Critical Care Nurse wants to try L&D or MBU.

alwayslearnin · May 19, 2009

Greetings,

Here is just my :twocents: from my experience.

One of the nice things about L&D/MB is you are dealing with healthy young women (for the most part). The atmosphere is pretty positive (although you do have the domestics, no dad involved, immature patients, or very demanding-all heathcare places have their particular pt. population problems).

You definetely won't be using all of the Critical Care Knowledge you have. Again, for the most part it's young, healthy women. But when the s*** hits the fan, you'll be in your element. The occassional pulmonary/amniotic emboli, ruptured uterus, etc. You will occassionally have medical emergencies and yes, there you will definetly be an asset. I guess for me it was just a different aspect/focus. I still used my critical thinking/ knowledge when looking at history and potential problems, labs, etc. But it was an opportunity to help these families through the birth process and becoming a new family that I loved. You will never get tired of seeing a baby bieng born. Always wonderful!!

There is alot of patient teaching-unfortunetely you usually have a very short time to do it in. Most people go home within 24-48 hours for vag delivery. But if you love patient teaching-this is definetly a place to do that! Not just mom care, but baby care and family.

After a while it just gets to be routine for the most part (again, you always have the "surprizes" Nuchal Cord, shoulder dystocia (always good for a few VERY intense moments) decels, fetal demise ( known or just revealed).

You might want to consider going into high-risk L&D. Management would definetly look upon your CC experience more positively:yeah:And you would probably feel alot more satisfaction. There you have the mom's with cardiac issues, diabetics with insulin drips, preterm labor, ruptured membranes, HELLP Syndrome .More of a challenge (which is what I like about Critical Care, you have to be dilligent, maticulus, always thinking ahead and prepared to intervene in possible life and death problems at any time.)

Typical day depends. Are you doing triage-You are assessing the mother who walks into your unit, gathering infor while checking Prenatal (or not-some mom's don't get prenatal care) reporting to MD findings and then doing whatever needs to be done-admit for labor vrs false labor, r/o rupture of membranes-all kinds of things. Just like doing traige in ER.

Or are you doing Labor that day. Get your patient, Take report-review patient hX, labs whatever, go in and pick up where the previous shift nurse left off (is mom in early labor, ready for an epidural, in the tub doing well with breathing and relaxing? Hows baby-Do you need to get them on on FM?

Usually we are one to one once a woman is in active labor (facilities will vary) and your follow through to delivery and into post delivery or to the end of shift. You might be very actively involved in the labor process (by the patient's bedside alot helping with breathing, positions, pain management, epidurals,etc, or more just on the sidelines and just making sure mom and babe are medically doing fine. Of course when you get to transition and full dilation/effacement you are constantly at the bedside-now your helping with pushing, setting up the delviery table and room etc.

If you are doing mom and babe-you have 4-5 coupletes. You are monitoring mom vital signs, bleeding, first void, pain management. With babe- transitioning to "the outside" again vital signs, head to toe assessments, temp monitoring, feeding, voiding/stooling, immunizations. And a whole lot of education and answering questions.

Granted this is normal mom/babe stuff not if there are problems (usually respitory, low blood sugar, poor feeding are the most frequently seen)

Any way I have written alot-whew. I hope this give's you one small view into the world of L&D. Whatever you decide-good luck. I hope you get a lot of responces. Go to the L&D unit and talk with the nurses there. You know how we all love to share :chuckle

alwayslearnin

L&DRN03 · May 20, 2009

I could have written this post 4.5yrs ago! I went right into Neuro ICU right after nursing school. I did enjoy the excitement of ICU but like you got pretty burnt out with the short staffing, the sundowners, the cleaning of all kinds of bodily fluids and the extra large patients. I made the transition to L&D after a year and a half and have never been happier. There was def. an adjustment period as L&D is a whole new world but I believe my critical care background has been a major asset. If you're an adrenaline junky like I am L&D will be a good fit. If you're more into the teaching aspect of nursing then mother/baby is perfect. Good luck in whatever you choose!

caitiecait · May 21, 2009

Thank you all for your input! It's wonderful to know that you have been through ICU hell and transitioned. I think L&D is more my thing and I think I still educate my patients. Not only that but for the most part it is a happy floor. What are the orders like? Do you have like 148974 orders for your patients?? Thats one bad thing about ICU all the orders!

L&DRN03 · May 21, 2009

Orders are pretty standard and few on L&D with the #1 drug being Pitocin. Remember for the most part these are healthy women that do not require a wide variety of medication.

RNBelle · May 21, 2009

If/when you transfer to L&D do not get discouraged your first couple of months. It is amazing how much there is to learn in OB. I worked post partum and now L&D. I thought I was somewhat prepared but realized quickly how little I knew. Now after being in L&D for over 8 months my confidence is growing and I feel like I know what I am doing. I work in a small rural hospital. A typical day for me goes from there being absolutely no labor patients all day. Then I can come to work the next day we got 1 that need c/s, 1 in labor, some inductions, OB checks and only 2 RNs. It gets kind of sporty most days but I work with some amazing nurses.

caitiecait · May 21, 2009

Whats the nurse to patient ratio? I could never imagine taking care of an active labor pt in bed 1 and say another pt needing a c/s right away. Does that happen? I know in ICU sometimes you will have 2 critically ill pts and the one starts to crash and your other pt who is still critical mind you hasn't seen your face for hours b/c you are so tied up with your crashing pt. That is where the other nurses on the floor look after that pt and give the meds and assess, because I am only one person and I can not be in two places at once, although that would be very conveniant in nursing lol :jester: Another question is since it is really hard to go from ICU to L&D and the information will be vast would it be better to make the switch now before school starts in Sept? My plan was to wait till August so I could atleast say I had 1 year in ICU but if I switched in June I could technically say I was in ICU 1 year b/c that is when my orientation started. I know that I'd be headed for a mental breakdown if I switched to L&D in Aug. and started FNP school full time in Sept. Atleast starting L&D in June, July would gibve me 2-3 months of learning before school. What do you guys think? :cool:

LovingOBFutureFNP · May 22, 2009

I just finished my second year as a nurse - a little over a year in the ER with OB/GYN patients, and this school year at an inner city high school as the school nurse. I'll be starting L&D in June, am planning to start FNP school this fall, and would like to work as a nurse practitioner with women's health patients after finishing up my MSN. ... Sounds like we're on similar paths! Best of luck to you. :)