LPN's In L&D........

Nurses General Nursing

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Hello all, I've been lurking on this board for a couple of weeks now, and finally registered. I take my entrance exam to Nursing School tomorrow, and if I get accepted I will be starting in September.

My question is, my dream in nursing is to work either in Labor & Delivery or taking care of the newborns in the nursery. Is this possible being an LPN, or is it just a dream? Are only RN's hired for these positions? Thanks for any help you can give me.

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Sheryl

Hello Sheryl,

Depends on the state in which you live and the facility in which you work that dictates what the LPN can and cant do. In oklahoma LPN,s can work L&D if they have had the training, and certainly in the nursery. Good Luck smile.gif

Definitely depends on the place, but with the shortage the way it is I am sure you will be able to find something. We don't have LPNs in L&D, NICU or post-partum anymore, but I know other hospitals that do.

Hi Sheryl,

My mother is an LPN and she worked L&D for 11 years. She did everything from labor to nursery, and was very good. It was a smaller hospital, and I don't know if that was a factor, but at least you know it is a possibility. Good luck!

Laura

Greetings,

I am a LPN and also have a calling to work as a Maturnity Services Nurse. I have a greater obstacle than just being a LPN. I am male! I desire wholeheartly to work in L&D oneday, until then I am seeking employment in any Maturnity Area. I feel the more areas you know the more likely you/I will be able to "float" to L7D oneday!

In my quest I have worked at an abortion clinic and volunteered at a hospital on the Post-Partum/Well-Baby Nursery floor. I did not do anything beyond passing food, babies, and some education to the new moms but it felt really good! The hospital I was doing that at did not have anything but RN's on that floor and a Unit clerk at the desk, not even one CNA or LPN! I would like to invite you to ask questions on the "LPN Corner" Disscussion Board here at "AllNurses.com" it was just started today "A place for LPN/LVN's to meet and greet each"!

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Visit my at http://www.geocities.com/4birthing

Have a Blessed and Peaceful Day,

Jami

[email protected]

[This message has been edited by jamistlc (edited April 23, 2001).]

Specializes in LDRP; Education.

Hello-

It definitely depends on the state and facility. I work at two hospitals in L&D right now...one hospital we don't employ any LPNs in either labor and delivery, nursery or post-partum. At the smaller, community hospital, we have one LPN who does post-partum only.

Check with your local hospitals and your state's nurse practice act.

Good luck - L&D is a challenging and rewarding area to work!

Thanks everyone for your answers. I don't know what Massachusetts laws are re: LPN vs RN. I have e-mailed local hospitals in hopes of finding something out. This is REALLY my dream, so I hope the laws in my state aren't against me.

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Sheryl

Sheryl,

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).]

Originally posted by lsmo:

Sheryl,

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).]

The truth is I don't have the time or the money to go for my RN. I have 6 children, 3 of them are 5 and under, and I am paying for schooling myself (well my husband is) as the nursing school doesn't charge "Tuition" as they call it "Fees" and the school has told me I would have to apply for a personal loan which I probably won't get due to the fact that there is no tuition. I am a stay at home mom right now. And where I am I would have to take a year of Science & Math before I could even apply to a 2 year RN program, and I just don't have 3 years (at this point in my life anyway) for an RN. Maybe someday, who knows??

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Sheryl

Sheryl, Hello again! I encourage you to check with financial aid sources. In todays market, many RN's are getting their school expenses reimbursed for a commitment to work at the worksite that pays for it. Check out your local hospital nurse recruiter for info as well as schools of nursing in your area. There is the possibility that you will have to take out a loan initially, but it is often paid off according to what I've been reading in our area (MICHIGAN). Don't let financing stop you. That all tends to take care of itself if you look for it and get creative. It is so worth the investment in your career to go for the job that opens your opportunities up in the area you desire to work. In addition, the pay is far better in the long run. Go girl!

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L.Smo RN

hey sheryl,

I just posted a message on another page about l&d. i'm an lvn i worked in l&d it sucks as an lvn. your just treated like a tech. you can insert foleys and start iv's but other than that you are doing all the dirty work for all the rn's on duty that day. the shifts where i worked were 12 hours. you don't get your own assignment. you wait around the whole shift until someone an (rn) asks you to help them recover the pt. basically clean up all the afterbirth, the room, stuff like that. and other things like stock the rooms and th iv trays. i don't know but if that would be something you would like, but for me, i want to use my nursing skills. i don't want to be a slave and just clean up after the rn. i already resigned from that job. im studying for my rn. i would love to work in l&d when i am done. i would recommend it only if your an rn. good luck!!!

Specializes in ER, PACU.

Here in NY they dont hire LPN's in L+D at all. Sometimes on a RARE occasion, some agencies have positions for post partum per diem but here is the catch: You need at least 3 years of maternity experience to take that kind of assignment, and since no hospitals will hire an LPN on staff into those areas, you cant take the assignment. If you happen to have experience from out of state than you may be in luck. L+D is a hard place to get into around here, even for new grad RN's. Only one of my classmates got into it because she did a summer externship for 2 years on an L+D floor at the hospital she got hired at. In fact, the hospitals in this area that will give a chance to a new grad almost always will only hire a BSN! (Not meant to start a discussion, this is just what I have heard from recruiters). Maybe in the future things will change, but in the meantime get your LPN get some work experience than let the employer pay for your RN!

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