Labor and delivery vs. Postpartum

Queen2u · Feb 20, 2011

I have no doubt that some PP nurses are up to the challenges they are supposed to be up to. Those nurses however are severely in the minority in the hospital that I work in. They only have 4 patients at a time and we do not do couplet care...so you tell me which is more demanding 4 stable (because they won't accept anything less) PP patients or two active labor patients? If you didn't choose active labor then you don't know what Labor and Delivery is like. I stand by what I said, PP is less demanding than L&D and that is a fact. If you want to compare helping a woman breastfeed to helping her push for three hours you are have never been in a demanding delivery, where as I have helped women breastfeed for hours. As for transferring them in pain, we medicate them before transfer but often do not have the time to wait for the medication to take effect...when we have women laboring in the hallways waiting for that room. As for L&D being slow...it's a rare occaision where I work with all the scheduled inductions and c/s everday. The PP unit where I work is the dumping ground for L&D nurses who couldn't make it in L&D...so no their skills are not on par with ours. That is not looking down upon them, that is a fact where I work sorry to say. We can be pulled to help them when needed, but when we need help there is none for us so we make due. They also have the ability to pull from Med/Surg which we can't do. Again when even the doctors are hesitant to transfer patients there for lack of good nursing care there is a problem. Maybe this is specific to the hospital I work in but it's been that way for as long as I've been doing this...10 years now. So don't lecture me on the few good nurses, I am speaking on the PP nurses as a whole, and where I work specifically.

....So, what are you gonna do to change things? You sound like a baby sitting in a poopy diaper:crying2:....what are you gonna do to make things better at your facility? As long as you continue to complain about the lazy nurses in PP at your facility and you do nothing to change things, nothing will happen....or did you just post this to complain? OH I SEE, THAT'S IT!!!!!!! YOU JUST WANTED TO COMPLAIN!!!!! :uhoh3: :uhoh3: If you want, you can come sip fancy drinks, get rub downs by hott guys and take a skinny dip in the secret Post Partum pool all the real nurses don't know about; we don't mind!!!:redpinkhe:yeah: :lol2: :nurse: :heartbeat:clown: :jester: BWAHAHAHAHAHAHA!!!!!!!!!! Know what's sad? I had no idea when I was preparing to get into this field that nurses that should work together would be so immature, petty and catty toward one another!!! This "I am a better nurse than you are" mentality is ugly. If you feel that way, poor you! That won't keep me or the PP nurses at your facility from from walking in to work every day with a smiles on our faces loving what we do....moving right along...... :lol2:

Queen2u · Feb 20, 2011

What the post before me describes sounds very facility-specific. My mother/baby floor does couplet care as well as high-risk antepartum and GYN care. We also deliver fetal demises under 20 weeks. From the time we get to work til the time we leave 12 hours later, we work. There are not just a 'few' good mother/baby nurses on my floor. There are a lot of good mother/baby nurses there, on all shifts.
Is the skill set different? Yes. But inferior? No. This is not a contest of whose skills are more advanced, whose nursing care is more intense, nor whose job is harder. I've worked med-surg, community, and on my current floor. I have come home physically, mentally, and spiritually exhausted working all three, and my skills have been stretched in all three as well. I coded more people working in a community health center(!) than I ever did working med-surg, and I can now say that I really hate coding babies, which I've done as charge nurse in the nursery. If everyone were good at L&D or postpartum, no one would be able to talk therapeutically to actively hallucinating people with schizophrenia, nor start IVs on a preemie, nor teach people with diabetes how to manage their insulin. And we need people who can do all those things too, so please....let's not turn this into any sort of war.

WLL SAID, ELVISH!!!!!!!!

