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- by jodyangel Sep 2, '12Ok question. I have only worked in L&D in teaching hospitals..and am not considering taking a position at a small hospital with No residents. No 24hr anesthesia...but an OB in the house.
The RNs do all assessments concerning admissions..verify ruptured membranes ect themselves. No NICU..so if baby comes out bad I will be doing the resusitation..and then shipping that baby Out.
No high risk..but we have all had perfect labors go bad at delivery..
Its alot of responsiblity to Not have that back up..and I'm a little nervous. Should I be?
- Sep 2, '12 by FyreflieMy last job was pretty much exactly that and after the first few months, when I was learning to do specs, honing my judgement skills and learning to Triage in a whole new way--I loved it!! I was always a little nervous but I think that's healthy no matter how long you've been working. My assessment skills were waaaay better in all areas by the time I left and I quite honestly miss the independence now.
- Sep 2, '12 by monkeybugThat sounds exactly like the first hospital I worked at. You will adjust. And you will be amazed at what you can do! As for the lack of a NICU, if we had a baby go bad and the pediatrician wasn't there, our OBs would step in and help, and our CRNAs would intubate if needed. I felt like I could handle just about anything after several years of that. I did end up at a teaching hospital as a travel nurse, and I HATED it. I missed my independence and autonomy. The hospital I'm at now has family practice residents, but most of our patients belong to the private docs so I get to be my independent self most of the time. Once you get used to it, you will probably like it. L&D tends to attract independent people. I can't speak for all small hospitals, but when I worked at one, it was not unusual to hear the doctor say, "I've been up for 2 straight days. If you really need me, call me. If you can handle it, write the order and I'll sign it in the morning." Or, if the MD found out that a med/surg nurse was being pulled to take care of postpartum patients, I've seen this order in every postpartum chart before he went to bed: "Consult with L&D nurse BEFORE calling doctor."
We really worked as a team there, the doctors respected each of us (once they got to know us) and trusted our assessments and opinions. I remember seeing one of the OBs mop the OR when we were crazy busy, had no housekeeper, and needed to do a c-section. I miss those days!
- Sep 4, '12 by MamaMadgeI work for a small hospital and we do not have docs or anesthesia in-house. Yes, it can be challenging, but all of our docs live close by and in an emergency, we can have a doc and CRNA there within a few minutes. Conversely, we have had nurses who came from teaching hospitals and they did not know how to to a cervical exam correctly. It really makes you hone those assessment skills!!
- Sep 4, '12 by HoneychildI work in a similar setting. It can be a little intimidating, but I think the atmosphere really depends on the team you are working with. I work with wonderful nurses and doctors that I trust. Work for me is exciting. I used to work in a NICU and loved it there too, but I really enjoy my independence.
- Sep 4, '12 by HeartsOpenWideI work in s hospital like this, plus no MD on site. All of the clinics are close by, but at night you are on your own. You really have to know your EMTALA stuff, we see, assess, and discharge labor checks without the doctor ever seeing the patient. We basically do it all. I have been at RN deliveries when the doc has not gotten there in time and the woman has bombed. You really have to be good at your assessment skills, your docs not right there. I think it would be hard to give up so many skills to a resident, I really enjoy my scope of practice.
- Sep 5, '12 by HeartsOpenWideQuote from jodyangelIt's not EMTELA. It's EMTALA= Emergency Medical Treatment Active Labor ActEMTELA??
- Never heard of it!! Off to read..
- Ok read it..but just seemed like alot of legal mumbo jumbo..what and how does this act apply to Me??