Advice please..NICU VS L&D

[rnmm18]

I have known ever since I was little girl that I wanted to work with babies. Throughout clinicals if there was a delivery taking place, I was always picked or in the position to go watch and be apart of the experience. I even got the opportunity to go to the NICU, which was a huge deal to me. I feel like God really is telling me that this is where I should be.

If anyone could tell me what they feel are the pros/cons of NICU and L&D, I would greatly appreciate it.

Is NICU more about the care of the infant than caring for the family?

Is L&D more caring for the mother than caring for the infant?

I also have heard from other nurses that once you go into L&D or NICU, it's hard to move to a different department because you aren't using the skills a day to day Med-Surg, ICU, or cardiac nurse would.

The instructors at our school have really drilled into our heads about "paying our dues to the med-surg floor" and how it will make us a better nurse.

[jennylee321]

Who are you more interested in caring for, the mother or the baby ?

What pathophysiology are you more interested in maternal or neonatal?

In L&D you are not taking care of the baby very long, it pops out, possibly give a bit of resus but if it's anything extensive NICU takes over. Eyes and thighs then maybe help with the first breastfeed. And before you know it, baby is off to postpartum.

NICU is an ICU, so you have to not just love babies but want to take care of critically ill babies. Learning drips, ventilation, blood gas interpretation, assisting and performing lots of painful procedures on them, ie. Heel pricks, IV starts, LPs, ect

[babyNP., APRN]

OP- depends on what you want to do. Do some soul searching. Most NICUs aren't full of sick babies, they're full of feeder-growers, little babies learning how to eat, convalescing. You might also consider post-partum/mother baby (they are the same thing, called differently depending on where you are where it's equal mommy & baby.

Don't believe the med-surg nonsense, unless you think you may want to work with adults in your career. I knew I only wanted to work with babies, period. So I started in the NICU as a new grad, went to grad school and got a degree in babies, and now work as a neonatal nurse practitioner. I can't imagine doing anything else (except on my crazy days when I consider doing women's health, but don't think I could stomach the M-F clinic schedule, too used to working my 6-7 24 hour shifts a month).

Another factor is that these units are highly desirable and you may not get your first choice anyway...may need to apply to multiple specialties.

[rleah, BSN, RN]

I am in nursing school so I am not a nurse yet, however I have worked in LDRP for almost 6 years. As I have only worked in a CNA position, for the same hospital for my whole career, I can only tell you what i know from my narrowed perspective. I always thought I would go into L&D. However after I started working there, I also fell in love with NICU. So I have been trying to decide which direction to go. This has lead me into so many conversations with nurses, I know. I think some of these questions could be answered by location. Do the hospitals around you hire new grads into specialties or do you need a year of med-surg. That could be one reason your instructors are pushing it. My hospital does not hire new grads, but there is one a little farther from me that has a program for new grads in both specialties. What I find really interesting and again this is just my experience talking to people. A lot of the NICU nurses I have talked to went straight into NICU, but the Labor nurses tended to do some med-surg first. Not what I expected. Something else to consider is there a hospital near you that has a LDRP? This might be a good fit for you if you really enjoy labor and mother/baby. In our unit a nurse might be L&D one day and mother/ baby the next. Some love it, some do not. Good luck!

[fmf13]

I was a Mother/Baby RN for 1.5 years and I loved it. The only reason I left bedside is because I fell into a different job that I love more. I am not someone who enjoys the ICU, so NICU was something I never enjoyed or considered. It is definitely more about baby and supporting families during a hard time (not much different than an adult ICU). I enjoyed caring for my mom's and teaching them how to care for their new bundle of joy. As a previous poster stated, L&D is definitely more about the mom and monitoring her labor. Depending on the delivery, mom will spend maybe an hour after delivering in L&D and move to PP.

I will say, specializing is hard as a new grad, because you don't have any of that basic knowledge. In the end, it may be difficult to move into different jobs later, but who cares if you love what you do. Don't let that scare you away, because, honestly, I feel that even with your years of experience as a Tele or Med-Surg RN, you'll probably have difficulty moving back into those jobs after working anywhere on OB. OB is a very different world and you can forget there are other parts of the hospital. Not to say my colleagues haven't moved onto other jobs such as ICU and such.

Maybe you can spend a couple days shadowing a nurse in each and see what you like better. Sometimes it is nice to follow a nurse through a typical day and see if it is something you can see yourself doing. Good luck!

[vintage_RN, BSN, RN]

This is my take on it. I am a NICU nurse, but have done several float/shadow days in L&D and my close friend who works in the NICU with me also works in L&D and has told me her perception of the two. I have absolutely no interest in caring for the mother or anything that comes along with that, also from what I've seen in L&D is that when it's busy - it's crazy...but there can be long periods of time with no deliveries or anything really going on. If anything exciting happens with the baby NICU comes and deals with it...so in this way L&D is boring to me personally...but I am an adrenaline junkie/type A/ICU person so that's why NICU is more appealing to me.

That being said, NICU is also boring to me sometimes (although I still love it). I work in a large, academic level IV and MOST of our unit is feeder-growers or stable vented babies. We have a lot of weird genetic things and rare disorders - being a childrens hospital. I wouldn't say its a TRUE ICU environment all the time. However babies can change quick and therefore in the NICU you are doing everything for them, monitoring things very closely. You are dealing with intubations, drips, vents etc. like in a typical ICU but also some stable patients learning to eat and breathe properly. Most times it's very busy and the pace can remind me of a med/surg floor at times.

My friend said that the reason she likes L&D is that parents are usually experiencing the happiest moments of their lives, and are very appreciative of the staff...she receives many cards and gifts and it's overall generally a happy place. In the NICU, the parents are usually going through the worst times of their lives, and sometimes take it out on us...are very stressed and overwhelmed so cards/gifts/thank yous are not the top priority in their mind. We have to do a lot of reassurance and teaching. We see very sick babies and very hard situations. We see babies die. But its great to have a micro prem be in our unit for 6+ months, get better and go home. Parents bring their babies back to see us. Many nurses have primary patients and get very close with the families, get invited to their patients birthday parties etc....to me this is so much more meaningful and I feel like I've really made a difference.

Both areas are great - just very different :) Good luck