New nurse in Labor and Delivery

Specialties Ob/Gyn

Published

So I am a new nurse.. just took and passed my boards and I got hired in Labor and Delivery.

I wanted to know if anyone has any advice to avoid pit falls or common mistakes.

Im nervous and need some advice :uhoh3:

Specializes in LTC, PCU, Med/Surg, Hospice, OBGYN.

I'm new to L&D too but not a new grad, however, I was hired with a bunch of them.

My advice to all you newbies...

DON'T act like you already know everything! It makes the experienced L&D nurses frustrated. Even if you already done something in clinicals like starting an IV, you can always use the experience and the nurse precepting you may teach you a new way of doing something. Also, if you don't know something or can't remember something, look it up. Don't always expect them to answer every little question from A-Z like your clinical instructors did. I go home every night and review my Maternal book from school just to refresh and relearn anything I did not know that day at work.

One last thing, it is true that older nurses eat their young. It is not that they want you to fail though. They already believe you are going to leave them in less than a year and go to that Monday through Friday OBGYN office job after you've gained some experience...PROVE THEM WRONG! And stick around, then they'll respect you more!

In the meatime, good luck!

Specializes in LTC, PCU, Med/Surg, Hospice, OBGYN.
Just curious, where are new grads being hired in L&D?? I feel like I've looked everywhere and a year of experience seems to always be required...

Something I've learned in the last 2 years especially when I was a New Grad and could not find a job at the time...apply even if it says experienced required, write an awesome cover letter stating why you are perfect for the job and what you can bring to the table, and give an excellent interview and show them how much you want it. And call them over and over again, once a week if you have to, until they give you that interview shot!

I never, ever wanted to be an OBGYN nurse and ended up being one now and loving it! When I saw the posting for the job, I never applied because I thought it was required to have L&D experience to get it. But one of the administrators saw my potential and my added benefit of being bilingual in English and Spanish and got the job offer after a short interview. The nurse manager stated afterwards that she loved my enthusiasim and my willingness to try something new, so I got the job!:yeah:

I dont mean to sound immature or gross, but how does working in LD work when there is a woman that is stinky down there or has std's? Id love to bring a baby into the world but I dont know how id handle that stuff.

Umm.. Well you can clean someone who stinks, and STD's are so common and you just use PPE.

I am a new nurse in Labor and Delivery as well - it is overwhelming and scary and I am not ready to be off orientation in less than a month. BUT -- just remember that most everyone feels scared starting off.

Some tips that I have from experience and asking my coworkers...

1) Write down everything you learn/patient requests so you don't forget. Keep a notepad in your pocket.

2) If your floor does not provide them already, obtain or create "cheat sheets" for different situations you will run into at work. For example, I have C-section, induction, lady partsl delivery and epidural check lists that I keep in my pocket so that I have access to what I need to do in the correct order. After a while you won't need the check list.

3) Volunteer to start IVs, perform lady partsl exams or to practice skills on different patients that you might need some work on during your orientation.

4) ASK QUESTIONS. No matter how stupid it may seem.

5) Expect the unexpected. Every patient's labor is different and no one follows the same path, regardless if they are nulliparas or multiparas.

6) Do not take your eyes off of the FM strip unless someone is watching it for you while you are involved in someone else.

7) Review the patient's history in the beginning - prenatals, lab values, problems, allergies, blood type etc so that you can make an appropriate plan of care for the patient.

8) Document carefully and CYA (cover your a**). For example, If a patient refuses something, document what they said and what you did or said. They can come back with a lawsuit 10 years later and you will have the documentation that clearly states that happened.

This is all I can think of for now. Good luck!

Specializes in L&D.

I cried a few times. It was overwhelming becoming a new nurse and also all of the L&D charting... I wondered how I was ever going to have time to care for my pts. Ask questions. Be easy on yourself. You're not going to get everything right. You'll make plenty of mistakes. Everyday you might learn something, take the time to write down questions or things to look up after your shift if you don't have time to during your shift. Review your procedures and protocols. Most of all, be gracious, accept suggestions, and always keep your patients in mind.

I went straight to L&D from graduation too. I have been there 3 yrs and LOOOOOVE it. Yes its scary but the thought of going from here to another unit is scary to me- bc i Know my stuff now and relearning new stuff is scary. any new nursing position is scary to begin with. Is there anything in particualar that scares you about L&D? like others have said ask questions, understand physiology, and learn from mistakes. thats all you can do. enjoy your new job!

and to the poster who said something about stinkiness.....almost all nursing can get stinky. i am sure you didnt go into nursing to smell the roses....

