L&D nurses who became CNMs

Specialties CNM

Published

Specializes in Coronary Care.

So I am in my 3rd semester of a CNM/WHNP program. I have been a nurse for 3 years, where most of my experience has been cardiac ICU. I transferred to L&D back in June of this year, and this is my last week of training before I am on my own without a preceptor. My hospital is the main hospital, with 3 other small outlying hospitals. We have been the only hospital in the system with L&D for more than 5 years now after 2 of the hospital's maternity services were shut down. As you can imagine, it's made our little community hospital quite busy! Its not unusual for nurses to have 3 patients, to deliver babies in triage because labor rooms are full, or be 6 inductions behind😳. I am super passionate about women's health and becoming a CNM, but I am starting to not enjoy the bedside nursing role in L&D. I can't slow down enough to enjoy it 50% of the time. I am super grateful, however, for the learning opportunity..it is invaluable. Wondering if anyone else that is a CNM or WHNP didnt particularly enjoy the bedside RN role in the field?

Specializes in OB.
So I am in my 3rd semester of a CNM/WHNP program. I have been a nurse for 3 years, where most of my experience has been cardiac ICU. I transferred to L&D back in June of this year, and this is my last week of training before I am on my own without a preceptor. My hospital is the main hospital, with 3 other small outlying hospitals. We have been the only hospital in the system with L&D for more than 5 years now after 2 of the hospital's maternity services were shut down. As you can imagine, it's made our little community hospital quite busy! Its not unusual for nurses to have 3 patients, to deliver babies in triage because labor rooms are full, or be 6 inductions behind😳. I am super passionate about women's health and becoming a CNM, but I am starting to not enjoy the bedside nursing role in L&D. I can't slow down enough to enjoy it 50% of the time. I am super grateful, however, for the learning opportunity..it is invaluable. Wondering if anyone else that is a CNM or WHNP didnt particularly enjoy the bedside RN role in the field?

I actually think your experience is pretty common. A lot of midwives I've met who worked as L&D nurses were motivated to become CNMs, in part, by the frustrations with and limitations of their bedside role. I myself worked in med/surg and postpartum. I already knew I wanted to be a midwife before even becoming a nurse, but taking care of postpartum women who had terrible births was definitely more impetus for me to finish school and try to "change the world." :happy:

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Its not unusual for nurses to have 3 patients, to deliver babies in triage because labor rooms are full, or be 6 inductions behindí ½í¸³.

This is super crazy and unsafe. I assume you mean nurses take 3 LABOR patients? Yikes.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Double post

Specializes in Coronary Care.
This is super crazy and unsafe. I assume you mean nurses take 3 LABOR patients? Yikes.

Not necessarily 3 active labor patients... but not unusual to have a pretermer on mag with an active labor patient, plus someone coming into triage.

Specializes in OB.
Not necessarily 3 active labor patients... but not unusual to have a pretermer on mag with an active labor patient, plus someone coming into triage.

That is still completely against AWHONN staffing guidelines and just crazy!

Specializes in L&D, OBED, NICU, Lactation.
That is still completely against AWHONN staffing guidelines and just crazy!

Then comes the famous hospital admin response...well, it's just a guideline!

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Then comes the famous hospital admin response...well, it's just a guideline!

I feel very fortunate that our state laws REQUIRE us to use our professional organization's staffing recommendations when determining how to staff the unit.

Specializes in Reproductive & Public Health.

I love women's health and I LOVE being a CNM. I didn't really like working as an RN in any capacity. The sheer volume of tasks that need to be completed and charted on, ugh it makes me tired just thinking about it. I used to have to manually transcribe every last PACU VS into the EHR, because the monitor didn't talk to the computer.

It is also really hard when you find yourself working in a less-than-evidence-based unit. It is very frustrating to feel compelled to deliver sub-optimal care, like being pushed to get weights and measures within a few minutes of birth, not even token lip service about trying to respect the1st hour.

One place I worked, a doc always did this annoying thing where he would proudly hold up the freshly born kiddo and direct someone to take their picture, before he would pass them to mom. If no one had their phone out, he would literally stand there displaying the crying, wet, cold, scared little baby, patiently waiting while grandma dug through the overnight bag. All the while mom is still in position, stirrups and all (because *of course* he did all his deliveries in a broken bed).

He also would sometimes do a vulvar betadine wash. Just sometimes. Not sure how he decided which women needed to be disinfected, and which did not.

This stuff drove me *nuts.* Perfectly exemplifies the culture of that unit.

Specializes in L&D, OBED, NICU, Lactation.

He also would sometimes do a vulvar betadine wash. Just sometimes. Not sure how he decided which women needed to be disinfected, and which did not.

This stuff drove me *nuts.* Perfectly exemplifies the culture of that unit.

We still do this on everyone for some reason. I have yet to have any doctor tell me why. Even ACOG doesn't recommend it, it's just stuck in their heads and the nurses too! If I need to clean something off, a little soap and water works wonders.

Specializes in OB.
We still do this on everyone for some reason. I have yet to have any doctor tell me why. Even ACOG doesn't recommend it, it's just stuck in their heads and the nurses too! If I need to clean something off, a little soap and water works wonders.

Your facility does betadine washes on every woman??!!?? And here I thought evidence was making some headway into OB :banghead:

Specializes in L&D, OBED, NICU, Lactation.
Your facility does betadine washes on every woman??!!?? And here I thought evidence was making some headway into OB :banghead:

We're still ice chips only for everyone too. They aren't even following ACOG guidelines or listening to one of our OWN academic OBs who just published a paper on liberalization of oral intake during labor. It doesn't help that the nurses do little to question anything. It's either "well that's how we've always done it" or "that's how I was taught" because the "we've always done it that way" are teaching the newbies. I get yelled at a lot...

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