Can someone tell me what L&D is really like?

Natalie513 · Oct 26, 2016

oh ps, i originally wanted to do L&D because i had such amazing L&D nurses when i had my own children. they inspired me to finally make a career change.

quazar · Oct 28, 2016

L&D is feast or famine, most of the time. You're either super busy or kinda dead. Or you're at a hospital (like mine) that is just busy busy busy all the time. A couple of hospitals where I worked, I have had nights without a single patient. Then there were nights that we had all the beds full, including triage, and had patients laboring in the waiting room waiting for a bed to open up.

Most nights at the hospital where I currently am, it's a very very high volume and we are busy all the time. I spend most of my shift running around. As for charting, yes, in L&D you are married to the computer (or paper chart). Just the way it is. If you have a patient in active labor, you are charting every 30 minutes at the very least, but usually it ends up every 15 minutes. When they are pushing you are supposed to document a fetal heart tone every 5 minutes. With the advent of EHRs like EPIC, there are a million boxes to tick off with each admission, and you have to check ALL THE BOXES which can take time to learn and really gets annoying when you have a patient laboring very fast and all you want to (and need to) do is patient care.

L&D nursing is one where you really have to cover your butt with your charting, because litigation is a very real risk. So you must make sure your charting is accurate and thorough. Also, L&D nurses have a lot of autonomy in a lot of places, so your critical thinking skills need to be top notch and you need to be a strong enough person to know when to stand up for yourself (and your patient) even when the doctor disagrees. Yes, that does happen.

You need about 10 arms at delivery, so you need to be able to multi-task well and handle multiple people talking to you/making demands at once. The obstetrician, the nursery, your patient, and your patient's significant other will all be asking you to do things at the same time at delivery.

Obstetric emergencies are frightening, and different in that unlike when a "regular" patient crashes, you have 2 patients to worry about, and one of those patients you can't directly touch or get to until that patient is out of the mother, a process that in and of itself can be complicated and chaotic especially in an emergency.

Babies die. Mothers die. Sometimes both.

There are good points, of course. You know that you truly have made a difference in your patient's life, because you have been present for one of the most life-changing events of their lives. Some days you can really give that good, solid patient care that made you love nursing in the first place: the warm blankets, the ice chips, the soothing and coaching, all those things that are at the heart of nursing care that really embody the "caregiver" aspect. Sometimes you catch a baby yourself (babies don't always wait for the doctor), which when it goes well, is cool and fun and you feel like a rock star. I love telling a patient "YES YOU CAN" when she insists she can't, and then celebrating with her when she DOES. I love seeing two parents hugging each other and crying with joy at the birth of their baby. I love seeing cute little siblings coming in to meet their new baby bro or sis for the first time, and holding them in their tiny laps. I love helping a mom breastfeed for the first time and seeing her wonder at the great thing her body can do. I love how little newborns look when they're all swaddled up like little burritos and those tiny butts all wrapped up in itty bitty diapers. I love getting "thank yous" and hugs from patients on a regular basis, which is something I know nurses in other specialties don't get a lot. I love the fact that most of our doctors and midwives really appreciate us, and show that appreciation in the form of coffee and sugary treats in the nurses' lounge. I love that my coworkers usually choose to deliver at work, and being present at those deliveries. It truly is a celebration.

L&D is a crazy, chaotic, stressful, funny, fast paced ball of wonderful sometimes. Sometimes it is profoundly sad. It is almost never boring.

Natalie513 · Nov 5, 2016

Wow, thank you so much for taking the time to write such a detailed response- I really appreciate it!

Katrose · Nov 17, 2016

I have nothing to add as I am a pre-nursing school student but aspiring to join the labor and delivery and eventually midwifery realm-I just wanted to applaud your response to this post because it was so detailed, informative and inspiring! wow.