CNAs in L&D

Elvish, BSN, DNP, RN, NP · Mar 26, 2009

We do have CNAs in our L/D department, but they do not do hands-on pt care except on a very limited basis. (Bringing a baby to the nursery after report has been called, helping to transport a pt back to the OR, a couple examples). Mostly what they do revolves around stocking, setting up rooms, and making sure the ORs are set up/broken down efficiently. It's still a good way to get your hands wet, even if you aren't actually "taking care of patients." You still get a feel for the flow of the unit, what the nurses do, how the docs like things, etc. :)

ADreamersWife · Mar 26, 2009

The L&D unit that I work for now, utilizes CNA's, LPN's and RN's. However, when I was in nursing school, the local hospital did not use CNA's in their L&D. So, I wrote an e-mail to the nurse manager of the L&D unit explaining how much I wanted to go into labor and delivery after school,how it was the reason that I was in nursing school, and that I would love the experience, if there was anything that I could do. She hired me as a unit secretary, and allowed me to work as a nurse tech as well. I worked L&D, Post-partum, and nursery. Of course, I could do a lot more in PP than nursery or L&D. However, it was wonderful experience for me, and I had a job as an R.N. waiting on me in L&D there as soon as I graduated. It worked well for everyone because I already knew the flow of the unit, the nurses, and the M.D.s. I suggest talking to the manager, even if H.R. states that they do not hire CNA's in L&D. It worked for me. :) The worst they can do is say no.

missy--kay · Mar 26, 2009

So... They just hired more RN's to have ample staffing- or they worked shorter staffed and made the RN do everything?

It was actually amazing how much staff they had. Each laboring patient had a RN for one on one care. On the post partum wing they had "assistants" for filing and such, but the RN also did all the vitals, baby care, etc. It seemed to work great for that hospital and the patients were well taken care of.

Seems each hospital is vastly different. I start another round of clinicals tomorrow at a different facility, so we'll see that that brings!

Equinox_93 · Mar 26, 2009

I don't work in a hospital, but when I was in L & D as a patient there were no CNAs during my stay. I was actually kinda shocked and depressed to see the RNs doing CNA work.

Maybe you didn't mean for this to come across this way, but "CNA work" is just work that CNA's do to assist the nurses- it's just non-specialized nursing work. CNA's are "nursing assistants". Before the influx of insta-degreed RN's all nurses had to do "CNA work" as part of their training and *jobs*. CNA's just came along to help out the RN's in some of the less specialized medical tasks that they could be trained to do- to assist the RN's- not do their jobs for them. Meaning- RNs should have to do all of the less than glamourous stuff too- because the CNA isn't always going to be around/available. Now- if you were just meaning that you were shocked/depressed to see them be short staffed- I totally understand that one.

mom-of-3 · Mar 27, 2009

Hi prisirn2b,

I am taking the exact same route as you. I was wondering if anyone could tell me of any hospitals in AZ that hire CNA's for L & D? or postpartum if it is a seperate dept. I really appreciate it. :heartbeat

prisicruz · Mar 27, 2009

mom-of-3:

I'm way in Mass, therefor, I wouldn't know. But what I did was just look at the job postings that the local hospitals around here have for CNAs and Techs and stuff. I didn't see anything listed at all for L&D, so I posted a thread hoping that someone would have some advice/info. and I got tons of replies as you can see.

From what I've gathered, it depends on where you live and what the hospital's preference is. It makes sense that the bigger the hospital, the more staff they're going to need, thus, they might need CNAs. But I'm not completely sure about it.

I'm going to make some calls and look more into it around my neck of the woods. I think that's the safest bet and the best way to know for yourself.

Hope that helps...

