I've always wanted to work on the OB ward..

TheCommuter, BSN, RN · Aug 4, 2008

The overwhelming majority of L&D (labor & delivery) hospital jobs are filled by RNs due to scope of practice issues regarding initial assessments and administration of sedating medications. The LPN is legally supposed to work in areas that have stable patients with predictable outcomes. L&D and OB are considered high-risk specialties that involve a degree of unpredictability.

However, a very small minority of LPNs are employed in postpartum or mother/baby hospital units.

BayouLPN · Aug 4, 2008

I am employed in a Mother/Baby unit of a Family Birth Center as an LPN. I love it. I am, as the previous poster wrote...in a small minority. I have, also, received NRP training and float to the NICU for stable babies (feeder/growers). It is hectic but wonderful. If you have the chance to get on....do so. Good Luck.

BayouLPN · Aug 4, 2008

RE: What can a LPN do in OB:

This is typical of my assignments (not assuming other facilities work the same way)

Labor & Delivery: Baby nurse (NRP certified)

Set up warmer and equipment (suction, oxygen, scopes)

Prepare eye ointment, Vit K shot, have rectal thermometer ready in KY jelly. 2 tolwels under heat well before baby arrives. Set up delivery cart for MD> maintain steril procedure.

As baby is born, decide if stable or not...if stable throw towel on mom's abdomen for baby, if not stable...take baby in towel straight to warmer. Begin to stimulate baby by rubbing and drying vigorously. Assess your APGARs at 1 & 5 minutes. Counts heart rate, resp, temp, listen to lung sounds, decide if baby needs suctioning. Admin eye oint, Vit K, RN will do nb assess during this time, weigh baby, wrap baby in warm blankets to be handed to mom. set up monitor for vs, clean up, ect. usually about 45min to 1 hour for mom and family to hold baby.

Begin recovery of mom and baby. mom's vs are frequent, baby's is q1hour (place baby back under warmer)fundal massage, initiate NS c Pit by pump, change peri pads. when baby's temp is norm...bath baby, back under warmer while drying, measuring, dressing. Rewrap and hand to mom or family. Clear equipment not needed out of room. This usually takes an hour up to several hours. Assist mom to bathroom, shower is desired, change bed linens, (we put another mattress on our LD beds). There is alot of teaching that goes on and alot of variables. Breastfeeding, lacerations, episiotomy, Natural and epidural births. After baby is transitioned...we take the security picture and set up the security monitor on baby.

A transitioned mom/baby is to assess mom & baby during your shift and we weigh babies every night. I can suction a baby at birth but cannot lavage one later. I can decided if it needs lavaging. I help new mom's learn to breastfeed. I can cut a cord that is left too long after birth. I feed lots of babies. I can do everything an RN can do with Mom (really like Med/Surg) except initiate a PCA or do an IV push. Once the PCA is initiated, I monitor it and can d/c it. If my iv push is a narc and I cannot find an RN (we do get that busy) Most of my oders do allow for an IM. I give my pt the option of waiting for the RN or have me pop their behind.

I was taught to scrub for c-sections. I set up the OR and assist the surgeon with delivering the baby. This is not a biggy. Alot of LPN's serve as OR Techs because RN's mainly circulate.

I go to the NICU. Full assessment on my babies every 4 hours, monitor vitals and chart every 2 hours. Maintain strict feeding schedule. Some are straight gavage, nipple/gavage, or straight nipple. strict I/O/s, weigh the diapers. I monitor vapotherm or oxygen. I have taken IV babies when times were very busy. But, with these, they are stable. I monitor them & call an RN when something needs to be changed. (TPN OR Lipids) Site becomes red. I DO NOT take unstable or critical babies (vents, post surgery, ect).

