I need all the L&D nurses out there!

rn4babies63 · Jun 24, 2008

Hi,
My name is Jen and I have been a nurse for a year and a half. Since I was a little girl, I always wanted to be a L&D nurse...after listening to stories from one...a neighbor.
I have always believed that being a L&D nurse would be going to my job to assist babies being born...I want to have a job where I am there on the most important day in a family's life...the impact of that inspires me...I have children and above everyone person I saw there, I appreciated the nurse's care the most and that was before I became one.
Now, I have been on a med surg floor since graduation (for experience) and I know that nursing is not the fantasy I always thought it would be ...and I also am very well aware that being a L&D nurse would not be great all the time but wanted to know your experiences .....do you LOVE it, HATE it...think it is the same exact stressors on this floor as every other? I feel that med surg is so generalized that it is impossible to sink my teeth in and be a good nurse with all the crap that goes with the job....(you know what I mean, documentation, short staff, untaught new rules, etc) I would like to think that going into a specialty will give me the chance to learn it well and be able to confidently handle each situations as they come and do it GREAT...Plus do you see a lot of sad cases? The hospital I am in is in a good area and from what I heard has a great l&d but wanted some inside insight before proceeding.
Am I COMPLETELY naive in my thinking..????? IS it possible to become inspired by nursing care again?

I have been an L&D nurse for 12 years. I have worked at 3 different hospitals during that time and did mom/baby home visits for 6 years. I would not work any other area of nursing. You still have the same "crap" such as short staffing, and documenting..........you have no idea. This is probably the area in which you have to document the most. As with any area of nursing, you will only know if you like it by trying it out! You have a year of med-surg in which alot of L&D's require (I started L&D right out of nursing school), so you should be able to find a position if there is a need in your area. Just remember, it can be a VERY high stress area of nursing. You never know what's going to walk through those doors. The great thing about nursing is, if you don't like it, try something else!! Good luck in your endeavor!!!

imfree · Jun 24, 2008

I have been working as a nurse in OB/gyn for 17 years, most of which has been in labor and delivery (2 different hospitals - 1 doing ~ 350 deliveries/month, the other doing ~ 200/month) The rest of my time was spent as an office RN in a busy OB/gyn/perinatology office. Obviously I love this area of nursing. Like you, I only really saw myself working in this area of nursing. I was fortunate to get hired right out of nursing school. Oddly, it is now commonplace (in my neck of the woods anyway) for RNs to come to work in l and d straight out of school. Not that it's always a bad thing, but honestly I think you will ultimately be glad you spent a little time on a med/surg floor. You are right to question whether l and d is often sad, etc. I have oriented many new nurses and have had some of them tell me they were not prepared for the "other side" of labor and delivery. Obviously when it is sad, it is very, very sad! I can think of few worse things than the feeling in the pit of my gut when I am not getting heart tones on a full or near term fetus and the anxious mom and dad-to-be are looking at me with fear in their eyes and I have tell them, without telling them (because I am not a physician and cannot diagnose IUFD) that their baby does not have a heartbeat anymore. I cannot describe the pain in the crying out of that mother as her agony begins. I have shed many tears over the years as these women labor and deliver the baby they have lost. It is profoundly sad. Babies are born with anomalies (either expected or not). Some are born living, some are IUFDs. Those cases are difficult. Recently, I assisted a new RN in caring for her first IUFD - a near term baby with known defects. Sadly, the baby likely had passed away many days prior to the demise being diagnosed. Labor was induced and after 24 hours plus, the baby was delivered. Suffice it to say - what happens to the fetus after days in the uterus surrounded by amniotic fluid - is not pretty at all and there is no way to properly prepare a new nurse for that. Again, all this to answer your question regarding the sadder side of l and d. Thank God, most days are not like that. Most days are happy and things go as expected. Some days you make a difference in what could have been a disastrous outcome because you reacted/acted appropriately in a dire situation (ie cord prolapse, placental abruption, etc, etc). There are also occassional situations in which you leave work feeling disgusted because you have had to provide care for a woman who shows no care for herself or her unborn baby, and is disrespectful of you and the staff - just downright nasty! But you have to put your feelings aside and "do your thing" with a decent attitude in spite of yourself! Oh and then there are the doctors!! There have been many over the years that I have dealt with. Almost all of whom I respect greatly. Only a few of whom I like!! Seriously, they can be a pain. I try to think of it this way - They are not on the unit most of the time (I have mostly worked nights). I am their eyes and ears - they are dependent on me to get it right. As a labor and delivery nurse, there is soooo much autonomy and so many judgment calls that we make. You have to be okay with that to be happy in l and d. Overall, for me it is the dream job I hoped it would be. Just when I think I can't take it anymore, a sweet little mom willl look up at me with tears in her eyes as I lay her baby in her arms and say "Thank you so much" and I know she means it, and I know I made a difference, so I come back to work again. I apologize for the length of my response. I just got going and couldn't quit! My recommendation - inquire about shadowing an RN in labor and delivery. Also, shop around (if possible in your area) - there is a pretty big difference in working in a busy unit with 300 or more deliveries a month, high risk antepartum care, possibly a physician residency program, NICU, etc, versus a smaller hospital with fewer deliveries, no high risk care, etc. As to your question about staffing, charting - oh yeah, always problematic. I would say maybe more in l and d than anywhere - charting is exceptionally important, staffing is tough as you may start your shift with very little happening and end it with a full board and no where near enough staff! So that issue I'm afraid is universal. Anyway, best of luck to you. I have always said labor and delivery nursing is a calling. If you are called to do it - you should. You will find that it will take at least 6 months to a year before you begin to feel confident that you can handle the job. It is just so specialized, but by all means - get in there and go for it if you feel it is right for you. Let us know what happens!

