A Day in the Life on L&D - Please Respond!

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Specializes in L&D.

Hey Everyone!

I'm from Canada and hoping to travel nurse to Southern California in November...maybe Colorado later on. I've worked 5 years in high risk obstetrics so I know the routine here in Canada, but I'm surprised by the "horror stories" I've heard about working L&D in the U.S. Eg. no breaks, 3-4 active moms per nurse, very little orientation given to travel nurses, etc. Where I work, a regular assignment would be 1 patient with no central monitoring (b/c we don't use it - yet), sometimes 2 in early labour, in c-sections 1 circ. nurse and 1 scrub nurse, or 1 nurse in triage with sometimes 7 or 8 patients...here we call most of our docs by their first name...you sometimes get 3 breaks in 12 hours or if it's too busy no breaks. When a patient delivers you get her breastfeeding, charting done, up to the bathroom, IV and epidural out if appropriate, and transferred to postpartum within 2 hours of delivery and then on to the next assignment. Enormous piles of charting of course, plus some computer stuff.

So....what's a day like there??? I'm really nervous about working there even though I'm comfortable working here - it seems so much more stressful in the states (or am I just paranoid)? :uhoh3:

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Specializes in OB.

It really varies widely among facilities. I've been traveling about 11 years so have seen quite a few. Usual load at most places is two labors, with someone watching your second while the other is pushing/delivering. Usually only such things as those on mag. sulfate are 1:1. Central monitoring is at most facilities, though I still work a few rural facilities without it and most of those do only low risk pts.

Breaks can be hard to come by sometimes, but being assertive can get you one most times if it's not a matter of everything breaking loose at once.

One to two shifts of orientation is pretty standard for travelers. It's not bad once you get an idea of what things you need to know at every facility. You already know the patient care, so it's mainly where the supplies are kept, where to find the docs phone numbers, where the policy and procedure books are (in case you want to check on their requirements) who to call if help is needed, and of course, where to find the staff bathroom!

In larger facilities OB RNs may circulate and/or scrub, but in smaller places I've found we mostly go in for the baby, while the on-call OR crew does the rest. Small facilities don't have enough staff on to man the OR and still watch any pts. on the floor.

The post delivery routine you describe sounds about the same, unless in a facility with LDRPs where after you get the pt. up to the bathroom, you remake the bed and she remains in that room and usually your care.

It's really not scary down here, except in the way it's always scary to try something new!

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Specializes in High Risk In Patient OB/GYN.

There's a sticky which talks about all the things an OB nurse might do on a daily basis.

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Specializes in postpartum, nursery, high risk L&D.

actually, the assignments where you work sound pretty much the same as the assignments where I work, except my unit is LDRP, and we do have central monitoring. Anyone in active labor, and/or on Pit, and/or with epidural, or anyone high risk is 1:1, and we usually keep them 1:1 until recovery is over but sometimes will pick up another, light assignment. And sometimes it's just too busy for breaks but we almost always at least get one.

So not all hospitals here are scary ;)

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

the sticky might help....

And the post that said it differs by unit is right-on. It is, for example, VERY different to work in a large city teaching hospital versus a very small community one. You may do it all: LDRP, like I do, where you take care of women from before birth until they go home....or you may do strictly L/D or antepartum and then these women go to a completely different floor and unit after giving birth.

It is so hard to generalize. You might want to figure out if you want to focus strictly on L/D or do Post-partum (moms and babies) or all of them. That would definately be up to you.

Meantime, check out the sticky: "Duties of OB/GYN Nurses" above for some guidance and information. And welcome to allnurses.com!

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Specializes in L&D all the way baby!.

I live in a medium sized community in Central California (approx 100,000 people). My hospital doees about 350-400 deliveries a month. Our workload is usually very manageable with 1:2 active pts. Pushing is 1:1. C/S also 1:1 but you will typically resume care of the pt. you left behind when you return. Breaks happen. Though usually we don't leave the floor by choice. Most feel better eating in front of the central monitor but certainly another RN would watch your pt. for you if you wanted to leave. Of course the central monitoring is a great thing but sometimes it's a pain in the rear to keep an active mother on the monitor (when she is wiggling around). We have had those days where we really were out of ratio but they don't happen often. We have a triage RN that sees any pt. over 20 wks. (even ER type pts. to be cleared prior to subsequent tx) and usually a back up for the triage as well. Of course hospital to hospital you will find differences but all in all I think you would find things in California to be pretty darn good overall. I certainly have very few complaints (and most of them have to do with very young mothers having meth addicted babies.. and that unfortunately is one thing you will deal with a lot herer in CA).

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