High Risk L&D question

[JPatchouli]

I have been a labor and delivery nurse for 7 years. I have been working in the same place that whole time. During that time I have done lots of "normal" and of course there is nothing better than a beautiful delivery! But I have also cared for plenty of women with GDM, IDDM, PIH, Preeclmapsia, morbidly obese, twin gestation, PPROM, PTL, pylo, PP hemorrhage, drug addicts with no prenatal care, etc.

We do level 2 maternal care and have a level 2 nursery. Anyone under 34 weeks gets shipped if appropriate. Not to say we don't keep antepartums under 34 weeks, because we do that too.

A while back our hospital built a brand new facility and split campuses leaving us and our nursery behind and taking EVERYTHING else 5 miles away. Essentially leaving us as a freestanding birth center, with the same pt population we have always had.

I want to start traveling soon. My recruiter keeps asking e how much high risk experience I have and has put me in for a couple of positions that are at Level 3 & 4 facilities where I would love to work and gain more experience, but I sure don't want to misrepresent myself. He asked me yesterday, on a scale of 1-10, with 10 being the highest risk, how much high risk experience do you have? I honestly don't know how to answer that and am looking for any guidance.

Thanks for reading this far, hope I'm making sense.

[Barkow]

I've worked in both high and low-risk L&D units. I think your bigger difficulty would be adjusting to travel nursing after only working in one facility for seven years rather than the high-risk/low-risk issue. At high-risk facilities you have sicker patients more often, but as long as you have the experience and assessment skills, I don't think it's difficult to adjust. Also, from an L&D RN perspective, a higher-risk unit might be delivering more preterm or sick babies, but it's not like the actual work of the L&D nurse differs much in this case since NICU is responsible for the baby.

If you want to start traveling as soon as possible, I'd focus on finding a first assignment where you can be successful and get used to traveling, without worrying about a crazy acuity jump. Your recruiter's 1-10 question is difficult to answer, but it sounds like you have a decent skill base. But a lot of L&D managers will be focused on delivery numbers that you're used to on your unit, how many patients you're used to taking at a time, and how often you do things like mag. Some high-risk units will be really focused on these numbers, while others might be desperate and give you a pass. I'd still favor a good, functional assignment initially at a travel-friendly location, and then you can more easily experiment with different types of units later.

[JPatchouli]

That makes a lot of sense. I really appreciate your taking the time to reply, you've given me a lot to think about.