babyktchr, BSN, RN · Jun 24, 2008

I was one of those nurses who specialized right after graduation. I was an ICU tech for a few years while in nursing school, and so it only made sense that I went right into ICU after school. It was a very smooth transition, and if it weren't for that experience, I don't believe I would have the critical thinking skills that I have now. With that said....it is a mixed bag for me, the whole go right into specialty or do some med/surg time. I have come to know that med/surg is now a specialty of its own, and it takes a special kind of person to do that kind of nursing...just as it does for any specialty out there. I have not worked med/surg in quite some time (over 14 years) and I can tell you, when faced with a sem-complicated GYN patient....I have to dig way back to early skills to care for this patient. Each specialty brings its own nuances, and it really comes down to the kind of person you are, and how you learn/absorb/assimilate. Sometimes that year or two of med/surg is a help, sometimes not. I have had some nurses come with not so great skills from med/surg and then want to work OB. Sometimes training the newbies from the get go can be a good thing. It is work in either case.

When I came from ICU to OB....OMG. I will say this till I die. I have worked in some serious circumstances with very ill patients and it didn't compare to the experience I had in my orientation in OB. I never worked harder, used my thinking cap more, and well....walked so much in all of my career. Now, before panties get in a bunch....ANY place in nursing is hard work. I am not minimizing anyone's job here. In my experience...nothing came close to what I have done in OB. And if you thought short staffing and paperwork is bad in med/surg........wait till you get to OB!!!!!!! lol.

Good luck to you in whatever you do.

JaneyW · Jun 25, 2008

I have worked in L&D for 6 years now. I am currently attending the AWHONN convention in Los Angeles (one more day!!) so I am feeling very inspired at the moment. It is not a fantasy world, but I couldn't imagine doing anything else. Jump in!

JentheRN2007 · Jun 25, 2008

Queenelizabeth, thank you for you insight. The sad part sounds incredibly heart-wrenching and is one of my fears yet at the same time I feel (maybe more like hope) that I can be there for them. I hope I can handle that part...I guess time will tell. I completely understand the frustrating side when you have a mom who doesn't care...that must be hard too...I am definitely use to patients that are difficult but having a baby involved would be tough. With that being said, I do believe it is a calling....I felt it when I was little....went through a stage where I had no idea what I wanted to do (teenage years...I just want to have fun...)and eventually came right back to it with the same feeling and passion I had then. Funny thing is...I have 9 1/2 year old twin girls and one is almost a clone of me when it comes to nursing.. I have never pushed or suggested it to them but she has become obsessed with the discovery health channel (and got me hooked) and loves Dr. G and all the shows in which babies are delivered. We now have conversations where we say "think she will get the epidural in the end" etc....So I think she feels it deep inside too. My other daughter is completely grossed out by it.

I am currently on maternity leave until Aug 15 (just had my third child, a boy in May) and will return to my med surg floor for the rest of the year and then look into L&D. I have been off since May 1st and feel like I won't know what to do as a nurse when I go back!!! Plus my IV skills still stink...so getting a little confidence before getting back in is needed..

Thanks again Ladies for your input!!!!!! I can't wait to become one of you....(even though I am scared to death too)

Elvish, BSN, DNP, RN, NP · Jun 25, 2008

May 1st and feel like I won't know what to do as a nurse when I go back!!! Plus my IV skills still stink...so getting a little confidence before getting back in is needed...

Well, if it's IV skills you seek, I cannot think of a better place to get them than L&D. :)

jenrninmi, MSN, RN · Jun 25, 2008

I love, love, love L&D! It is everything I've fantasized it to be. I too always wanted to by a L&D RN. My whole life. Just like you. I've only been an RN for 3 years (l&d for over 1 1/2 years). But I also work in a hospital that follows the AWHONN guidelines. Actually is usually better than AWHONN guidlines. As in 1 labor patient to 1 RN etc.

Go for it!

Also, I found med/surg much more stressful!

jenrninmi, MSN, RN · Jun 25, 2008

I never worked harder, used my thinking cap more, and well....walked so much in all of my career. Now, before panties get in a bunch....ANY place in nursing is hard work. I am not minimizing anyone's job here. In my experience...nothing came close to what I have done in OB. And if you thought short staffing and paperwork is bad in med/surg........wait till you get to OB!!!!!!! lol.
I think this is going to vary where ever you work. I definately walked more and worked harder on med/surg. But it was a floor, not an ICU with very high acuity for patients. Where I work in L&D, we don't have issues with short staffing like we did in med/surg. So, again it will be different everywhere.
But I hear this a lot on this board and it makes me really afraid to ever leave my hospital. lol! I would love to move back down south someday but I do not want to work in dangerous situations.

sdmidyette · Jun 27, 2008

I'm new to the nursing forum but also to nursing, by new I mean I start my CNA program in a month and I will continue on to my RN. I have always wanted to be a L&D nurse and since reading the replys, that is what I'm going to do.