Doula turned RN....L&d or Mother/infant the right place for me?

TarheelRN · Nov 5, 2007

Hi there,

Congrats on joining the RN field...we need more nurses! I am a L&D RN and was a birth doula for 2 years before going to nursing school. I did peds cardiology before joining L&D...so like you, I did a telemetry sort of unit before considering L&D.

Everyone is different, but what I can say is that L&D nursing is NOTHING like being a doula. This is something I still struggle with from time to time. As a doula, we are taught that birth is the most natural thing a woman can do, however, in L&D we view every birth as a potential emergency...always waiting for the next PP hemorrhage or stat c-section.

I can vouch for the more "positive" atmosphere, although L&D nurses do have a reputation for being aggressive and mean in general (I think because we have to advocate on a minute to minute basis and we need things done "now" for the sake of our pt.) And L&D is like a ticking time bomb, everything happens fast and unexpectedly. You can never plan your day and make a "brain" like in other units and you must be a bit of an adrenaline junkie.

That being said, sometimes you witness the "normal" birthing process and it makes your day. I work at a level 3 hospital, so we get more high-risk women and the concept of "normal" isn't really a norm.

I'm glad I have the doula experience for those moms alone or without epidurals....you bring experience from anything you do I feel. You will bring cardiac experience, which is a plus. So if womens health is your passion, you'll love L&D. But I don't want you to think that it will be like our past doula world (which I gather you don't think anyway).

Just my two cents:) Good luck.

allthingsbright · Nov 5, 2007

Hi all!
I became an RN in July, and I am currently working on a very busy telemetry unit. I absolutely hate it, I dread working there every day.
I have worked as a postpartum/labor doula for the last 8 years, and I am wondering if there are any others on this forum that have turned from doula to RN, or even RN to doula.
Any advice on working L&D or mother infant would be appreciated. Are there any Rn's that have moved there from telemetry? I need a place that is a little more positive. I started on the telemetry floor to get a good "base", but I might end up in the hospital myself if I stay here!!
Do you like it? Is it a "happier" place than the "sick" floors? Are the nurses generally happier with what they do? I know some of these are harder to answer, but I am just trying to get a general consensus. I LOVED being a doula, and witnessing the birth of a child, but I was there under the best of circumstances, and with relatively little responsibility. Thanks for any advice!!

Hi-former doula here and I am graduating in Dec with a job in labor and delivery waiting for me. I dont expect it to be ANYTHING like being a doula...though the doula stuff is what got me interested in L&D.

Have a friend who works labor and delivery and they have their fair share of stress and emergent care, but overall it sounds very positive. I am really excited about tehg job and man, do I have a lot to learn! :uhoh3: I know I would NOT be happy in any other area of care, like you. The whole reason I went to school was L&D. Mother/baby was my 2nd choice and my clinical experience there, while good, was on the slow side. I like my adrenaline!

Good luck to you!

PRESLA · Nov 6, 2007

:uhoh3: ]Heartlover07 I hope you are or were a better doula then the one's I have experienced in the past. They drove us crazy up in our face demanding that the pt do this do that, yell at them when they want some relief, belittling the labor pt. I just don't like the doulas that we had at a hospital that I worked at. Good luck in you nursing career you will love it from our side.

Lisa :smilecoffeeIlovecof:nurse:

queenjean · Nov 6, 2007

I was a doula, then a medical floor nurse, then a nurse with a midwife attending out of hospital births, then back to the medical floor, and now that I've finished my RN degree (I was an LPN), I'm back to mamas and babies, this time in the hospital setting.

Sometimes it is difficult, because as a doula you were there for the mother. As a nurse employed by the hospital, you have many more entities pulling you from different directions. Protocols, physicians, other patients, in addition to the patient.

I find that post partum is most similar to doula work. You evaluate the mother's education needs, and fill in the blanks. You support her in those initial days of breastfeeding and parenting, much like you would do as a doula. Of course there is the nursing assessments and care, but they aren't really much different than what you would see in a home birth or birth center birth setting, and they are not terribly invasive. Mainly the focus is education and support. I've done some orienting on L&D, and I can see that's not my thing, not right now, anyhow. It is sooooo different from doula work, and I find that I want to doula more than be the nurse in some of those situations.

