Advice RE: L&D vs. NC

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I have a huge decision to make about where I'll start my career as a RN. I have 2 job offers.

Job 1: a small community hospital where my roles will be in labor & delivery/postpartum and cross-trained in SCN level II.

Job 2: bigger hospital in NICU level III.

I got the job in L&D first, and am really stoked about it. I always wanted to be a midwife, so years ago I became a doula to become more involved in the pregnancy/birth process. I love the small hospital, where I will have a chance to work with moms, babies, and babies who need a little extra help. I have a really good feeling about this hospital. The people are very nice and the nurses are very loyal to this place.

In nursing school, I had a short rotation in the NICU at job 2's hospital. I really liked it. I love babies, and I am very interested in how to help them survive using amazing technology and meds. I do enjoy caring for babies more than moms, but I do love the interaction with mothers.

I don't know what to do! Any words of wisdom are greatly appreciated. I have looked through previous posts regarding this same issue, but they were from months-years ago. If you have any advice for me, that would be great.

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Specializes in Maternal - Child Health.

Assuming that both hospitals offer excellent orientation and good working conditions, I would recommend going with the NICU job.

I started as anew grad and worked in NICU for 5 years before deciding to try L&D. I went to a hospital with a relatively low risk population to learn mother-baby, L&D, and circulating for C-sections, as well as staffing a Level II NICU (which was the easy part for me).

Even with 5 years of experience and a solid NICU background, I was overwhelmed by all there was to learn in L&D, the OR, and post-anesthesia care. I can't imagine trying to learn all of that stuff plus NICU as well.

I would recommend taking it in smaller steps. Do NICU first, or work mother-baby, or find a unit that is strictly L&D. I think it is almost impossible for a newbie to do it all at once.

Congratulations and good luck!

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Specializes in Perinatal, Education.

My advice is the total opposite. I started out cross trained to L&D, PP, and well baby. It has served me well and helped me to be flexible in my job options. I would say to go for the first job. Listen to your gut and do what it is telling you instead of doing the "right" thing for your career. I recently took the "right" job for my career and really regretted it. Good luck.

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Jolie and JaneyW--thanks for your advice. I am really torn. The more I think about it, the more confused I am. I can see where both of you are coming from.

I must add that I am very flattered by getting the offer from NICU. I never dreamed they would even call me for an interview. It was so much easier when I got the first job I applied for (after doing lots of research, I might add). I was rebelling against the whole "you have to do med-surg first". . . "you'll never get into a specialty". . . To these people I say--don't try and bring me down! I can do what I dream! Humph! ;)

I look forward to seeing what other nurses say about my predicament.

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Specializes in Rural Health.

If all things are equal as far as orientation and support goes.....

Your original post leans towards your 1st job offer and you seem to only be considering the 2nd because it flattered you to be offered the job (as it very well should).

If L&D and working with babies and mommies is what you want....then I say take job #1.

Good luck!!!!

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Specializes in Med/Surg, Tele, IM, OB/GYN, neuro, GI.

If you still want to eventually become a midwife I would say go for the L&D position because you will be able to learn and pick up different things about the birthing process. You'll also be able to use your skills as a doula which will be very helpful to your patients.

The NICU sounds interesting because of the higher acuity of the patients you'll be treating.

My advice is if your interested in both I would weigh out the beneifts that they offer and go from there because you're interested in both positions and the benefits may sway you to go one way or another.

Good luck and congratulations.

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OP here. Well, I might add that I love being a doula to laboring women, but am a little weary about being the nurse. I am afraid that I'll be upset that I can't spend as much time with hands-on care bc I'll be too focused on the EFM, watching the strip.

I graduated from an ADN program, and have been accepted to start a RN-to-BSN program later this year.

*The antepartum/L&D/PP/nursey manager is not keen on me furthering my education during my 1st year on her unit. I understand why, since there will be a huge learning curve. She is not willing to work with me at all.

*The NICU manager is happy I want to continue education, and believes in me. I will be finishing up orientation by the time school starts. If it's too much, I would slow it down though.

