What does it take to be a good L & D nurse?

BRANDY LPN · May 26, 2004

BINGO Brandy. OB is often considered "easy street" by other nurses. It can be in a way, I guess. WE are ESSENTIALLY dealing with alert/oriented women who are most often healthy. But when OB's "go bad" they go REALLY REALLY BAD FAST!!!
It is NOT easy when you have moms who appear healthy suddenly go bad, somehow, babies born still, babies who develop severe distress right after birth when you think they are ok, moms who seize, PP hemorrages in the middle of the night when there is no physician around to call right in, women who come in w/o any doctor or history who are almost too hot to touch (Read: SUPER HIGH RISK), Psychiatric problem cases, drug abusers, etc. We are the primary triage point for ALL women over 20 weeks' gestation and we see it ALL as would any ED seeing adults. I have seen countless women sent up to us for NON obstetric complaints, as well, which can be a major time-eater.
Often, too staffing is cut and in many units, OB nurses "floated" to other "busier" floors. Yet rarely is this reciprocated when the need exists for OB. (too specialized). This is a HUGE point of frustration for many OB units that are not closed.
SO NO ONE thinking she/he "needs a break" need apply.
I see some really good definitions of a "good L and D" nurse already above. I think you guys are SOOO SMART!

Well what Deb said is a definate "con" you get every pregnant women over 20 weeks even if their complaint is NOT ob related in any way. For example once got a women in L and D where I used to work, she was in because she had a laceration on her hand that she got while washing dishes it needed to be stitched, now why in the world didn't the ER just sew her up and send her packing? Another time got a girl with a sprained ankle, no fall, no ob problems/complaints. again more of a ER kinda thing. Stuff like that irritates me, as well as when they send me girls who are less than 20 weeks, I mean what am I supposed to do they aren't viable there isnt anything that I can do that ER or MS can't do and then this girl who may possibly be losing a child won't have to hear the happy sounds of an OB unit. Okay so that is my major pet peeves, well some of them anyways, I have millions lol.

Energizer Bunny · May 26, 2004

Thanks Brandy. i think I am going to pose this question in all the specialty areas I am interested in. Maybe I should start another thread to get more responses? hmmm....yeah, think I'll do that! LOL!

QTRN74 · May 26, 2004

Would you say that working in a teaching hospital would be "less" stress in the sense that there would always be an MD just a phone call away if not already sitting in the unit? Although, I am sure teaching hospitals would see more "high" risk patients, which would be more educational for a transferring nurse...any opinions? Thanks!

rn500 · May 26, 2004

I have worked L&D in both small community hospitals and a large teaching hospital, and here's my perspective: I think a teaching hospital is great for a new L&D nurse because of the reasons you mentioned. BUT - I originally trained in a small hospital and it was great for teaching me to be autonomous and to use my nursing judgement (in the teaching hospital i work in now you can barely make a move without checking with the resident first), for learning vag exams (the residents do most of them here), and to learn to prioritze well (in a small hospital you are frequently the chief cook and bottle washer as well as the L&D nurse!).

You get a good education either way, but don't rule out trying the other eventually to get a different experience.

BTW - I WAS an ER nurse who went to L&D - worked great for me!

BabyRN2Be · May 26, 2004

As a doula, I work daily with L&D nurses. I've seen a lot of them in my 6 year tenure working as a doula. I'll give you my opinion on what it takes to be a great L&D nurse.

1. Treat every woman as if she is special. No, she may not be the first woman ever to have a baby, but this pregnancy is very special to her. Take the time to listen.

2. You are dealing with more than one person. This might take a little while to get used to. Offer suggestions to dad on how he can help his partner. Talk with them together.

I'll probably come up with more, but it's a little late. Just wanted to give my suggestions for now. Also, keep in mind that this is a momental day in a family's life while it's just another day in yours. They will carry memories of this day for a lifetime while you may not remember the family a month from now. They will remember you - you may even be part of their baby book from pictures at delivery. Do everything you can to make this a positive memory for them. You might be a little tired, but trust me, everything you do for them is really appreciated, and they will remember you.

