Long: Another newbie with an intro and very specific L&D questions

SmilingBluEyes · Apr 1, 2004

I have some very specific questions regarding L&D nursing:

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HI AND WELCOME, I am Debbie, an L and D nurse of 7 years' experience in Washington State. I will try to help you out here if I can.

1) Is it possible whether through pools or some other method to avoid the dreaded weekend shift or will that be a permanent part of my life?

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Ok, if you do L and D, count on working at least one or two weekends a month---- AND starting out on nightshift is a distinct possibility as a new nurse. You know as well as I, babies are born 24/7; they don't follow a banker's hours schedule. Yes, after a while in nursing, you can move to dayshift, but still do not count on Mon-Fri. work only. Ain't gonna happen------unless you are in a rare hospital.

One way that I can it may work out is if you can take up agency/travel assignments, perhaps, whereby you only work weekdays, (you can possibly make your schedule), but that is still after you get experience some place first. Most agencies do NOT want graduate nurses fresh from school, understandably. You just have to be prepared to pay your dues for a while before this happens. Even as per diem workers, we work at least 2 weekends a month everywhere I know of in my area. It's the nature of the beast, I am afraid. If you cannot work weekends, you best look somewhere else than L and D. Even nurses with over 20 years' experience are working weekends where I work. You will be, too.

2) If you believe in more natural birth options, what setting is best to work in and can you help out mothers in hospital settings to have their birth their way?

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I would recommend finding a birth center to work in where midwives are located and do deliveries. Some hospitals even have seperate family birth centers where natural birthing is encouraged and practiced, to include tub birthing and Bradley methods as well as having the presence of doulas for family support. Also, there are free-standing birth centers run by midwives that sometimes employ RN's to help out .....check it out. These are wonderful, gratifying places to work if you can get in. But again, they want EXPERIENCED RN's in their employ, esp. since they ARE free-standing and very well-developed assessment skills are a MUST.

3) Are there any Arizona L&D nurses on this forum? If so, how long is preceptorship out here?

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Sorry, I work in WA State, but used to live in Phoenix a while back. Good luck!

4) Can you come out of nursing school & immediately get into L&D or do you have to do med/surg or telemetry?

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I graduated nursing school in 1997, when a manager decided to take a chance on me and hire me, 3 months before I graduated. I got very lucky; most places do NOT want new grads in L and D, but some DO. Check around in the hospitals as you near graduation and get a feel for who has openings and is open to hiring a new grad. Network with L and D nurses and managers as much as possible, to get contacts and potential jobs later on!!!! Yes, you CAN go straight into L and D right out of school, if you play your cards right--- and a little luck comes in your favor.

5) What are the best and worst aspects of L&D nursing?

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What is possibly better than helping to assist in new life coming into the world? Seeing new families born? I can't think of a more exciting, priveledged and honorable area of nursing to work! I love what I do.

6) I wholeheartedly believe that birth is a natural process that should not be invaded by unnecessary medical interventions that are purely for the comfort of the physician or are simply preventative measures. Will my "natural" birthing outlook make my work difficult and or frustrating?

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I also believe in a woman's body to do the right things when allowed to.. ....BUT I have enough experience to know it does not always happen for many reasons......Largely, too, It can depend on where you work. Some places are much more progressive than others. Understand, in many hospitals, the c-section rate approaches or even exceeds 25% for many reasons. Can you deal with that? IF you choose hospital nursing, you will have to, trust me. It varies a lot by where you work. Again, birthing centers are probably the place for you, if you can find them. Check the bigger hospitals in your area and see how many midwives have priveleges there and IF they have a separate birth center. This does make a difference. But I do caution you to enter L and D with an OPEN mind; don't be closed and set before you enter this area of nursing. It's critical.

7) What is involved in preceptorship? What I mean is that my mother says that the hospital that you recieve your training at requires you to work for them for a certain amount of time after they specialty train you. Is this true? And for how long does that particular hospital "own" you after your specialty training is complete?

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Depends on the hospital. You need to ask THEM, cause again, this varies. Some offer better preceptorships than others. Check around. And it depends, too on what conditions in which you are hired. IF you take a sign-on bonus, they DO "own" you unless you pay it off if you leave early. Otherwise, just because you took up a speciality in the hospital, no, they do NOT "own" you.......but if you quit early-on, be prepared to explain why when you go looking for other work.