This is not by any means all I do but a general overview. Hope it helps.

armynavygirl86 · Aug 4, 2008

WOW that's is alot but at the same time nothing at all thank you so much for telling me that.That's what I needed to keep me motivated.Thanks a billion.... :loveya:

Fiona59 · Aug 4, 2008

What you have to do is research your local job market. Don't be discouraged by what is NOT allowed in some states/provinces. Look for the local picture.

daazy28 · Aug 6, 2008

Wow! :urck: BayouLPN!!! Thank you for all that info! Like many, my heart is truly in L&D. I am taking my boards on the 15th this month and am nervous as all heck! But I know now I have something to look forward to! I used to live in upstate NY and we couldn't as LPN's do ANYTHING in L&D, NICU. Not even stable babies and mommas. But now we're in NC and I can't wait to see what opens up for me! I think I already have a job lined up too! It's LTC, but I like that area too! I was a CNA for 3 years (was also in school for my LPN for 2 years 4 nites a week).

litebrightgirl · Aug 11, 2008

Does anyone work in L&D? If so, what do you do?

kat7ap · Aug 11, 2008

I started in OB by working in a small hospital that had an LDRP (labor, delivery, recovery, postpartum all in the same room). My role was to assist RNs with paperwork, go to lady partsl deliveries to be a "second set of hands", scrub for c-sections (our normal OR crew was only there M-F days), and care for stable postpartum moms and babies.

Now I'm at a much larger hospital and do soley mother-baby, which includes caring for a postpartum mother and her baby who is in the room with her after their intial 2 hour recovery up until discharge from the hospital. At my job now, there is very little difference between RN and LPN. I take my own patient load, do all my own meds and assessments. The only things I don't do is take antepartum patients, patients on mag sulfate or needing a blood transfusion.

VM85 · Aug 11, 2008

this is exactly where I want to be, for personall reasons. When I had my son last may, I didnt get to hold him right after i delivered. He stayed in my room with me for the two days I beleive it is, an dthe doctor came in on the last day (around 10 am) and said that they would like to keep him overnight for observation in the L2 nursery/nicu.He said he really didnt think he needed more than 24 hours but they just wanted to be safe I satyed with him until 11:30 that night. I didnt leave to go to the br or eat or anything-i didnt put him down. Finally they suggested I go home and see him in the morning, as in the nicu they have all the babys on monitors and no place for mom to stay. I apparantly needed my rest. SO i did, but broken haertedly. I was there at 8 the next morning. LIke i said for personal reasons, he wasnt there for 24 hours....more like 4 1/2 weeks- Im glad because thats the safest place for him to have been....but it was the hardest thing that i had ever done. I felt like gonig home everynight that i never even had baby-like he didnt exist-it was so wrong!. BUt anyways thats when I decided I wanted to become a nurse. They took such great care of him and i had worked as a home health aid 3 months prior to me giving birth. I thought becoming an LPN was the best way to start at that goal, since going to school doesnt pay the bills. I thought for some reason, there was lpns working with moms on the maternity ward but an Rn had to be on the floor at all times. I really hope i am able to work within the nicu. also at that hospital, there wasnt all the same nurses, they all rotated from maternity to special care, Im pretty sure. ANyways if I can help any moms make it through that scary and hard process and show them that thatll allow them to go home with healthy babies-- or just to make the most out the situation if thats not the case and offer comfort....then thats where i want to be!

Roozeyk · Aug 12, 2008

I worked in a small town hosptial too a few years back, and as an LPN, I did everything the RN's did (with the exception of pushing IV meds). I did L&D (actually delivered one baby that decided to come on out before the doctor got there..he got stuck in the office trying to remove a buried Norplant....member those??), Newborn and Level II Nursery, Postpartum and post op GYN care. I went to C-Sections to receive babies. We had surgical staff 24/7 so I did not to any assisting with the surgery part. Everyone licensed person that worked on the unit had to rotate through each section of the department until they could interchange at a moments notice without any problems. After a few years of doing this, the census got low and when your working 12 hour shifts, we were losing hours left and right and I transferred to an OB/GYN Clinic, it's interesting to kind of see how everything starts and then how it ends up. Womens Health is a very interesting area. I now do ER Nursing as an LPN and am trying to finish my RN degree, which I then think I want to do Urgent Care work as the hours are a little better.

Lauraj28 · Aug 20, 2008

I am starting College for the first time next week. I have always wanted to be a nurse and now I am not so sure. I am thinking I would like to be an LPN in obstetrics. Can someone tell me what they do? Also what are the best and worst parts of being an LPN?