I have a few "nuggets" of advice to share; I hope they help you on your way.

I advise you look into getting NRP (neonatal rescusitation program) ASAP. Ask the manager about finding a text to study and an instructor to take you through the hands-on and code drills. It is ESSENTIAL for ALL ob nurses, be they PP/L and D or antepartum. On most units, this training is MANDATORY anyhow. Also good for beginners is PCEP (perinatal continuing education program) and Strong-Perifax continuing education. See if your unit has these materials to look at and borrow.

http://www.aap.org/nrp/nrpmain.html
the above site tells you about the program and materials to study.

I also recommend you take the time to read some good materials on perinatal loss and how it affects families and staff alike. Find out who the nurse is who "heads this up" and where the memory boxes are. Find out what arrangements are made for the families who lose a baby (e.g. funeral arrangements, etc.)

No, certainly, It is not everyday a baby dies in utero or right after birth, but it is an unforgetable, painful rollercoaster ride for the families and nursing staff, alike. You need to be able to be there for them, without getting too caught up and drowning in the grief yourself. I may sound silly saying this now, but when it happens the first time, you will see what I am saying here. There are excellent grief seminars out there, or like I said, find out who the "grief counselor/specialist" on the floor is, and seek his/her help. Social workers are also of great help in pointing you in the right direction for assistance.

http://www.modimes.org/

The March of Dimes has an excellent array of perinatal loss/birth defect and prematurity (a confounding issue to the medical world as well as expectant parents in this country) information----- great resource available to both medical personnel and lay people as well. Check it out.

Also, you will need some training on fetal heart monitoring, so get a jump on things by asking your manager where you can get into a good class or conference for beginners. Harvey and Troiano and Michelle Murray are the BEST!!!! Check to see if the unit has some textbooks on this subject for you to borrow and read up. Two sites to help you see what I mean and for your information:

http://www.lww.com/product/0,0,0-397-55467-2,00.html
http://www.proedcenter.com/pdf/AFM2004.pdf
http://www.proedcenter.com/



Consider joining AWHONN (www.awhonn.org) Lots of good books and materials and the standard of care by which we American OB nurses practice can be found there.

Get some training on assisting new mothers to breastfeed. Lots is offered out there. If you have a certified lactation consultant on staff at the hospital, see that person ASAP for info on classes/seminars and books to help you learn to support the breastfeeding family. There are LOTS of special situations that make breastfeeding difficult for a family, such as prematurity, birth defects, breast anatomy problems, etc., that can and are overcome with the skilled assistance of staff members. Our (nurses) influence on breastfeeding experiences cannot be over-emphasized, so good training is essential!

www.breastfeeding.com
www.lalecheleague.org

There is also a member here (mitch'smom I believe ) who has a site of her own regarding breastfeeding issues. If she is around, perhaps she can help out. She has a LOT of resources about breastfeeding and special situations and is a really great source of information here.

Relax and enjoy the ride. I love Labor and Delivery nursing and have for 7 years. No where on Earth is there a better place to work, for me. It is powerful, being part of new families and life being born each day, but also exhausting.

I wish you well. Hopefully, you will be assigned a really good preceptor to help you along the way. If not, find a good experienced nurse to follow. You already KNOW as an experienced nurse, no question is stupid or wrong, so ASK. Be a SPONGE and hang in there. I think you will LOVE IT!!!! Best of luck. If you have more questions, please ask me or ask here. There are a bunch of experienced and smart nurses here with lots more experience than I have to help you on your way!

Oh before I forget another site to check:

http://listserv.acsu.buffalo.edu/archives/pnatalrn.html

This site has discussions affecting perinatal nursing and standards today. I have learned A LOT THERE from nurses across the country and in Canada. Again, welcome and I sincerely wish you the best in your new career path!

[SmilingBluEyes]

Also, please see this thread for more info on "what it takes to be a good labor/delivery nurse:"

http://allnurses.com/forums/showthread.php?t=66718

[pebbles1977]

I appreciate all the words of encouragement, advice, and links. I have lots of reading to do!
One good thing is that my current floor is the designated OB overflow unit. So we have to cross train on all the PP competencies. We don't have to get the certification, but do have to know what to do in a newborn emergency and how to use the Neopuff and warmer. Just enough to keep them until the NICU team arrives! Also, we have to know basics of breastfeeding, etc. We don't get ante's except for under 16 wks.
One thing that has impressed me (and sometimes annoyed me!) is the dedication L&D nurses have to their patients and profession. I work charge days on my shift, so I know that they can be VERY passionate about getting patients placed to make room for more deliveries, etc. We have to take the OBs before our own in bed crunches. I love taking care of them though.
We also get the losses, as it is more appropriate to have them away from the nursery and happy healthy babies (they at least don't see as many on our floor as they would on PP). So I'm familiar w/the perinatal loss program and the counselor (he is the chaplain and also serves our patients).
I have a LOT to learn, and it's very scary. But I think at least I have a basis and know the system as well as a lot of the nurses and manager on L&D. I don't want that to impede me though. I also fear that because I've done day charge (aka clinical lead: 1/2 charge 1/2 anm) for 3 years, that some of the charge nurses may feel that I'd come in believing that I should get special treatment, "know it all," etc. But I totally don't feel that way! Thank you for suggesting I let them know.
I'm loving this forum. Thank you guys for all your help! Keep it coming!