Feeling discouraged

klone, MSN, RN · Mar 16, 2018

What posts are you referring to? I didn't realize there were a large number of posts complaining about L&D?

cayenne06, MSN, CNM · Mar 17, 2018

I can't imagine anything more different from medsurg than L&D. Do you do postpartum as well? What is that you don't like?

labordude, BSN, RN · Mar 17, 2018

I have nothing but positive things to say about the specialty. Even on the days that suck for one reason or another, I still love my job. Did you have the opportunity to shadow before interviewing and accepting? If you didn't, you should have. You won't have as many patients, but don't mistake that for any lower acuity. You also have one (at least) smaller patient hiding inside the bigger one that you can't see but who will speak to you through the monitors and assessments you do. There is a different kind of work involved in this specialty. L&D nurses have a lot of autonomy, but with that power comes great responsibility (that's what my Uncle Ben said). I dislike trying to compare workloads across units, the patients and their needs are so drastically different that volume means nothing and actual duties are so varied.

FurBabyMom, MSN, RN · Mar 18, 2018

So if you're interested in something, you should try it. What's worse in life - regretting something after finding out it might not be the fit for you or regretting you never took the chance? You can always switch to something else if you dislike it or the workload. That's be beauty of nursing.

I have friends who do L&D and postpartum. They love it. I think it takes a certain type of person but you could be that person.

I work in the OR in a trauma center. We do emergent and scheduled c-sections from time to time. The case may need to go and the L&D ORs are busy, or the mom may have been in a car accident and the section be truly emergent. Sometimes though, we do sections in the Main OR because mom and/or baby is so sick they need advanced interventions we don't routinely utilize in our L&D ORs (our L&D ORs do not put patients on ECMO if needed - we've had to put babies and moms on ECMO). We've been set up to do an emergent section during other procedures where not intervening is life threatening for mom and baby but there's also a high likelihood mom could code and we'd have to emergently deliver baby.

I think that both good and bad things happen no matter what setting you work in within nursing and healthcare. You will have to learn to advocate for your patient(s) which may be different than it was on the floor. Death happens anywhere and nobody has ever escaped it. We prolong it, but it's a fate we're all destined for. That said - you don't have to help care for families with critically ill neonates or dying neonates on the floor. I've cared for kiddos who were hours old in the OR and they've had to have their procedures or they wouldn't be able to survive. The only thing I could do to reassure those kids' parents was promise to stay with their child, make sure they were as well cared for as we could, and call them when I could with updates. That's as close as I come to understanding some of the "bad" or "less good" that occurs in L&D or postpartum.

NurseNora, BSN, RN · Mar 23, 2018

I worked LD for 45 years and loved my last delivery as much as my first. Every once in a while you will have a period with no patients. Every once in a while you'll run out of beds (I once had a patient in early labor in a recliner in the residents lounge). One Thanksgiving we called the OR in TWICE for failed sections. Each patient unexpectedly delivered lady partslly in the OR. You'll deliver a few babies yourself. Most of the time it's a happy place, but you do lose a baby or even a mother sometimes. I taught fetal monitoring, but I was the granola nurse. When I was greeted with "Do we have a patient for you!" I knew to expect a 10 page birth plan or a lotus birth or someone refusing Vit K and Hep B. I've also cared for eclamptic women, HELLP syndrome, post kidney transplant moms, moms on peritoneal dialysis. Pregnancy and childbirth is a normal part of a healthy woman's life and goes well most of the time with nothing but encouragement from us. Sometimes it is critically dangerous. I liked never knowing just what I would find each day when I went in to work. Give it a try. I think it's the very best place in the world to work.

queenanneslace, ADN, MSN, APRN, CNM · Mar 27, 2018

" Any L & D nurses have positive things to say about the speciality?"

Loved it. It's HARD though, too. I think I love that it's hard, that no two days are the same, that no two labors are the same, and that you have to expect the unexpected.

For nurses who love organizing and planning a full med/surg roster of patients, I would not recommend L&D. I can't tell you how many times I was doing one thing (helping with pushing with a primip, post c-birth recovery) and a charge nurse would yank me out of a room, and whoa, before I'm even really oriented to what's happening, "OOOH, WE'RE HAVING PRECIP, PRETERM TWINS! Hooray!"

Some people would hate this type of thing. Those people shouldn't work in L&D. If you like being surprised, if you like INTENSE EMOTIONS and momentous life events. Go for it.

The nurses who tended to leave L&D were the ones who expected to be able to control it. You have to have some appreciation for change, and changing quickly, and re-prioritizing quickly.

Good luck! Let us know how you're doing!

ADNRN2016 · Feb 20, 2019

On 3/23/2018 at 2:16 PM, NurseNora said:
I worked LD for 45 years and loved my last delivery as much as my first. Every once in a while you will have a period with no patients. Every once in a while you'll run out of beds (I once had a patient in early labor in a recliner in the residents lounge). One Thanksgiving we called the OR in TWICE for failed sections. Each patient unexpectedly delivered lady partslly in the OR. You'll deliver a few babies yourself. Most of the time it's a happy place, but you do lose a baby or even a mother sometimes. I taught fetal monitoring, but I was the granola nurse. When I was greeted with "Do we have a patient for you!" I knew to expect a 10 page birth plan or a lotus birth or someone refusing Vit K and Hep B. I've also cared for eclamptic women, HELLP syndrome, post kidney transplant moms, moms on peritoneal dialysis. Pregnancy and childbirth is a normal part of a healthy woman's life and goes well most of the time with nothing but encouragement from us. Sometimes it is critically dangerous. I liked never knowing just what I would find each day when I went in to work. Give it a try. I think it's the very best place in the world to work.

I am a new grad nurse who will be starting L&D soon.

In your example of a pregnant patient with non-OB specific issues like mom is on peritoneal dialysis, post-kidney transplant,... since you might not see these everyday (or maybe you do...), do you ask the nurse educator to help you?

I barely know L&D, much less peritoneal dialysis or post-organ transplant concerns- how would I troubleshoot something like this? Once we are off orientation, are we just expected to know how to take care of these atypical patients?

Wish I could just crack open my textbook or google it on the job, but that is not practical, and I am assuming that it is very fast paced and I might not have time for that.

As you can see, I'm very nervous... I don't have any med-surg experience, and there are so many med-surg/acute issues that can present in a laboring patient....

Hoping you or any other L&D nurse can give some insight or advice.

Much appreciated, thanks! ?

RatherBHiking, BSN, RN · Feb 22, 2019

On 3/27/2018 at 11:41 AM, queenanneslace said:
If you like being surprised, if you like INTENSE EMOTIONS and momentous life events. Go for it.
The nurses who tended to leave L&D were the ones who expected to be able to control it. You have to have some appreciation for change, and changing quickly, and re-prioritizing quickly.

Well said!!