I am surprised to find that I like nursery nursing. I thought I wouldn't like it, I would find it too interventive; and while I have found it a bit interventive to my taste, it's not as bad as I envisioned, and I have enjoyed it tremendously. Which makes me think that eventually I will also enjoy L&D. I fully recognize that my discomfort with it rests purely with me. Mentally I'll be able to wrap may brain around it in a few years, I'm sure. At this point, I'd like eventually to go the CNM route, and thus need the L&D experience.

I loved being on the medical/tele floor; I also love what I'm doing right now. I like having the medical base, I feel it makes me more confident in my assessments, and more comfortable with mothers who have other issues--chronic hypertension, diabetes, pacemakers, etc.

PP *is* a happier place. People are there for a happy event, not sick or dying. It can be just as stressful, but in a completely different way. Not acuity of patients way as much as just trying to get things done so that a mama and baby can go home in a normal time period. I have more patients on mother/baby than I did on med/tele, I find. I always had 3-4 patients on the med/tele, but usually have 3-4 couplets on mother baby. Which equals 6-8 patients to chart on, take vitals on, and if mom isn't able or willing to take care of baby, then I have even more responsibility there, as our nursery nurses primary responsibility is baby catching and attending to the sick babies, not watching well babies that should be in with their mamas--that is the postpartum nurse's responsibility primarily, with the nursery nurse backing her up.

Anyhow, it is possible to go from doula to RN. It is different, and sometimes very difficulty, don't get me wrong. But it can still be very rewarding and satisfying. I can honestly say that if the pay were the same, I still wouldn't go back to being a doula. I enjoy my career as a nurse, and enjoy nursing on a mother/baby/nursery unit.

Good luck, hope that helps!

MissMonica · Nov 7, 2007

i made it official and left med/surg for good. i actually get bored at times on ob and i get complacent--- but after my last day on the med/surg unit was another day of pure hell with disgruntled patients and family who are never satisfied, never say thank you and persistently miserable and rude, i decided that for the exact same paycheck it just wasnt worth it. i find that my coworkers on ob have relatively the same range of personalities you find anywhere else but in general it is a more pleasant work environment than the sick people units!

i used to worry my skills would be lost, but now i realize my personal health and stress level are most important. its ob for me!

best wishes to you from a former medical/surgical/tele/ortho/neuro/trauma rn!:balloons:

JaneRNBSN · Feb 23, 2008

I'm an RN with surgical experience, wannabe nursery nurse. Since I could not get hired without experience, I took a birth doula workshop and ended up working as a staff doula. I get all the fun and none of the responsibility! I also became a certified lactation counselor, so I get to help moms get a great start on breastfeeding. I don't make near the money, mind you, but then again...I'm getting paid to PLAY!

CallMePatti · Feb 24, 2008

Hi!

I was a doula for about 6 years before I started nursing school. Now I'm a L&D nurse and love it. I think my experience as a doula has helped make me a better L&D nurse. Unfortunately, I don't get to spend time helping my patients through each contraction the way I could when I was a doula, but I love my job. Wouldn't trade it for anything.

mommy2boysaz · Feb 27, 2008

I realize this may not be an option for many, but I work in a small, community hospital where we have LDRP rooms and we "do it all". There aren't separate L&D, PP, Nursery depts. I admit a woman, care for her through Labor and delivery, and continue to care for her and her baby until discharge. I wouldn't be happy only doing one aspect of that, I don't think. Also, we tend to have more "normal" natural deliveries. There are 2 CNMs working at our facility, and that helps, too. I couldn't work in a high risk area with constant interventions. That's just me, though!

Anyways, in answer to the original question, there are different types of places to practice. A smaller hospital might be something you want to look at?

Good Luck!

nurserynurse55 · Feb 27, 2008

Why don't you just ask if you can cross train? See which one you like better.