tablefor9, RN · Feb 20, 2011

I have no doubt that some PP nurses are up to the challenges they are supposed to be up to. Those nurses however are severely in the minority in the hospital that I work in. They only have 4 patients at a time and we do not do couplet care...so you tell me which is more demanding 4 stable (because they won't accept anything less) PP patients or two active labor patients? If you didn't choose active labor then you don't know what Labor and Delivery is like. I stand by what I said, PP is less demanding than L&D and that is a fact. If you want to compare helping a woman breastfeed to helping her push for three hours you are have never been in a demanding delivery, where as I have helped women breastfeed for hours. As for transferring them in pain, we medicate them before transfer but often do not have the time to wait for the medication to take effect...when we have women laboring in the hallways waiting for that room. As for L&D being slow...it's a rare occaision where I work with all the scheduled inductions and c/s everday. The PP unit where I work is the dumping ground for L&D nurses who couldn't make it in L&D...so no their skills are not on par with ours. That is not looking down upon them, that is a fact where I work sorry to say. We can be pulled to help them when needed, but when we need help there is none for us so we make due. They also have the ability to pull from Med/Surg which we can't do. Again when even the doctors are hesitant to transfer patients there for lack of good nursing care there is a problem. Maybe this is specific to the hospital I work in but it's been that way for as long as I've been doing this...10 years now. So don't lecture me on the few good nurses, I am speaking on the PP nurses as a whole, and where I work specifically.

Almost *16* years experience & most of it, and currently, in L&D w/ abt 1-2 shifts out of 8 in nursery or dyad care. Other background is ICU, with a little home health & camp for kicks and giggles, and have done travel many different places. I'm sorry for the facility you work in, and I'm grateful that my PP nurses have had my back EVERY SINGLE PLACE I've ever worked.

And, I hope that what you posted here is out of your frustration, and isn't how you come across at work. Because then, I'd just feel sorry for your coworkers. If their skill level is lacking, help them. Work to bring more education, drills, re-orientation, whatever to your unit. But for mercy's sake don't take the suffering martyr position. It'll burn you out of your specialty before you know it, because you'll be the nurse the pts can't stand and the coworkers dread working with.

Queen2u · Feb 20, 2011

Almost *16* years experience & most of it, and currently, in L&D w/ abt 1-2 shifts out of 8 in nursery or dyad care. Other background is ICU, with a little home health & camp for kicks and giggles, and have done travel many different places. I'm sorry for the facility you work in, and I'm grateful that my PP nurses have had my back EVERY SINGLE PLACE I've ever worked.
And, I hope that what you posted here is out of your frustration, and isn't how you come across at work. Because then, I'd just feel sorry for your coworkers. If their skill level is lacking, help them. Work to bring more education, drills, re-orientation, whatever to your unit. But for mercy's sake don't take the suffering martyr position. It'll burn you out of your specialty before you know it, because you'll be the nurse the pts can't stand and the coworkers dread working with.

BEAUTIFULLY STATED, TABLEFOR9!!!!!!!:redbeathe:nurse: :yeah: :redpinkhe

Irishobrn · Feb 21, 2011

It's not my attitude it's the way it is where I work. We tried floating the PP's over to us but unfortunately it wasn't mandatory so most refused. The several that were really interested eventually made their way over to our unit. We offered them EFM and NRP certification (because for some reason NRP isn't required of PP even though they have the well nursery there) and most of them were not interested. Then that became mandatory but still the L&D nurses still have to go over to monitor patients or review strips for them. NICU is called for to check out babies that they need help with. We have formed joint committies for better communitcation between the units, but none of it has worked. They won't even call the docs directly...they call us hours after a patient has transferred to ask what to do..and we tell them to call the doctor. It's totally crazy. And no I'm not venting just stating how it truly is where I work.

tablefor9, RN · Feb 26, 2011

I'm sorry that your unit is in such crappy shape. All I'm saying is that one can't paint all PP RNs with that same brush. Most PP RNs are *not* like that.

What is your unit director's take on the situation?

Queen2u · Feb 26, 2011

Great statement and question Tablefor9.....

