Med/Surg RN considering L&D

  1. I have been a Med/Surg nurse for about 4 years. 8 weeks ago, I had to go out on disability due to complications of pregnancy. Im 25 weeks now, at 16 weeks had to have a cerclage r/t DES exposure, (thanks mom) I like Med/Surg, but im afraid I will get burned out soon due to the extrememly stressful conditions some days. 12 hr shifts are just about always at least 13, some days, the ball gets rolling and ill skip morning break, take 15 minutes for lunch, then its back on the floor to continue doing 3 things at once, as quickly as possible till 8pm!(then all the paperwork until....) It can be exhausting, taking the entire next day to recover physically and emotionally from it, and I only work 2 days a week!! I would appreciate any insight anyone could give me on what your days are like, how many patients are you assigned? How stressful are your days? Has anyone switched from M/S nursing and if so, how does it compare? What are the downfalls of L&D? I love being a nurse and helping people, feel as though it is my calling, but I think it may be time for a change..... any comments will be appreciated!
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  2. 8 Comments

  3. by   2banurse
    I think that your med/surg experience would be an asset for L&D, and I'm sure that you will hear that by experienced RNs working in L&D. One thing, you talk about how a 12-hour day would become 13 hours, I'm sure that you will find that also in OB. I mean if your patient is about to deliver when your 12 hours are up, you're not going to get up and leave, right?

    The one thing that I would think that is a little different is that you won't have as high a census. I mean I'm sure that in med/surg you've had 8 patients or so a shift (maybe more??), I would figure the census would need to be much lower. Can an experienced L&D RN give an example of how your census runs?

    Best of luck and health to you and your little baby,
    Kris
  4. by   fergus51
    Please don't go to L&D expecting it to be restful. I've seen that happen and it was a train wreck!

    Our census is generally 1:1 for women in active labor because you need to be assessing fetal heart rate every 15 minutes, then every 5 when pushing. Other assessments depend on the patient and whether she is low or high risk, has epidural, etc. The stressful aspects include: crazy patients who should not be having children (you need to be prepared to provide good care to drug addicts and other women who could care less about their babies), relationship issues (have had more than a few abusive men in the last little bit), the speed at which things go wrong (and when they go wrong they go VERY wrong) and the crazy pace it sometimes entails (I had 4 patients deliver on one shift last week!!!). The lifting is probably my biggest physical complaint, along with the constant standing.

    Your med surg experience would no doubt serve you well because as you know, sick people get pregnant and pregnant people get sick. I work with a lot of women with diabetes, heart conditions, Hep C, HIV, etc. That said, if you are really burned out right now, I would suggest you take a real break before going into L&D. The skills and assessments there are very different from med-surg and the transition can be stressful. I worked med-surg BRIEFLY as a new grad and hated it. I like L&D because I like the one to one ratio. I feel like I really get to connect with my patients. The hardest part for me was the times when childbirth went wrong. I had to accept that there would be a lot of unwanted children born, and that some very wanted children could be stillborn. There have been many days I have driven home crying. That said, I love this area. It isn't always happy, but it's always meaningful.
  5. by   SmilingBluEyes
    Originally posted by LA-NJRN
    I have been a Med/Surg nurse for about 4 years. 8 weeks ago, I had to go out on disability due to complications of pregnancy. Im 25 weeks now, at 16 weeks had to have a cerclage r/t DES exposure, (thanks mom) I like Med/Surg, but im afraid I will get burned out soon due to the extrememly stressful conditions some days. 12 hr shifts are just about always at least 13, some days, the ball gets rolling and ill skip morning break, take 15 minutes for lunch, then its back on the floor to continue doing 3 things at once, as quickly as possible till 8pm!(then all the paperwork until....) It can be exhausting, taking the entire next day to recover physically and emotionally from it, and I only work 2 days a week!! I would appreciate any insight anyone could give me on what your days are like, how many patients are you assigned? How stressful are your days? Has anyone switched from M/S nursing and if so, how does it compare? What are the downfalls of L&D? I love being a nurse and helping people, feel as though it is my calling, but I think it may be time for a change..... any comments will be appreciated!
    I think if you would enjoy L and D it may be time for a change. I would welcome anyone with a great attitude and skills like YOURS to contribute.....

    But if you think L and D is any less stressful, busy and exhausting, think once again. This is a common misconception held by non- OB nurses. I suggest working with an OB nurse, say shadowing, or floating, to see if it's for you. OUR 12 hour days can EASILY turn to 14 or more, just trying to keep up with charting and such, also. We do many change-of-shift admissions and deliveries and can't just leave cause the 12 hours are over for us, either. Babies come when they damn well please, and are NOT convenient, either. I have done MANY a change-of-shift csection, and that easily adds 2 or more hours to my already-long day/night. The paperwork involved in any delivery is MIND-BLOWING and it must be PERFECT and LEGALLY defensible, like anyplace, so you have to do that after the delivery is done. I come home DOG TIRED sometimes, so numb I cannot even think or sleep. ANY area of nursing can do this to you! Ob is certainly NO different in that aspect.

