Med Surge to Mother- Baby unit

[EmIly Grace, BSN, RN]

Hi all!

So I am a relatively new nurse- started on a med surge floor around five months ago.

While I love the management on my floor and take a lot of pride in the hospital that I work at, I’ve always known Med Surge wasn’t for me. I wasn't entirely sure what I wanted to do after graduating so I figured starting out here would be a good idea.

There are a lot of days where I absolutely dread going into work and I can’t say I’ve ever felt “excited” or even happy to go in. A month or so ago I bought a Postpartum Nursing book and began studying it to see if the topic interested me. On a day where I felt particularly down about my job I applied to a mother baby unit at another hospital.

I didn’t think I would even be considered considering my lack of experience but I have an interview next week. While I haven’t even been offered the job yet clearly I’m very torn if this is a good idea.

I know I shouldn’t pay attention to posts like this but on a nursing Instagram I recently saw a bunch of posts saying “mother baby is where nurses go to die.” I’ve always been interested in L and D and postpartum and plan to continue my education and get my masters and do some work either with women’s health or public health.

I’m nervous working on this unit would box me in and cause me to lose skills/ not develop further nursing skills. But I’ve always had a passion for education and prevention and would love to work on a unit I feel more passionate about and then perhaps be more involved in the unit.

Another thing is this hospital is not nearly as established as the hospital I currently work at. Also I feel guilty leaving my job after only a few months there. I understand that’s a lot of money wasted on my orientation.

I just want to be happy with my work and do something I’m more passionate about but I’m worried about making the wrong move. Clearly I am going back and forth in the topic.

opinions anyone?

thanks in advance!

[ThatTallNurse, ADN, RN]

Mother Baby is certainly not where nurses “go to die”. Postpartum nursing requires a lot of critical thinking and as you mentioned educational skills. You will need to think fast on your feet in emergency situations. I’ve been in postpartum a little over 3 months and I’ve seen multiple hemorrhages and a dehisced c-section as well as a case of postpartum pre-eclampsia that nearly ended in a transfer to ICU. I am lucky because my postpartum unit also doubles as the antepartum unit so I get lots of cool experience with PROMs, high-risk multiples, etc.

Our nursery is separate from NICU and postpartum but it’s similar to a Level 2 NICU so it depends on how high the acuity of your mom baby unit is I guess, but our nursery nurses start umbilical lines and peripheral IVs and catch babies at deliveries etc. they certainly are sharpening a number of nursing skills there. Not to mention newborn assessment is quite the skill in itself!!! I’ve started to orient to the NICU (I’m an LVN but they have us practicing at the top of our licenses due to the nursing shortage) and newborn assessment is a challenge (but a fun one)!

if you’re really passionate about postpartum it’s a very rewarding specialty. I wouldn’t do anything else, except maybe L&D when I finish my RN. I promise you it’s not just passing Motrin and Colace out like people seem to think. ?

[iPink, BSN, RN]

When I first started as a GN, I worked PCU, which is a step-down ICU unit. I was there for 11 months and moved into Mother/Baby. I’ve now been here for 6 years. My 11 months on PCU prepared me for blood transfusions, electrolyte replacements, Postop surgical checks, cardiac issues such as hypertensive crisis, insulin checks such as sliding scales, knowing the difference between NPH, Humalog and Humilin, and knowing hypoglycemic protocols. I had to learn what to do in a postpartum hemorrhage, the meds and knowing which meds are contraindicated in a HTN patient during a hemorrhage vs an asthmatic patient during a hemorrhage.

I went from a high acuity critical care floor to a high risk med-surge where we receive patients other hospitals can’t handle due to patients complications. Most hospitals don’t get patients on Mag sulfate on their mother/baby floor. They usually send those patients to WICU. In my hospital, we get many of those types of patients on our mother/baby floor daily. We have 4 mother/baby units, making us top 3 largest in the country. We have between 15-18k deliveries per year.

I am a preceptor and Charge nurse and I’ve seen ICU and Med surge nurses get overwhelmed when they come to my floor. I can’t speak for other hospitals but my hospital is not where nurses come to die. Many feel like their going to die due to the amount of work taking care of four couplets (8 patients) with many of our patients being high acuity.

[klone, MSN, RN]

I have tremendous respect for my mom/baby nurses. Not only is it incredibly busy (typical assignment is 6-8 patients, often with total care, I.e. no CNAs), but a freshly stable mom (or baby) can become unstable very quickly (postpartum hemorrhage, postpartum pre-eclampsia, hypoglycemia, respiratory distress, etc). We rely SO MUCH on the postpartum nurses' keen assessment skills to be able to identify when a mom or baby is starting to go south. NEVER believe that a postpartum nurse is "less than". They're superheroes in my book. Also, never believe that you will "lose skills" in mom/baby. You will just gain DIFFERENT skills, just like any other specialty.

[klone, MSN, RN]

In fact, this thread has made me realize that I'm not giving enough love and appreciation to my mom/baby nurses. They're the unsung heroes of the hospital. My Friday email to my staff this week will be to recognize and sing the praises of the mom/baby nurses, because they don't get the "sexy" stuff like the L&D nurses, but they freakin' work HARD and are so good at what they do!

So thank you for starting this thread!

[LibraSunCNM, BSN, MSN, CNM]

I agree, I worked in Mother/Baby for 3 years and it was less stressful than Med/Surg, in that my patients were more stable, but I HUSTLED. Usually 4 couplets, sometimes a group of 6-7 couplets with the "assistance" of a CNA (please ?). It was a Baby Friendly hospital so there was a huge emphasis on breastfeeding assistance, and it was a wealthier clientele so they had high needs and expectations. I've heard many nurses dismiss postpartum as a complete joke, and I do think at other hospitals the culture may be that postpartum nurses barely do much, but that was definitely not my experience. If you have a passion for education and you work on a unit with a good team, you'll love it.