Labor as a spring board to acute care?

ThePrincessBride, MSN, RN, NP · May 28, 2018

Many new grads would kill for a job offer in labor and delivery (which is definitely an acute care specialty, by the way).

If you don't want it, let someone who does have it.

jcol1460 · May 28, 2018

Many new grads would kill for a job offer in labor and delivery (which is definitely an acute care specialty, by the way).
If you don't want it, let someone who does have it.

I never said I didn't want it.....it is a speciality I like and applied for specifically. But that doesn't mean I don't have interests in other specialties as well. Really just curious how transferable the skills a L&D Nurse are to other areas of critical care.

SmilingBluEyes · May 29, 2018

ICU is rough. The lower pt-nurse ratios exist for a reason.

I would really think twice. It's far from easy and you will run like a chicken without a head there believe me.

It's about level of acuity and even in ICU the ratios are as high as 3:1 or 4:1 with titrating drips, hourly vital signs, total care (meaning you toilet, bathe and change linens). L/D is NOTHING like ICU/CCU.

Coffee Nurse, BSN, RN · May 29, 2018

Just to say, I'd hazard a guess that the majority of high-risk pregnancies are to do with the baby, not the mom, and as an L&D nurse you'll have little to nothing to do with a NICU-bound baby (one with an antenatal diagnosis, anyway).

turtlesRcool · May 29, 2018

When I was in nursing school, a classmate and I both really wanted to go into L&D. We were on a med-surg (ortho/neuro) floor at the time, and I remember the nurse manager saying that if we went into L&D to make sure that was REALLY what we wanted, because once you're there, you're there. I'm not saying it isn't possible to move from L&D to another unit, because it is, but it's definitely not a spring board to something else.

Every once in a while you'll get a mother with comorbidities that need to be managed or a c-section that gets complications, but for the most part, you're not going to see the disease processes that you'll be expected to be on top of in an ICU. For the most part, your patients will be healthy in L&D.

If you think you want critical care, you'd be much better served in a position where you're taking care of sick people. Look at med-surg, telemetry, etc. Yes, sometimes med-surg does feel like one big med pass, but it's a great place to learn time management, and you'll see many different disease processes passing through. Med-surg is much more likely to be a springboard to critical care than L&D is.

Of course, there's nothing wrong with going into L&D, if that's what you want. Many nurses spend years trying to get a foot in the door there because it is a very sought-after specialty in its own right. But if you take the L&D job it should be because you think that's the job you want for the foreseeable future, not because you think it's going to get you closer to ICU.

klone, MSN, RN · May 29, 2018

FWIW, if you work at a hospital in a community that has a nursing shortage, then it should not be difficult moving from one specialty to another. We have a nurse who started out in ICU, then trained in L&D for a few years, then went to ED. Every department was happy to have her, because having an experienced nurse applying for an open position (as opposed to a new grad) is a rarity.

So no, I wouldn't say it's the kiss of death necessarily, depending on where you live. But the skills you learn in L&D are not necessarily transferrable to other specialties.

ICU-BSN · May 29, 2018

L&D will not be a springboard to ICU. Two very different specialties.

If your reason for liking ICU is simply the ratio, then ICU is not the place for you. That ratio exists for a reason. I've had many nights where I had just one patient and I spent the night running my behind off because sometimes they are just that much work.

I think you need to do some soul searching and determine where your interests actually lie before you accept a job. Otherwise you many end up miserable.

mrf0609 · May 29, 2018

As others have stated, L&D is a specialty. It would not be a good way to go into critical care. One year in med/surg will give you the experience that will help you move on to other specialties. I do not recommend going the mother/baby route unless that is where you want to be. Good luck on your path!

NurseSpeedy, ADN, LPN, RN · May 29, 2018

Will it be a springboard, no.

Will it be a job that you can make a career out of and enjoy? You said you were interested in the specialty and have the possibility of working it...I cannot tell you how many people would jump at the chance for that position. When I went to school our instructor told us that L&D was a position that was one of the hardest to get because nurses that have those positions don't ever leave-because they love-or at least like-their job.

If you truly don't want to be doing this later then allow someone else their dream job. However, if you can see yourself in L&D as a career I wouldn't turn it down. The opportunity may not be there later on when you think about trying for it later. I've seen many nurses work one year in acute care as a floor nurse and then transition into critical care.

jcol1460 · May 29, 2018

I accepted the position today. It was a difficult decision for many reasons, but I'm happy with the decision I made.

Thank you everybody who chimed in with your thoughts. It definitely helps having a sounding board. Now I'm off to go catch some babies í ½í¸„.

Sour Lemon · May 29, 2018

I accepted the position today. It was a difficult decision for many reasons, but I'm happy with the decision I made.
Thank you everybody who chimed in with your thoughts. It definitely helps having a sounding board. Now I'm off to go catch some babies ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½.

Congratulations!

headofcurls, BSN, RN · May 30, 2018

Congratulations! Let us know if you end up changing into critical care. The great thing about nursing is you can move around. Although, I did find it challenging to move from women's health to critical care (after several applications, I finally got my foot in the door).