I wish you the best in your endeavor. However, I would strongly encourage you to get your RN license in order to open more opportunities up to yourself since this is your dream.
Now, here goes a true story about utilization of LPN's in L&D: I believe that using LPN's to labor patients in this day and age of obstetrics is very risky for many reasons. With the advanced technology and complexity of care, even in the most "normal" delivery scenarios, it is necessary to require continuous management of the patient and thus, the critical assessment skills required by license of an RN.
In an era of cost containment, this is not a pill easily swallowed by administration. Obviously, RNs cost more, so administration can put up a good fight about justifying the type of staffing pattern . In some cases, even the LPN's argue that they are capable of doing the job. I have witnessed hospital administrators try to set policy in place that is opposed to current standards of care.Hospital policy will not over ride scope of practice issues that licensure dictates.
Since standards are guides, and constantly being researched and updated, it isn't that unusual to find that many RN's and LPN's are not cognizant of the current standards of nursing practice. But, it is up to the nurses to keep administration apprised of what we need to practice safely, assure quality care, and to advocate for an appropriate practice environment. For example years ago, our hospital staffed LPN's who labored patients, unquestioned. Then, we started moving toward an all RN staff shortly after I started working there as a new LPN. I went on for my RN and continued to work in L&D where I've been for 16 years.
When work redesign came about just a few years ago, the hospital converted to a "team" staffing approach in L&D in which more LPN's were to be added to our staffing and less RN's. The idea was that they could still "do labor", and if it got complicated, the RN on her "team" would take over care. It is not possible to stop everything and initiate emergency procedures for the other team mate's patient at the drop of a hat. In fact it was often very difficult to "back up" the LPN who had a labor patient, and when the L&D unit's acuity or census rapidly increased the LPN was not able to assist in many of the scenarios independently. It became a strategic nightmare at times, we just simply needed more RN's for the type of work we were doing. Additonally, the acuity of our patient population was becoming more and more complex. Epidurals, pitocin and prostaglandin inductions, addition of perinatology and neonatology etc.
During our investigation of the appropriateness of the team approach, we learned that by continuing to have LPN's labor patients, we were jeopardizing their licenses and our own due to the rapidly changing face of intrapartum management and ongoing evaluation. We gathered much data from AWHONN, our professional organization for O.B. and it was made very clear that the role in management of the intrapartum patient was well suited to the RN role by license. In fact, we were strongly advised to redefine the current role of the LPN in L&D because the national standards of practice for O.B. as established by AWHONN, would be the template from which we would be judged in the event of litigation.
So please avoid working on OB units in hospitals that do not follow AWHONN guidelines, because they are asking the staff to risk their licenses which may put the patient(s) care in jeopardy. I wish you goodluck..... and hope you keep pluggin' away at your dream job. It can be such a neat place to work.
[This message has been edited by lsmo (edited April 23, 2001).]