What's more stressful, L&D or Med-Surg?

deehaverrn · Oct 17, 2007

Land D can be extremely stressful, its not really "a day at the beach".

I worked med surg for five years before changing to labor. While on med surg, I only ever had 3 surgical emergencies...which required patient transfer to the OR, plus some codes and the inevitable deaths. In almost every case, these deaths were expected and came after long illness and to elderly peoople. When death comes on an obstetric floor it is always a tragedy. Babies born too soon or with abnormalities or those who had unforeseen complications during the pregnancy or birth process...their passing is life changing for their families. As the nurse you have to cope with the medical issues as well as the emotional ones. The detachment which is sometimes possible on a med surg unit can't be maintained--you cry along with your work. I couldn't even attempt to count the numbers of women whom I have rushed to the operating room for an emergent delivery. The women who I have helped to deliver stillborn babies after someone couldn't find a heartbeat in the doctors office or by ultrasound. The women whose water broke at 20 weeks.

Especially if your facility is at all short staffed, basic needs become a problem. You can't simply take a break to eat or even use the restroom, unless help is available. YOu can't really plan your day to organize duties and schedule your lunch or break. Laboring women can be very unpredictable and are sure to need you right when you sit down to eat.

You also need to consider the physical strain...needing to turn and lift women of sometimes greatly enlarged size...often further compromised in their helpfulness in this endeavor by either pain or anesthesia. Many of the nurses that I have worked with now have orthopedic problems attributable to these duties.

I don't want to be completely negative. There is absolutely nothing so rewarding as to be there while a new life comes into the world. As the nurse, you are often the lifeline these patients and families cling to while they navigate unknown and shark infested waters. while waiting for the "ship captain" to come and deliver them to safety. Families NEVER forget you..they have your picture in their baby albums. Right now I am coping with a work related back injury..and I can tell you that THIS is the one thing that I truly miss! It makes me weep when I think about the fact that this is something I will most likely never be a part of again.

Even though you may have been there as a student, it is not the same at all. I know that some of our longtime nurses aides who went to school and became nurses...had severe reality shock when they came back and worked as a nurse, even working with us for years..they had no idea of the skill and responsiblity that we had. I would say that you should try it..but only if your hospital allows you to transfer if you don't like it. Sometimes after all the time it takes to train for this specialty, the hospital requires a certain amount of time spent working there before you can transfer.

Good luck, let me know how it goes.

MedSurgeNewbie · Oct 17, 2007

God Bless L&D Nurses, they have nerves of steel; Meg Surg can get crazy but anyone who works with wee ones gets my admiration.. that and the fact they can make you feel like you are their only patient..After I finnished nursing school I wrote a note to the divison where I had my kids expressing how much I appecited them..

TDub, MSN, EdD · Oct 17, 2007

I am sorry not to help solve your dilemma, but I think they even out. They both have their stressors in different areas. More lifting in Med-Surg, more lawsuits in L & D. More acute pain in L&D, more chronic pain in Med Surg. You get the idea.

dansmom6 · Oct 17, 2007

Stressors in L&D are of an immediate, acute nature...Impending delivery, dealing with newborn recussitation, communication with pts, families, & physicians (sometimes firmly or very assertive), poor outcomes, & thinking on your feet (many times while running down the hall). Although this is stressful, it's important to remember it is very temporary...the light is at the end of the tunnel. You do need to have a little adrenaline junkie in you to appreciate it, though. Also, as deerhavern stated, there is noooo way to schedule anything in L&D. Every day is different--a vast difference from sched med passess and assessment times on Med/Surg.

On med/surg, the patient load is greater-- more meds, treatments, more frequent head-to-toe physical assessments. Time constraints are a big stressor. And that patient who is on the light every 5 mins may come to visit you frequently for years and years. But there is not the daily influx of emergent situations (generally).

I've done both, and really love OB! I did not Med/Surg nursing--just not my cup of tea. As far as stress, just ask yourself WHAT stresses YOU out. If you don't have a bit of the adrenaline junkie lurking around somewhere, OB may not be right for you. If so, give it a whirl!!!