MissBrittanyRN · Sep 11, 2009

I worked as a Labor and Delivery Patient Care Technician during nursing school. This required a CNA certification, and on the job training (or a PCT program) for foleys, newborn and maternal bloodwork, etc. We attended lady partsl deliveries, baby baths, IV insertion, and typical duties within the scope of cna's (VS, hygiene for bed-rest patients). We could attend c-sections to assist the circulating OR nurse, but they had surgical techs also. Many hospitals only have surgical techs, if any nursing support. Some sugical techs in hospitals scrub csection and perform other duties, and others do csections exclusively. I have also seen hospitals that employ L&D CNAs, but their duties were limited to clerical work, vital signs, and linen changes.

I absolutely LOVED working as a Labor and Delivery tech, and I highly recommend it to someone who wants to be a labor and delivery nurse, but be sure about what your duties are and clear about the experience you want to gain during your interview.

When you are in nursing school, I recommend doing an internship in a medsurg or ICU setting, not L&D, because much of what you learn in L&D cannot be applied to other settings. Although I do not think it is absolutely necessary to do the year of medsurg before your specialty as a new grad (you will hear that during nursing school), when you are a labor and delivery nurse, you are treating the whole patient, not just her uterus and baby! Emergencies can occur and you want to be knowledgable, and valuable knowledge can be gained from good ICU exposure, or even medsurg. Of course medsurg/ICU/whatever nursing is a great idea before L&D, but not absolutely necessary.

misty1998 · Sep 16, 2009

Those of you who currently work in L & D and/or newborn nursery as a CNA...can you tell me some of your job duties? I am a CNA in a small rural hospital in L & D and newborn nursery/postpartum..and we are updating our standard..just curious what everyone else is doing out there! Thanks!

MissBrittanyRN · Sep 16, 2009

again, not currently working, but it has only been 3 months since i left. we got to do a lot, and it is great experience, especially if you want to become an L&D nurse. the cna's were highly trained because it is a very busy hospital (about 5500 births per year)

triage:

vital signs

collect urine specimen

help change into gown

start IV saline lock (no fluids or meds) or draw blood as delegated by RN.

transport to sono if ordered

Labor and Delivery:

set up sterile delivery tables.

insert foley catheters.

assist RN during delivery by recording birth time, baby gender, weight, etc.

start assisting in resuscitation if necessary.

clean mom up after birth and put bed and stirrup back together

break down and clean up table and instruments.

open and hand supplies to nurse or physician (vacuum, forceps, gel)

call for additional help from other L&D staff or NICU during emergencies (shoulder dystocia, hemorrhage, meconium, baby code, etc)

Postpartum:

assist mom to bathroom.

transfer mom and baby to mother/baby unit. some hospitals dont have separate units.

assist MD during circumcision

baby baths

draw blood on babies as needed (CBC, CRP, PKU, Bili)

transcutaneous bilirubin.

antepartum:

fill water pitchers, answer call lights, etc.

bed pans and bed baths/linen changes for clients that were high risk and on complete bed rest (yes, some L&D techs have med/surg duties, just for women of child bearing age!) some of our ladies would be there for several months.

between patients:

set up delivery rooms, ensuring that all supplies were readily available and stocked, setting up warmers, ensuring that it was stocked, suction and ambu bags were ready, etc.

clean triage beds in between patients.

environmental staff cleaned delivery rooms between patients.

we did not have enough IV poles and epidural pumps for each room, so the techs obtained them if asked by the nurses.

we would help transfer patients from delivery room to OR if needed, and from PACU to mother/ baby unit.

I was never trained, but some of the CNA's that started working before me were trained to scrub c-sections. when i started they kept the techs on for scrub that they had, but only hired new surgical techs that were certified.

everything that the techs did could be done by the RN, but we were trained for all of the above to assist the RN when delegated.

LDRNMOMMY, BSN, RN · Sep 17, 2009

At my old hospital we had a few CNA's that were unit secretaries. But my old manager decided to not hire any new CNAs. I work in a military hospital now. We have Air Force and Army medical technicians. They are like a CNAII-LPN hybrid. They start our IV's, draw blood, but they are not allowed to administer medications.