Med/Surg RN required to care for L&D patients

[Pjun581]

I am a Med/Surg nurse with 20+ years' experience, recently due to budget cuts, my managers have mandated we begin caring for L & D Moms and babies. I am told this practice is a growing trend in healthcare. I feel L & D is a highly specialized area of nursing with great liability risks. My managers are mandating a 6 week on the job training course to prepare me for these new duties. Are there other nurses in a similar position and is this a new trend? Does anyone have comments or suggestions that I may use to support my reluctance to provide care for both Med/Surg and L&D/new borns.

[LR59]

Where are u located? I work in a small rural hospital am floated to L and D occasionally.

[Cuddleswithpuddles]

Hi pjun581,

I can't comment personally on working L&D but will you be working postpartum too? If so, I think it is a fairly easy area of nursing. Most if not all of your patients are walkie talkies and most postpartum problems in the mothers such as excessive bleeding and infection are easy to recognize by med-surg nurses. Babies may be a little trickier but they are healthy for the most part if they are in postpartum, couplet or newborn nursery units. They have different vital sign ranges, a unique set of reflexes, subtler cues and such but I think caring for a healthy baby is more than manageable after some reading and collaboration with experienced baby nurses. The meds are easy too. There's usually a list of usual orders and orders not in the "menu" usually involve antibiotics or meds for moms with chronic conditions like HTN. You are no stranger to those :)

[Orange Tree]

I work in med/surg, and we are occasionally floated to mother/baby (postpartum), but required only to care for the mothers. I wouldn't know what to do with a baby at this point, and I would flat out refuse to float to labor and delivery.

[brownbook]

I'm confused. Are you being trained to admit and assess mothers in labor? Put mothers on the monitor to assess contractions and fetal heart beats? That is a specialized area of nursing and I wouldn't feel comfortable with a med/surg nurse doing this.

If it is postpartum mothers and babies, that is 99% stable healthy patients. However they do need a lot of support and teaching.

[LR59]

When we float to L&D it is to care for post partum Moms and babies. we also had orientation to unit and duties. We do not care for laboring Moms. It is good to stretch our horizons especially in this job market, make ourselves more employable.

[klone, MSN, RN]

OP - is it L&D or is it postpartum? Two totally different beasts. A postpartum mother is really no different from any other med/surg patient, except for checking a fundus. Actually, a postpartum mother is much easier than the average m/s patient.

[edtgirl]

on the other hand, L&D is a highly specialized area.......things can turn sour quickly and you have to be physically able to run code pink.....

[KateRN1]

Are the internists (MDs) also going to be managing laboring moms? That would be my first question. And undoubtedly the answer would be, "But that is outside their scope of practice/knowledge base." And then I would be quick to point out that the same is true of nursing. The OBs want L&D nurses who are specialists and can assess their patients accordingly. Same with the internists. Get the docs on your side.

[vashtee, RN]

You are getting 6 weeks of training, which is about what I got as a new grad RN. Personally, I think I would be happy with the training. Who knows? You may like this field better.

[MomRN0913]

I have the same question, is it L&D, or postpartum Mother/baby?

When I was a med-surg float, it was my favorite assignment! When taking care of the post partum mothers I was always given stable patients and always had the resources of the other nurses. I sometimes got an antepartum patient who was being treated for something medical, and if fetal montioring was needed, the mother/baby nurse did it.

When taking care of babies, I just helped feed them and change their diapers. No blood draws and another mother/baby nurse needed to be there.

It was great. I loved it and even picked up OT there when they were short.

[ilmbg]

As I worked L&D for 15 years, along with other units, I see no reason to be worried about your new unit IF you have good crosstraining and someone looking over your shoulder routinely if it is indeed L&D. With all the crunching of jobs in todays world, you can figure you will be getting floated to different units. It is just a money number to the hospitals now. I hope you become comfortable and have good coworkers to support your jitters.