L&D Travel Nursing 101

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Are you a labor and delivery/L&D nurse who is interested in travel nursing? Congratulations, this is one of the most in demand travel specialties out there! There are many helpful resources available on the web for first time travel nurses. This article will focus on some unique considerations for L&D nurses when deciding on travel contracts, as well as highlight the most common certifications needed for this specialty. 

When you're considering different jobs, it's essential that you evaluate your current skill set and work environment and whether you will be a good fit for a potential employer.

Are you a good fit for this unit? Is the unit a good fit for you?

What setting are you currently working in?

Do you work in a high-volume tertiary care facility? A smaller LDRP unit? A critical access hospital?

Now, look at the setting of a job you are considering. Do you have the skills necessary to fill their staffing need?

Here's an example: Let's say you currently are a staff RN at a very high acuity L&D unit that does several hundred deliveries a month. You regularly take care of patients with multiples, patients with diabetes on insulin drips, patients with pre-eclampsia on magnesium sulfate, etc. Anytime you have a high-risk birth, you requested the NICU team be present for the delivery.

Now let's say you're interested in working at a remote critical access hospital. You learn in the interview that the L&D nurse works by themself, and they are required to assume care of the baby after delivery as well. While you have fantastic skills taking care of high-risk patients, if you do not feel comfortable stabilizing newborns independently, you would not be a good fit for this assignment.

How do you build skills as a travel nurse?

A successful approach to build skills that many travelers employ (author of this article included) is this: take a travel contract that is just enough similar to your current staff job that you will have most of the skills necessary to do the job and have the opportunity to acquire new ones.

A standard component of any travel nurse job application is a skills check list. While these can feel tedious to fill out, they are an essential component of your application, because it allows a manager to see whether you have the skills necessary to work on their unit. Travel nurse orientations are significantly shorter than that of a staff nurse (typically a couple of shifts, tops). Above all, BE HONEST on your skills check list and during your interview with a unit manager. No manager expects a nurse to be proficient in every skill on the check list, but they do expect you to provide a transparent assessment of your current abilities. This is essential for patient safety.

What are some other L&D specific questions to ask the manager in the interview?

Does the unit staff to AWHONN ratios? 

If you are used to working in a setting where there are mandatory staffing ratios (such as one-to-one nursing with active labor patients), it is essential that you know what you are signing up for with a particular job. It can be a rude awakening to go from a unit that followed AWHONN staffing ratios and learn that you are you expected to take care of multiple active labor patients.

Will you float? And if so, what type of specialties will you be floating to?

Some managers consider sending an L&D nurse to postpartum or antepartum to be a float assignment. Others, especially in smaller hospitals, will send an L&D nurse to a non-OB specialty such as Medsurg or ICU. Ask about the specifics of float requirements in your interview, and then make sure this is specified in the final assignment contract.

Other things to consider as you brush up your resume:

Make sure you have your certifications up to date. Your recruiter will let you know what ones are required. Below are some of the most common ones:

• Neonatal Resuscitation for Provider (NRP)
• CPR
• Advanced Cardiac Life Support (ACLS)
• S.T.A.B.L.E.

Another way to strengthen your resume is to get credentialed as a Certified Inpatient Obstetric Nurse. 

Fetal Monitoring

Most if not all hospitals will have some type of requirement to verify that you can interpret a fetal heart tracing and respond appropriately. Many long-term travelers are certified in all three of these:

• AWHONN Intermediate Fetal Monitoring: 2-day in person class.
• AWHONN Advanced Fetal Monitoring: Prerequisite is the AWHONN Intermediate Fetal Monitoring course.
• NCC Certification – C-EFM: You sit for this exam.

While this is not an exhaustive guide, this should give you an idea of where to get started regarding L&D specialty considerations for a new travel nurse. Best of luck and enjoy the opportunity to travel the country and build your skill set!