Is postpartum a lower stress specialty?

[studentnurse9806]

I am currently a nursing student in my senior year and have to put in my request as to where i will do my preceptorship next semester. I wast thinking about postpartum... but am not actually sure what i want to do:confused: I will be completing my OB clinical this semester so im sure i will have a better idea of what the floor is like once im done with the rotation but what can i say, i am impatient, lol. I was hoping for a specialty that is not as high stress as medsurg. I hated my med surg clinical and will hate my med surg 2 clinical this semester. I know i will never work med surg, and actually cant picture myself working anywhere in the hospital besides OB. Either that or i was seriously considering looking for an office job.... with a pay cut obviously:banghead: So what I'm wondering is postpartum nursing a low stress job ? "Stress" to me is... - high acuity patients, tons of meds and procedures, turning and position obese patients, and bathing them (I am 5'1, and 100 pounds)... i need help of another student for EVERYTHING (bed pan, bath, help getting up.)

Yes i know postpartum would have stressful days as every specialty does, but I am asking in general. Please do not respond with "Oh, all nursing jobs are stressful blah blah blah." I am looking for input from postpartum RN's who can tell me their opinion of postpartum vs. other specialties, or just their experience in postpartum in general. Also interested in what you would consider "stress" in postpartum. thanks in advance!

[geminiRNC]

I've worked L&D, LDRP, and just postpartum. Out of all three, I would have to rank postpartum as the most "low stress." I say that very cautiously, depending on the facility. In a high risk facility, your pp patients can be VERY sick. We are talking cardiac issues, brittle diabetics, pregnancy complications, etc..In a high risk facility, you probably have a NICU or nursery--that elimates your responsibility for a baby. That is a plus. But, if you work at a smaller hospital, I do believe that it becomes more difficult. You have more autonomy and rely on co-workers more. I have worked at both types of facilites and do not take away from ANY nurse in either. In a smaller facility they are moving more towards LDRP's (combined units). You are responsible for mom & baby from admission to discharge. You need to know your stuff-on both ends. You don't have NICU, interns, or CNM's for backup. But, at a high risk facility, your patients are usually more acute. I know my advice sounds contradictory, but I don't mean to be. I just don't want you to think that because you work "postpartum," it is a walk in the park. It could be. But, it can also turn BAD--very quickly....and you need to be competent, educated, and ready for the unexpected. (and have patience of steel for breastfeeding, lol)

[Elvish, BSN, DNP, RN, NP]

I work in a high-risk facility that does couplet care, exception being for NICU babies. We are responsible for 3-5 couplets (read: 6-10 patients) and depending on the shift it is either a cake walk or it is balls to the wall busy and I'm glad everyone is still breathing at the end of my shift. We also house high-risk antepartums on our floor, so throw that into the mix. Of all my couplets, I am glad if just one is an uncomplicated one. I might have an antepartum with mono-mono twins getting monitored 3x/daily, a fresh postop c/section with breastfeeding difficulty, a lady partsl delivery with chorio and both she and baby are on IV antibiotics, and one 'normal' couplet. God forbid my section bleed, or one of my babies crash. Rare is the day when all my patients have only minor issues.

The trend nationwide is toward couplet care; many hospitals are eliminating or severely downsizing their nurseries. If you work postpartum, you are likely to be responsible for babies as well. Don't let their smallness fool you; they can compensate for a very long time. When they finally crash, they can do it very very quickly, so you'd better be at the top of your game. Most of my scariest patient scenarios have been with newborns.

I say this not to scare you, just as a healthy dose of reality. We had a recent transfer from med-surg come to our unit and talk about how a bad day on our floor had to be better than a good day on med-surg. After about 4 weeks she started crying mid-shift and said what a bad couple weeks she was having. This is not intended as a gloat, because it truly has been insane lately, and bad days suck. But I think at that point she started to 'get' why postpartum isn't the unicorns and rainbows that people think it is. Don't get me wrong - I'll take this over bed-jumping and DTs (which I have also done) any day of the week. But it ain't holding and rocking babies, either.

I'm hesitant to put one answer to your poll, because honestly it depends on what day, what shift, what the answer will be.

[studentnurse9806]

Thank you for your input guys! I understand it is a big responsibility and things can quickly go wrong. I just had my orientation for OB today and have learned alot more than i knew before. I also found it very interesting. I will let you guys know what I decide to do once i complete some clinical rotations in this area.

[jwelsh]

I am excited for your consideration of working in OB. I have worked in so many areas as a nurse and I would have to say I absolutely love my job on the postpartum unit where I currently work. I agree with Elvish's comment about the stress level depending on what day it is. We have approx 4,000 births per year. We do have a level 3 NICU ran by Nationwide Children's Hospital in Columbus Ohio. And sadly, women still die in our country as a result of childbirth.

What I feel most blessed about is that I'm a part of the most special time in a person's life. I have the ability everyday to be a powerful, positive influence and become a small piece of someone's childbirth experience.

[SydneyJo1]

I began working nights on Mom/Baby right out of nursing school, so I've been doing it just over a year now. Like you, I did not enjoy my Med/Surg clinicals AT ALL and really didn't want to have to ever do that, so I was so grateful to be hired into OB right off the bat. I think the stress level on postpartum is usually at a tolerable level, with the occasional shift from hell thrown in there for good measure. Usually it's very managable and I leave feeling pretty good about my shift. There is lots of teaching involved, lots of emotional support, encouraging new parents, etc. There can be some patients who are pretty sick, but that is (at least in my experience at my job) more the exception than the norm. I think OB requires a very high level of compassion, empathy, great communication skills, patience, and amazing people skills. If you feel like those things are your strenghts, I'd recommend postpartum in a heart beat.

Good luck!

[AnnaBSN]

I work postpartum couplet care, ob/gyn as well as intermediate nursery. I love it! I pretty much give the same meds to all my pts. Prenatal, docusate, ibuprofen, percocet, etc. and the only brief changing I do is for babies. Most of the moms are independant and can toilet and shower themselves. For the most part the aides have it easy. Also, It is highly specialized so I see the same things, and am prepared for it. Unlike med surg where you have tons of different things going on. There is also plenty to keep me busy as mentioned in previous posts. And I definitely have had my bad days. Good luck!

[M/B-RN]

I think if I worked med-surg I would hate my job. Mother-baby is still stressful, but at least I like what I do. The only thing I wish I didn't have to deal with is helping women breastfeed. Boy do I get so frustrated with those sleepy babies and would like to dump cold water on them so they could just wake up and eat already!! (I would never actually do that LOL)