    Another personal information byte: I was pregnant with my 2nd child and was in preterm labor at 30 weeks due to my work in OB. I had to be taken off work for *5 weeks* before I was able to resume my pace. The work itself put me in labor, period. When not working, I was ok. YOU ARE ON YOUR FEET ALL THE TIME, not just rocking babies, like so many seem to think. It's like anyplace, when you are busy you are KILLER BUSY, and when slow, VERY SLOW. I savor the slow days, when I get them. I will say, Some places have better staffing ratios than others.....Labor nursing, ESPECIALLY, is labor-intensive, requiring you to be on your toes every minute and very emotionally available. Don't let any 1:1 or 1:2 ratio involved in *labor* nursing fool you; you will earn your money and then some when doing this. Also, In some places in postpartum nursing, you may be caring for 6 to 8 couplets( that is really 12-14 patients you care for and chart on). I am lucky, usually I never do more than 4 couplets under normal circumstances, due to very good staffing ratios.

    The ups? 99% of the time, it's a happy event you are a part of. The hugs you get....the tears that fill your eyes when new life comes into the world and new families are created! I LOVE moments like these and they are what keep me doing what I do, really. It is indeed WONDROUS! The other 1% can be horrendous tho: stillbirths/losses and/or rare maternal deaths. Losing a baby or mom is VERY hard on the psyche, believe me. Babies born with severe defects that may or not be compatible with life, that is another toughie. It is also among the most-- if not THE most ---litigioius areas of nursing you can choose. There are insurance carriers who refuse to cover you if you have ANYthing to do with Obstetric nursing. anyhow....I could go on and on....this is WAY too long already.....

    I wish you well in your pregnancy and delivery and whatever you decide. Like I said, your skills are a definate asset to ANY place in nursing, so you will be welcome wherever you go. I did NOT mean to discourage you in any way, just make you aware to our realities as labor nurses. Welcome to the boards and OB, if you so choose. Good luck!:kiss
  6. by   SmilingBluEyes
    Originally posted by fergus51
    Please don't go to L&D expecting it to be restful. I've seen that happen and it was a train wreck!

    The lifting is probably my biggest physical complaint, along with the constant standing.

    .
    These are the things I was saying also. LIFTING will KILL you in OB ....just like anywhere. I simply CANNOT suggest you do OB while pregnant, esp in a high-risk situation like yours. You may have to plan on a leave of absence to preserve your pregnancy and prevent pre-term labor. What Fergus says is true.
  7. by   SmilingBluEyes
    Originally posted by 2banurse
    I think that your med/surg experience would be an asset for L&D, and I'm sure that you will hear that by experienced RNs working in L&D. One thing, you talk about how a 12-hour day would become 13 hours, I'm sure that you will find that also in OB. I mean if your patient is about to deliver when your 12 hours are up, you're not going to get up and leave, right?

    The one thing that I would think that is a little different is that you won't have as high a census. I mean I'm sure that in med/surg you've had 8 patients or so a shift (maybe more??), I would figure the census would need to be much lower. Can an experienced L&D RN give an example of how your census runs?

    Best of luck and health to you and your little baby,
    Kris
    Wrong assumptions that our census is low as in the above post.......please read my post below. If not, it's stated here: If you have just 4 couplets, you have 8 patients. It goes up from there. And don't let the 1:1 or 1:2 labor patient ratio FOOL you...there is a REASON for that and in OB your liability is way too high to assume a greater ratio. See, misconceptions abound by those not experienced in OB nursing.
  8. by   L&D.RN
    I think the shadowing is a great idea, you'll see exactly what is involved. I also think the nse/pt ratios are a misconception. We very seldom get 1:1 at our hospital, usually we have 2 patients, and watch each others when one of theirs goes to delivery or a section.

    We just had a seasoned ICU nurse go through our residency program to become a L&D nurse, and she said it was tougher than she anticipated...the numbers fooled her. I will add that she is awesome and doing an awesome job too! It's great to have her on board, because she helps us see the other stuff when we are so focused on L&D stuff.

    Good luck to you, I think you'd love L&D!
  9. by   LA-NJRN
    Thank you all for your supportive insight, I like the idea of shadowing, ill have to see if that opportunity exist in my area. You all seem like such nice nurses, on my unit we have a few bad old seeds that try to make their days easy by dumping, which adds to the stress of the situation. We usually get 5 patients, sometimes 4, occasionally 6, with the help of a tech, that can do lab draws, ekgs, am care,d/c foleys, ect. So our pt #'s are good, its just a busy unit. Again, I really appreciate all of your comments, thanks!
  10. by   SmilingBluEyes
    I wish you well in yoru pregnancy and decision-process. I hope you find exactly what you seek and that you remain HEALTHY in doing so! Let us know how you are doing!

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