I went straight to L&D from graduation too. I have been there 3 yrs and LOOOOOVE it. Yes its scary but the thought of going from here to another unit is scary to me- bc i Know my stuff now and relearning new stuff is scary. any new nursing position is scary to begin with. Is there anything in particualar that scares you about L&D? like others have said ask questions, understand physiology, and learn from mistakes. thats all you can do. enjoy your new job!

and to the poster who said something about stinkiness.....almost all nursing can get stinky. i am sure you didnt go into nursing to smell the roses....

Hi, I am a nursing student who is starting my labor and delivery clinical tommorow. I will be assigned a laboring patient and need to perform a standard head to toe assessment. How do you accomplish this easily on a laboring woman? I cant believe we are actually hitting the floor tommorow since we have only had one 3 hour lecture on OB and just finished our med-surg final on Friday. We basically had 3 days to learn new material (+ 30 new meds and Lab homework to do on the weekend) and had even more thrown at us today. Im very overwhelmed , I dont want to fail but dont feel prepared for this yet.

What should I be assessing that is different from med-surg when I walk in the room? Sorry, if this sounds like stupid questions but we have not learned much in OB and are expected to be ready to go tommorow.

I remember those days! Well, when i first meet a patient I start a conversation about how they feel generally. I take a set of vitals to assess for HTN or hypotension if they have en epidural- with that i will assess for headache or blurry vision (think Pre-eclampsia and yoou will prob. alreadyy know if the patient has been Dx with that before you go into the room). Take a TEMP! very important. if her water is broken the risk of infection to baby increases the longer she is in labor. I monitor them for ctx in correspondence with the external (or internal) fetal monitor to make sure I am picking up her ctx. I monitor the fetal heart rate. If her membranes are ruptured I check the underpads for color, odor etc. I check for edema from head to toe. The assessment is different than a med/surg patient but I think I covered everything I do on my initial assessment. Just be sure to look over the chart for her history, diagnosis and current status as far as gestation, start of labor, induction, augmentation, risk factors, allergies, rupture of membranes, labwork etc.

Good luck! I LOVED my L&D rotation hence why i went straight for it after I graduated =)

Specializes in OB, Women’s health, Educator, Leadership.
I remember those days! Well, when i first meet a patient I start a conversation about how they feel generally. I take a set of vitals to assess for HTN or hypotension if they have en epidural- with that i will assess for headache or blurry vision (think Pre-eclampsia and yoou will prob. alreadyy know if the patient has been Dx with that before you go into the room). Take a TEMP! very important. if her water is broken the risk of infection to baby increases the longer she is in labor. I monitor them for ctx in correspondence with the external (or internal) fetal monitor to make sure I am picking up her ctx. I monitor the fetal heart rate. If her membranes are ruptured I check the underpads for color, odor etc. I check for edema from head to toe. The assessment is different than a med/surg patient but I think I covered everything I do on my initial assessment. Just be sure to look over the chart for her history, diagnosis and current status as far as gestation, start of labor, induction, augmentation, risk factors, allergies, rupture of membranes, labwork etc.

Good luck! I LOVED my L&D rotation hence why i went straight for it after I graduated =)

I co-sign with everything already mentioned and to add, when you walk into the room scan quickly with your eyes EVERYTHING before you even lay hands on the patient. Specifically the monitor, settings and IV fluid status. Make sure rate on IV fluids pump is correct. I make sure to scan the room to check that all equipment is in place in case of a stat delivery. As I'm doing this I talk to the patient and usually start out checking how alert they are and my very next question is their comfort level ie how much pain are they in.

It is normal to be nervous! OB is it's own little world onto itself. If you wasn't nervous then I would be scared. You are going to makes mistakes...accept that...you are human. The key is to learn from those mistakes. Enjoy the easy deliveries...drink em up and learn from those deliveries that are not so perfect. Trust me, those will be the ones that you will not forget. The stakes are high everywhere in nursing when you consider that you have someone elses life/well being in your hands, however OB takes it to a whole new level. You are now dealing with 2 lives instead of one.

I have been a nurse for almost 10 years and I have worked in med-surg, home health, LTC, ER, OB plus some administrative stuff thrown in here or there. Out of all of those different places, I love OB the most! Is it more stressful...yes, is it demanding.....yes. There is alot to learn and that learning is constant however it is the most rewarding job that I have ever had. I can't imagine ever doing anything else again. There is nothing like getting to see and participate in a family being created. It is priceless so hang in there and take it one day at a time and keep learning! You will do fine!

Be patient....OB nurse are not grown in a day

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