Hope this helps!!!! If you have more questions, please ask me here or via IM.

deb

Atensibilla · Apr 1, 2004

Hi Debbie:

Nice to meet you and thank you for all your help. It is very appreciated. I am so glad I found this forum. :rotfl: I have so many questions that I had no idea how to get answered and now I can finally get some clarity. For that, I apologize up front.....I will ask a LOT of questions. I feel it's necessary to ensure I am doing the right thing with my life.

It's not that I'm not willing to work weekends, just that I wanted to know if there were ways to either not do so at all or get around it with tenure. I am curious as to whether you can request specific weekends off. And, what about the pools, once I get my experience with preceptorship, can I go to work for a pool or agency & attain free weekends?

If not that, then is it possible to work in an Ob/Gyn's office after L&D and how does one get those coveted "office" jobs?

Also how difficult is it to change specialties? Say if I decide after 5 years in L&D that I want to do Oncology or Emergency or Anethestist?

Once again, my hugest thank you's.

Renee'

Dayray, RN · Apr 3, 2004

Atensibilla, hello and welcome to the boards.

Q1

Weekends can be a touchie subject on some floors. It might be possible for you to find a coworker that wants to work weekends and is willing to work all yours for you. However, it would probably be a good idea to plan on working some weekends and except that as a trade off for getting to work where you want too.

Q2

Although I have never worked in a true birth center or attended home births I would think they are the best for this. Although in the hospital you might be a real help to women who end up there in spite of wanting "natural child birth"

Q3

I'm not from Arizona but I would recommend you find a hospital with a nice long preceptors, theres allot to learn.

Q4

some places will hire you strait out of school. It's a topic of some debate (look back on the boards) but I think a year in nursing before going to L&D helps allot. I worked as an LPN for 1 year on PP, I also worked in EMS and many other areas before I was an LPN, L&D is the only place I've worked as an RN. I really think my past experiences helped prepare me for what I do now and sometimes wonder if I should have work a year med surg as an RN.

Q5

I could go on all day, For me the best part is the nurse patient relationship, I love people and in L&D you get to help people at one of the most difficult times of their life. You also get to share in one of the most beautiful and personal moments in their life. Other reasons, autonomy, learn new things all the time, babies (enough said), add to that challenge it's really hard and you can be proud of what you do.

Q6

This is the question I wanted to answer the most, because it's one I still ask myself quite often. I started out determined that natural low intervention child birth was the best way to do it. It's been almost 2 years now and my view has changed so many times and I don't think i could stand on either side of the fence. At times this question has tormented me and I've felt allot of guilt and disappointment over interventions.

The first hospital I worked at was pretty low on interventions c/s rate was 5 % , 40 % epidural rate and many many "natural patients". For the most part I loved it but I also saw the flip side in that some women were pushed to go natural because we didn't have anesthesia on deck. I also saw some bad outcomes or had to ship laboring patients out to larger cities because we didn't have the ability to preform the interventions they needed. the hospital I work at now is the largest and most advanced L&D in the state. Interventions happen all the time, many are unnecessary and I do my best to keep my patients from being exposed to to much too soon.

that being said the best advise I can offer you is too check them all out and to keep an open mind. Yes much of what we do is unnecessary however some of it is very important. You have to remember that many people died before there were medical interventions. It's true that the majority of the time things will be alright without any intervention but you do not want to be stuck in a situation that is the minority and not be prepared for it.

For some people natural child birth is very important for others labor is just means to geting a baby and they don't desire the "experance" of natural labor.

So now my view is ever changing and specific to each patient. It comes down to patient choice and safety of the baby.

Q7

most hospitals will train you without a commitment, at the time your grandmother was training that was probably a requirement but the nursing shortage has changed that in most cases.

BBnurse34 · Apr 3, 2004

St. Joseph's in Phoenix offers nurse externships in many areas including L&D. They work part time during the school year and full time in the summer for about $11 an hour. You are required to work as an RN for them the same ammount of time that you were an extern. They offer lots of classes and free (actually you get paid) NCLEX reviews to nurse externs.

As for the weekend issue, St Joe's went to a premium Baylor weekend plan. So everyone wants to work weekends. Most new hires will not work weekends.

Other hospitals may have similar programs.

Pools or registry will not utilize someone for L&D without experience.

Email me if you need for info on woman and infant nursing in AZ