Labor and Delivery Travel Nurse

Traveldee · Aug 6, 2013

Well, I am a week away from finishing my first L&D contract, so I can tell you what this experience has been like. Just know that it will be different wherever you go. :)

1. Can't really speak to that since the two hospitals I worked at and the hospital I ended up traveling to used the same charting system (CPN/QS). Really subjective about whether it's "easy" to pick up a new system, everyone is different at how good they are with computers. The LD travelers I've talked to all say that they have charting pretty much down by the end of their contract. Hehe. And I guess you could say I feel the same way about all the paperwork in general at this facility.

2. I've had some major sh*t hit the fan on my assignment, and have been fortunate to have people backing me up in those emergencies. Again, that was my experience at ONE facility.

3. The hospitals I came from had residents but not that many (and not on every shift), so nurses still had quite a lot of autonomy. And at the facility I'm traveling at, they don't use residents at all. If you have only worked with residents, it might help to pick a first assignment that does use residents. But, maybe not. You will fill out a skills checklist before your assignment and the important thing is to be honest about what skills you do and don't have. For instance, the hospitals I came from never used cervidil or prostin gels for induction. This place does that all the time, and the RN places them. Simple once you learn how to do it, but I didn't feel bad for not having experience with them when I arrived because I had been honest on my skills checklist that I'd never used those before. (Now, at the end of this assignment I'm going to update a lot of areas on my checklist because I've had the opportunity to acquire new skills, one of the many cool things about traveling.) So, just don't misrepresent yourself on those and you should be fine. No one expects a traveler to know how to do every single thing on the skills checklist.

4. I would recommend traveling in LD. There are a lot of job opportunities and I have enjoyed acquiring new skills. Some of the things I did that I found helpful: First, before I even started traveling, I picked up a prn job in LD in addition to my full time LD job at another hospital. My full time job did around 60-75 deliveries a month, with postpartum and newborn nursery. My PRN job did about 170-180 deliveries a month. Between working the two jobs I was able to get used to DOING THINGS DIFFERENTLY. (This is a REALLY hard concept for some people to wrap their head around.) This travel assignment I'm at does 350+ deliveries a month. So, if you're really unsure about whether you can "handle" a travel assignment, perhaps try a prn job first at a facility that is either smaller or larger than the one you work at.

Second, I HIGHLY recommend getting your Inpatient Obstetric Nurse Certification and C-EFM for fetal monitoring. Some places require this (particularly the C-EFM), others don't. What getting my RNC-OB did for me mentally was remind me "ok, they do things differently here, but I passed this national certification exam which means I do know SOMETHING." :)

And this is advice for any traveler: Have a lot of savings set aside. I thought I had enough, and now I'm wishing I had more. :) You will not get rich from traveling, at least probably not on your first assignment.

Hope that helps! Best of luck!

NedRN · Aug 6, 2013

Both those specialties are great for traveling, but it sounds like a focus on OB would be better for your skill set. OR is a huge field, even if you are just limited to pediatrics, and it is less likely that you would be able to swing into other ORs proficiently (speaking as an OR nurse). The time to orient to a new OR is also much longer than L&D.

I know a smidge about OB, and your questions are mostly related to unit culture. Which varies widely. Don't worry too much about it, just be prepared to be flexible and do things their way. From my experience as a travel OR nurse, I will say that it is very surprising the number of hospitals I go to where the OB staff nurses not only will not do sections, but may not even help in any way with the OR staff (most will at least assist the pediatrician though). Of course, I only do sections at such hospitals, and perhaps most OR travelers have never done sections (I had never done one until I started traveling). That was just a long winded way of saying that you may not even participate in sections, either circulate, scrub, or assist.

Fetal monitoring certification is a plus, as is specialty certification. But you will find plenty of work without it, it just gives you an edge for a desirable assignment over a nurse with equivalent experience.

You may have to do things you are not used to doing, but that is a good part of traveling: professional development. You are right to ask for adequate inservice (nursing practice laws demand this), and if there is a known unusual practice at that unit, the manager will likely query you during the interview. Yes, in some places, nurses do place internal monitors, and it may even be a unit expectation. But that is rare, and it is very unlikely that would be an expectation of a traveler.

One of tools that will be used by agencies in the professional profile they submit to hospitals is a skills checklist. This lists the various specialty skills and your self assessment of your abilities. One such item is placement of internal monitors (I believe they are called fetal scalp electrodes). In addition to your work history, the self assessment by you on such items will give the nurse manager with a pile of profiles to go through with an idea of the kind of work environments you've been in, as well as specific interview questions if, for example, internal monitor placement is of special interest in that unit.

You can Google OB or L&D skills checklists and come up with a lot of agency links and look at them for yourself. If you fill them out honestly, you will not misrepresent yourself to managers and set yourself up for failure. A number of these skills checklists are pretty horrible to put it mildly. Some agencies will accept other skills checklists (they really want L&D nurses!) - the ones on PanTravelers (free to download) are far superior to most agencies so if you feel strongly about painting the real picture of your professional abilities, I would take a look at them.

NedRN · Aug 6, 2013

Well, I am a week away from finishing my first L&D contract, so I can tell you what this experience has been like. Just know that it will be different wherever you go. :)
Snip....

Great post! I wrote mine before yours posted. We seem to be on the same page, so good reinforcement for the original poster. I especially liked the advice to try per diem to experience other hospitals - I did just that myself before I started traveling.

In summary:

Yes to certifications!

Yes to honest self assessments! Don't worry about specific skills - yours are on record.

Travel promotes professional growth. Embrace it!

Yes, hospital cultures are very different. Pay heed and be flexible.

Consider local per diem before traveling. This will help you assess your ability to hit the ground running in new environments.

I might add: remember basic nursing. This gets you through more new situations than you can imagine. I've never turned down an assignment in the OR, and basic OR nursing assessment and actions always got me through. Swinging from sections to open heart surgery might give the non-OR nurse an idea of the range possible in the operating room.

Traveldee · Aug 6, 2013

Haha that's funny Ned about the posts. You're right, sounds like we're on the same page. :) Your comment about C sections made me think of something. Don't be afraid to say when you need help. You are not only advocating for your nursing license but for patient safety. Even though I had circulated C sections at both of my staff positions, I never received orientation to the OR at my travel assignment. My first night off orientation they called a section on one of my patients, and a couple nights later I had a crash. Both times I told the charge I wasn't going back without help. So again, be honest about your skills as well as what you were oriented on (there's no way to know everything after a couple shifts) and ask for help when you need it. :)

NedRN · Aug 7, 2013

If patient advocate first, there is little need to worry about your license. Did your staff positions employ a tech to scrub sections? I've always thought that would be a dream job, at least if it paid the same as an RN. I love scrubbing sections, so easy, and usually excellent results for the patient.

Traveldee · Aug 7, 2013

My staff positions used CST's, yes. Travel assignment does have some RN's who are trained to scrub, but they also employ CST's. Usually the RN is just expected to circulate.