The hospitals have pretty much the same benefit plan.

Well, thanks for helping me here. I like being able to post, because when I formulate a response, that helps me with my decision making!

You are true nurses out there--helping me solve my own problem!

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Specializes in LTC.

From what i read, it sounds like the NICU would be the better option for you, because they are more than willing to help you further your education, and it seems that that was you plan before you even recieved the job offers.

I personally would not want to go into a facility as a new nurse and have them discourage me from furthering my education as a nurse. They should be looking at it as helping themselves as wel by having a more educated nurse.

Let me know what your decision ends up being! And good luck!

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Specializes in OB.

Hi. I had worked in a small community hospital OB dept. for a few years when a larger local hospital offered me a job in their NICU. I, too, was flattered and the idea of learning something a little different was exciting. I figured I'd still be sort of in OB.

Well, for me, it was the wrong decision. Within a week I missed Labor & Delivery and just being a part of the whole birth process. In NICU, all I knew was this baby and it's symptoms/diagnosis. Seemed like no one in NICU knew anything about the mother's pregnancy, delivery, etc. I felt like a big piece of the puzzle was missing. Needless to say I quickly returned to my OB job. That was 6 years ago and I'm still there and now studying to become a CNM.

Good luck to you on your decision!

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Specializes in L&D, Antepartum, Postpartum, MB, Special.

I graduated May 07 from an ADN program and I did my final internship on the unit where I work now. I was hired before school ended and started 3 days after graduation... Anyway, I work in Birth Center and my job includes High Risk antenatal care (ie severe preterm labor, prolonged rupture, cerclages, hypertensive disorders, magnesium sulfate admin and care) then there is L/D of any pt 20-42 weeks along, I circulate for c/s and provide PACU care afterwards, Mom/Baby including late preterm 35-37 week baby care, PP readmits, and post surgical care of pregnant moms.

It was alot to learn but I have been on this unit for 9 months and feel pretty comfortable with all of these things. It was overwhelming at first and we get 12 weeks of one to one orientation. I actually got 16 because of my internship. We started with 4 weeks of M/B, and 8 weeks of L/D. The rest you learn at a later date once you have got the basics down.

My point of this is that I can now go anywhere I want to go that has to do with moms and babies. I have some experience in every area and only need to expand knowledge.

I also want to be a midwife and was previously a doula as well as a lactation consultant.

Edited to add: I agree that the first year is tough. I didn't agree with the "wait 1 year before moving on" thing either but I certainly do now. But that is just me. I have 4 children 5-13y old. I felt that I shouldn't have been working/orienting while trying to study for boards either but I pushed myself and it worked out. Passed the first time with the minimum questions. I also start a rn-bsn program this fall 2008. Good Luck!

Follow your heart!

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thanks for all of your advice.

after nearly a week of thinking and pros/cons lists, i decided to go for the nicu position.

it was a difficult decision to make, but nicu is what interests me most at this point in time. i had to let go of the fact that i wanted to be a midwife. that's where i was over 2 years ago, now things have changed. i'm done with school. i realized i liked my rotation in l&d less than the nicu. i've passed my boards, and i am in a different place. things change, you are exposed to different areas of nursing, and sometimes things don't happen the way you imagined.

sometimes things happen the way you once only dreamed they would!

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Specializes in Med/Surg, Tele, IM, OB/GYN, neuro, GI.
thanks for all of your advice.

after nearly a week of thinking and pros/cons lists, i decided to go for the nicu position.

it was a difficult decision to make, but nicu is what interests me most at this point in time. i had to let go of the fact that i wanted to be a midwife. that's where i was over 2 years ago, now things have changed. i'm done with school. i realized i liked my rotation in l&d less than the nicu. i've passed my boards, and i am in a different place. things change, you are exposed to different areas of nursing, and sometimes things don't happen the way you imagined.

sometimes things happen the way you once only dreamed they would!

congratulations i hope you enjoy your new job!

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