NawtyNurse69 · Mar 3, 2011

Ok, I just have to chime in here and agree with Irishobrn. The situation that she is describing is NOT specific to her hospital or unit. I have been an RN for 19 years, and have spent the last 5 as a Labor and Delivery nurse in a relatively small community hospital. We have 6 LDR's and 3 triage rooms. We have a separate pp unit and nursery. We have just recently transitioned to "couplet care". We are currently running L&D with only 9 (YES NINE), full time Rn's and 4 OB techs. We do about 60-100 deliveries per month. When I oriented to L&D, 5 1/2 years ago I was REQUIRED to orient to all 3 areas (L&D, as well as post partum and nursery). The problem that we have is that NONE of the post partum/nursery nurses has ever been adequately oriented to L&D, and when the issue is pushed, they simply REFUSE. 90-95% of them have only worked post partum in their careers and they have been there for at least 10+years. So that means that when the s*** is hitting the fan in L&D, there is no one we can call on for help, other than ourselves, YET when the **** is *supposedly* hitting the fan in PP, the L&D RN"s are expected to be "super nurse" and float over there and save the day. And what I mean by *supposedly*, is that, if a pt passes a dime size clot in pp, it suddenly becomes a PPH, or a baby has a glucose of 48, the kid goes into Extra Care. *EVERYTHING* and I do mean *EVERYTHING* is an emergency and a crisis. It's really hard, as someone who values my ability as an RN and critical thinking skills to not find working/floating over there as boring, frustrating and simply ridiculous...especially when I am told I have to float over there to help out, b/c they can't handle more than 2 couplets each! Really??? Apparently, it's easy to forget that I am usually responsible for at LEAST that many pts, and the ringer is that, 2 of my patients, I can't see nor put my hands on, as they are still in utero!

Tablefor9 and Queen2u, you make some very valid points, and there is no doubt in my mind that you are both EXCELLENT pp nurses. In my world tho, you would be the exception rather than the rule. And it's easy to say to another nurse, "well if the way things work at your hospital don't work, then change them". HOWEVER, that is not so easy....we have been trying to change things for years, but between hospital admin, the union, and the staff who have been there since Jesus was a boy, it's not so easy. Working in L and D, we have been literally DYING for years, for pp/nursery to be competent enough to come over and help when we need it, and it's just not happening. :crying2:

Queen2u · Mar 3, 2011

NawthNurse69, maybe I am that nurse who is the exception, and I don't think I am the only one. I am currently crosstraining to L&D from PP (by my OWN will, not by a post that someone put on this website to try and make me feel worthless as a PP nurse) and I plan on working at the hospital I am working at PAST my 2 year contract to also learn nursery. I WANT to be that nurse who can be put ANYWHERE on a Women's Services area schedule at whatever hospital I work at. I am currently at a hospital that is short staffed in every department. Perhaps the PP nurses in your facilities refuse to help you guys because they know the attitude you guys have about them and their department. Maybe they are aware that nothing is gonna happen to them if they don't help you guys. They are probably using you guys or playing with your emotions and minds and laughing at you when you leave PP to help them with their "crisis"..... It's ABSOLUTELY not fair, BY ANY MEANS for them to behave that way. I don't run to LD with my PP problems. If we do have issues going on in our department, I turn to my fellow PP nurse, we put our heads together and we work it out. It's messed up that your facility operates the way that it does and there is nothing you can do about it..... I believe all nurses in this area of nursing should be trained to work in LD, Nursery and PP to be able to rotate to all 3 units if need be. :nurse: :cool:

passionflower, BSN, MSN, RN · Mar 10, 2011

Been reading the comments left here and wanted to mention one thing and I'm not being harsh, Just being honest. After working postpartum for the last two years, the skills I came in with such as starting an IV are now suffering. I look for opportunities to engage my skills on my unit but find myself spending more time handing out pain meds and asking if the baby peed or pooped. Love postpartum and not putting it down, but you're not seriously gonna tell me that those nurses have sharper skills than L & D nurses who regularly start IV's, work in the OR and PACU. Sorry don't buy it.

digitalgirl20 · Mar 11, 2011

I've been a pp nurse for three years and its far off than being easy. Normally have 5-6 patients and ocassionally 7. It gets frustrating when you have to deal w/ that many patients and I think the misconception is that some think that most of our patients are healthy. However, that is not true. We do get those pts that went through high risk pregnancy and still have complications after their delivery.

I think its not fair to say that L&D nurses are better or PP are better. Each department/unit runs differently in every facility and I think like any other unit the level of stress, acuity of the patient or how busy the unit gets are all different. I have respect for the L&D nurses and also for my dept in postpartum.

tablefor9, RN · Mar 26, 2011

NawthNurse69...you did see that I am a LABOR RN, right? all kinds of crazy letters behind my name and closing in on 16 years of experience in front of it.

So, with that being said, I think I am qualified to say this: there are lazy, pathetic people in all kinds of nursing. Ever seen a labor RN who labored women from the desk? Couldn't even get off her butt to file a strip, instead *rolled* her chair to everything within reach? Wouldn't take a triage pt because she was "busy" with her one stable ptl?