Antepartum Nurses..

I'm in APU. Our patients are high-risk or complicated pregnancies and stay anywhere form a couple of days to a couple of weeks. APU is my niche and love it.

Diagnosies typically include pregnancy induced hypertension, diabetes, preterm labor, ruptured membranes, placenta previa, placenta accreta (or increta or percreta) and multiple or high-order multiple pregnancy. We also get stuff like pregnant and post surgical, post MVA, and we also take complicated post partum patients at our facility.

Antepartum experience could be helpful to your L&D goal as some places keep antepartums in L&D. Also, getting in to a facility that has and APU means that facility probably has a lively L&D as well.

A typical day for me is: report on 3 or 4 pts, chart check, assessment, monitoring, and assisting with am care (as necessary). After the morning rush, things slow down a bit and then pick up again in the afternoon.

Our worst events are the "something's hanging out" call, a placental abruption, or a postpartum hemorrhage but we are very good at managing those. Rarely, we do get the occasional seizure as well.

We also deal with some unusual occurrances such as twin-to-twin transfusion syndrome, demise of a twin (had a couple that delivered a twin but kept the other in), Rh incompatibility that needs an intrauterine blood transfusion, and anmio reduction for polyhydramnios.

Out best events are getting someone well along into their pregnancy before they deliver. I never get tired of those!

Besides all the high risk pregnant pts, our antenatal department also gets the women who experienced fetal demise as opposed to them going to mother/baby with all the crying babies. I'm not sure how common that is.

Probably not that helpful, but my one clinical day that I spent on antepartum was centered around a SA at 16 weeks. We had to dress the poor fetus in a tiny gown and a knit cap. It was heart wrenching....

Thank you for the replies, they are very helpful and informative!

Our antepartum unit gets ALL patients who are pregnant and admitted to the hospital for any reason. So it can be like a med/surg unit where all the patients are also pregnant. We get a lot of non-compliant diabetic patients who stay until their blood sugars are regulated. Then, they're released and almost always come back in a couple weeks for the same problem. The other day we had a mom who was 6 weeks pregnant for blood sugar regulation! Same as the other people have said...our magnesium patients go to antepartum and also any post delivery infections. It can be challenging over there but I like it. I alternate between post partum and antepartum. I like being able to move around a bit.

Going to interview for an ante-partum position tomorrow! Hopefully my 2 years of Med Surg experience will help, I've always been interested in OBGYN!

So, I know this post is super old but I figured if I was able to google to find it, others might still find it too! So I graduated in May 2017 with my ADN and my husband is active duty. He was due to PCS in July, so I waited until we were settled to start applying for jobs. I finally found a position accepting new grads in a high risk antepartum unit and I was offered a position. I started in October 2017 and so far it has taught me so much!

These are the usual diagnoses we deal with:

DKA

Pre-Eclampsia

Preterm Labor

Premature Rupture of Membranes

Fetal Demise, Still Birth

Twin Intrauterine Pregnancy w/ complication

Addiction during pregnancy, particularly Heroin

Postpartum w/ any major complication

Magnesium- for both neuro protection and for pre-e

However, because pregnancy and labor is so unpredictable, in my four months there I have also seen the following:

Cord Prolapse on a PPROM mom at 27 weeks

Eclampsia pressures of 250s/110s and seizures

Chorio

Post-partum incision infections

You name it...I've probably seen it already or someone else on the unit has. We are literally the catch all unit of women's health. We get anyone and everyone that doesn't fall into active labor or stable postpartum. It's a fabulous opportunity to learn about complex disease processes and how to handle emergencies. I feel like it was a great place for me to begin my nursing career with a nice balance of mother/baby and med-surg experiences.

I work nights 7pm-730am, so this is my typical nightly schedule...

7 pm: get report on up to 4 patients, as our highest ratio we are allowed is 4:1

730-8: Chart review and shift planning, I finish filling out my report sheets and make a plan with med administration and such

8-10: Assessment of my patients, administer medications, do fetal heart tone checks, vital signs if I don't have a care partner working, patient education and take care of any loose ends physically (IV site rotation, fluid bolus for contractions etc)

11-12: Rounding

12-1: Midnight rounding, vitals, fetal heart ton checks and tuck them in for the night

1-4: Documentation and care plans, rounding every 2 hours, administer PM meds as ordered

4-5: Rounding, vital signs, fetal heart tone checks

6-7: Documentation and preparation for change of shift report

Hope that helps anyone who is curious about what a high risk antepartum nurse typically does and sees on a routine basis.