Oh....one big bonus on L&D. You're not usually ever around any sick people! I love it!!!! No more worrying about what crud I'm bringing home to my kids!

Good luck on whatever you decide!!!

beachmom · Oct 17, 2007

Thanks to all of you for your input! The Ob-GYN forum has a great bunch of nurses.

The L&D manager has just become our unit's manager also. I was thinking this would be a good time to ask to cross-train. If I don't like it, I would have more of a chance to come back to my present unit.

I think I would like the work, I'm just looking at all aspects before I make the leap.

mimmy · Oct 18, 2007

I have been a med surg RN for 12 years. A few months ago, I switched to L&D. It is very hard for me-going from being comfortable to feeling like a new grad all over again. Every once in awhile, my med surg experience pays off. I am okay with the norm vag delivery and inductions. But when it comes to emergent csections, etc...I admit- I get very nervous still. I enjoy the one on one and seeing the miracle of life. I think it just will take more time and experience for me to be comfortable. Back to the issue at hand- (sorry, I got carried away with my own experiences) Med surg takes alot of organizational skills and time management as you have many pts to deals with, pass meds, etc. L&D is a more intense one on one. They each have different kinds of stress. I hope this helps:)

LNDis4ME · Oct 18, 2007

I have been a med surg RN for 12 years. A few months ago, I switched to L&D. It is very hard for me-going from being comfortable to feeling like a new grad all over again. Every once in awhile, my med surg experience pays off. I am okay with the norm vag delivery and inductions. But when it comes to emergent csections, etc...I admit- I get very nervous still. I enjoy the one on one and seeing the miracle of life. I think it just will take more time and experience for me to be comfortable. Back to the issue at hand- (sorry, I got carried away with my own experiences) Med surg takes alot of organizational skills and time management as you have many pts to deals with, pass meds, etc. L&D is a more intense one on one. They each have different kinds of stress. I hope this helps:)

Hey hang in there! When I came to L&D 2 yrs ago, I had been an RN for 13 years. I had done a lot....I've also been a nursing sup, a DON, home health, a traveler (hit the floor running!). I had at least 10 years of acute med surg, and I STILL felt like a fish out of water!! My poor head literally SWAM with all the new info that I was trying to absorb while on orientation. I CRIED. I cried even tho I have always wanted to do L&D. The experience that I'd had before was what gave me the courage to go on....I knew what I knew and what I could handle, and there was no reason I couldn't handle what L&D threw my way. It took about a year to 18 months before I stopped having anxiety on my drive into work, about what COULD HAPPEN. I learned to reassure myself that I know what to do, I know the basics. There are still things that I have yet to experience, but I am not a mess of nerves as I am punching in anymore, b/c I let myself have confidence in what I know how to do and what I have experienced so far. L&D is tough, in ways that are too hard to explain. Just keep hanging in there!!! It IS like being a new grad all over again, but that's ok, b/c you have seen and done things a new grad hasn't experienced, and you just have to focus on the OB part of it! Because you know all the rest...just keep focusing on that and hang in there...it really does get better!!!

I really hope this helps!!!

mimmy · Oct 18, 2007

Thanks for your words of encouragement! It helps to know that you felt the same way. After orientation I literally cried everyday and questioned my decision of going to OB. I would get panic attacks while punching in and prayed I would get post partum. Now I still get nervous...just not everyday, So, I guess I am getting more confidence. I am midnights now and going to days next month...eeeekkk. I am afriad of the faster pace (mostly csections) of days. I hope after a couple weeks...it will be okay. Thanks again of your kindness!

BeccaznRN, RN · Oct 18, 2007

I have nothing to compare it to since I started out in L&D as a new grad, but L&D is just as stressful as any other nursing specialty out there. Each specialty (including med/surg) has its own challenges and stressors, and L&D is no exception. I'm almost to my one year mark and I still feel stressed before every shift. However, I'm starting to enjoy that I never know what's going to come through our doors - you can go from a boring half-asleep shift to emergent C/S for (insert complication here) in a matter of minutes.