Autonomy in Labor and Delivery units

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Hi everyone,

I've been following this website and these boards for a while, they are always so informative!

I'm a Labor and Delivery nurse at a high-volume hospital in Tampa, FL with antepartum experience. I'm considering relocating to NYC for the hubby's job. I met a nurse recently who relocated from Brooklyn (not sure which hospital) and she said she was unhappy there, didn't learn much, and has had a much better experience here at our hospital. As much as we aren't doing things right, we do have a good education policy (ACLS, STABLE, NRP, Breastfeeding Basics, Intermediate Fetal Monitoring are all required) It was pretty discouraging to hear but I wanted to throw out these questions to a wider community:

Does your hospital have residents in-house? How many of your patients are cared for by them vs. private docs? Do you do VBACs?

Do your nurses place IUPC's or FSE's?

Does your hospital allow midwives?

What kind of support and continuing education does your hospital provide?

Does your hospital have a bereavement program for patients experiencing a demise?

Thanks for any opinions & info!

God bless,

Rebecca

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Specializes in RNC in OB and experience in Peds.

Hi Becky,

The start of my L&D experience was from Orlando, FL at Winnie Palmer where we did 14-15,000k deliveries a year. And now I'm doing per diem here in NYC and can give you some quick information on differences here in the state.

Here, there is honestly hardly any autonomy. Most hospitals you will NOT being doing SVE, IUPC/FSE placement, Cytotec placement and such. There was even one hospital I went to where only the MD's titrated the pitocin and not the nurses (huh?)

Most of the hospitals have MD's but some will also have midwives, ie: I do work at Woodhull Medical in Brooklyn and the midwives do the majority of the deliveries and there's no private doctors but we do have 2 attendings. Woodhull does not have OB residents but residents/students may pass by for a few days then leave. Also, Woodhull does do VBAC's if able to.

As for continuing education, that depends on the facility. Some facilities have inhouse CE's and some others you have to go off-site to complete. Also in Florida I was use to my department paying for CE courses but I noticed here in NY you have to PAY for the class FIRST, then get reimbursed from your job.

But yeah, I honestly feel the difference and can say I am so glad I was able to function independently as an L&D nurse in the past.

I hope other people will chime in with their experiences, hth's!

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Thanks so much for your reply! I am super glad to have gotten experience in a hospital that gives us autonomy, but I hope that doesn't get me into more trouble!

Does your unit have any openings?

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