I am currently thinking about leaving ER and trying out my other interest in L&D.
ER has been a very exciting yet stressful environment for me since you never know what is going to come in the door. My question is for the L&D nurses...what is a "typical" day like?
How many patients are you assigned too?
What do you do if more than one patient are fully dilated and ready to push...does another nurse take over?
What is your typical stress level on average (1-10)?
What is the best/worst part of your job?
Do you think an ER nurse could make the transition easily or do you think it is a "whole other world"?
How long do you think the orientation would be?
May 16, '04
Keep in mind that I'm not an L&D or LDRP nurse, but I am a NICU nurse and have worked side by side with these nurses during deliveries and sharing information about undelivered patients that we as NICU nurses need to be aware of.
I think you'd transition easily considering the aspect that L&D is like a mini-ER... you never know what super-emergency could walk through the door at any given moment. That's a very ER type of existance. I believe only the ER and L&D are pretty much routinely like that.
Considering the difference between L&D -vs- LDRP (where L&D delivers babies, triages undelivered patients, and cares for critically ill undelivered and delivered patients -vs- LDRP where they do all L&D does along with the Postpartum aspect) The L&D is much like an ER where you "Treat 'em and street 'em"... the street 'em part is when you send the mother and baby to the postpartum/well baby nursery as soon as they are stable, which is usually within a few hours after delivery, unless the mom is very sick and needs to be on a MgSO4 drip for severe PIH after delivery, etc. On the other hand, the LDRP patients do not get the "street 'em" part because they stay with you for a few days while mom recuperates and baby gets used to the world. There would be much more time for teaching and bonding with the patients on an LDRP unit. It would be much less like an ER "in and out" setting. Extra time spent enjoying the new family is very rewarding for nurses. That's what I loved about my years on a Mother-Baby unit.
If you've never peviously worked in an OR or PACU, that would be a new experience for you since most L&Ds/LDRPs have their very own Operating Room Suites and often do the Recovery Room (PACU) care for their surgery patients. Some critically ill undelivered moms require central lines and other such procedures which you would assist with. I don't know if you do c-lines in the ER much...
This is all that comes to my mind right now.
The only other thing I would add is that laboring patients is a very high-risk area prone to law suits (after all, what in the world means more to a person than their child), so they are often very, very good about orientations, safe and proper nurse-to-patient ratios, and other such matters. A good orientation and safe staffing are definate strong points for working with laboring patients.
I hope the nurses here can help you. I doubt I've been much help but I do wish you the best in your decision. I encourage you to seriously think about stretching and growing as a nurse. It keeps us fresh and passionate about our work. I spent 7 years on a Mother-Baby unit (postpartum-well baby) and got bored with it after I felt I had learned all I could there; I transferred to the NICU and fell in love with nursing all over again. The biggest plus is that my experience helping mothers and babies bond and prepare for going home has helped me tremendously as I work with the parents of these sick babies. I'm sure lots of your ER experience will come in super handy in L&D. After all, all kinds of women get pregnant and in the ER you have been used to seeing patients having asthma attacks, hyperglycemia, seizures, high blood pressure, kidney stones, sepsis, and a host of other things. I actually think you'd be welcomed as an excellent resource for your L&D comrades for the knowledge you would bring to the unit.
The more I think about it the more I say "GO FOR IT!"
Last edit by Tiki_Torch on May 16, '04
May 25, '04
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!
Last edit by SmilingBluEyes on May 25, '04