From my experience as a doula, multips will always remember the name of the nurse who delivered their baby. Or at least it seems that way. If they were in the hospital for any other reason, they might not remember any of the nurse's names. Recently, I visited a mom who had really great birthing experiences at a local hospital. At all three deliveries, she remember all the nurses from the shifts. This really amazed me, and I asked her if she'd be in the hospital for other reasons that childbirth. She said yes, and I asked her if she remembered all the nurses from those shifts. She said no, not one.

You may be in their lives just a few hours, but you become an indelible part of their lives. Think, how do you want to be remembered in a family's life?

I know that this probably isn't practical all time, but keep these few things in mind. You will be worth your weight in gold.

Saved_by_Grace · May 26, 2004

Around here it is next to impossible to get into L&D without having at least 1 yr experience first. All the hospital adds have that in bold print here. Since I know I want to get into L&D after I get my RN does anyone have any advice on how to get that experience? Is that the norm for most hospitals?

rn500 · May 26, 2004

Around here it is next to impossible to get into L&D without having at least 1 yr experience first. All the hospital adds have that in bold print here. Since I know I want to get into L&D after I get my RN does anyone have any advice on how to get that experience? Is that the norm for most hospitals?

My advice to you is to APPLY ANYWAY! The advertisements may SAY one year experience, but in my OB unit we are constantly training new grads because there just aren't always experienced nurses available for the jobs. I think a larger hospital is your best bet.

Energizer Bunny · May 26, 2004

In my birth stories from my deliveries I have the names of each nurse on each shift listed so I can remember them. When I went in to have my last, I even remembered that one was in training when I had my first and her name, etc. She was impressed, but I say that shows just how great that floor is at my hospital!

mother/babyRN, RN · Jun 21, 2004

You're prepared for anything....You individually taylor your care to each person, family, nuance, culture, personality, psychosocial situation, etc...You learn something every time with every patient.You listen to your peers and see what works for them.You take the time to thank those you work with every end of shift. You be yourself and learn, learn, learn.......

Dixiedi · Jun 21, 2004

I've never worked L&D so I can't answer any of your questions. But I've been there 6 times for personal experience!

I have but one request...don't even forget that even though you are the nurse, the pt is the mom and she just ight know more about what's going on than you do.

If you always remember that, while at the same time there are more wives tales than there are days in the year that many women still believe and can cause lots of probolems for you and them, you will do great!

Most days, if you are in an "average" (what the hell is average in this business?) ER I would think most days would be described just like those in the ER.

Some days are quiet, some are zoo-like. Hey! that 's the same as where I work!

Just please, always remember that sometimes mom does know what's going on.

Belinda-wales, RN · Jun 24, 2004

Hi I am currently a midwife working in the uk who is moving to AZ with my family and hoping to work in labour ward I realise that I will not be working as a midwife but as a ob nurse that is fine my worry is that I will have difficulty finding work I currently deliver high risk and low risk in a hospital that has 2500 births a year and will have been working as a midwife for six years... any advise would be great Thankyou Belinda.

BabyRN2Be · Jul 1, 2004

You're prepared for anything....You individually taylor your care to each person, family, nuance, culture, personality, psychosocial situation, etc...You learn something every time with every patient.You listen to your peers and see what works for them.You take the time to thank those you work with every end of shift. You be yourself and learn, learn, learn.......

That's something that I forgot: culture! Find out the demographics of your area and read up on those nationalities. It can make for some very interesting, engaging reading. In my case, I'm dead smack in the middle of the U.S., work in a county hospital and most of our pts are Hispanic and Native American. If you work in cultural hotspots of the country (the West Coast or East Coast), find out more about what your hospital sees. These cultures are fascinating.

Childbirth is indigenous to all races - it's truly an opportunity for a fascinating experience!