Mother Baby/ Nursery/Labor and Delivery Nurses

NICU_Nurse, BSN, RN · Jun 24, 2003

Hi! Welcome to the boards! You might want to try posting in the Ob/GYN or NICU forums; there are a lot of nurses who may be able to give you more information on those specialty forums. You can find them on the main forum page or click here:

Ob/GYN

NICU

A lot of people have posted their experiences and stories and questions in those forums.

If you don't want to work with the sick or premature babies, you wouldn't be interested in the NICU, but the newborn nursery (sometimes called "Well Baby", sometimes called "Level I") might be for you. Though, remember, those babies get sick too! In that type of nursery you would be working with primarily babies (although you certainly have interaction with the families).

If you were wanting to work with adults as well, you might consider a hospital that offers "Mother/Baby" nursing or "Couplet" nursing, where your assignment consists of a pair of patients- one mom, and her baby.

I would definitely have to say that I don't feel it is any easier than working in a "regular" unit. Our newborn nursery is extremely busy, and it's not uncommon for a nurse to have seven or eight babies per assignment. Consider that those are infants, who know no schedules, may have treatments/tests/medications in addition to routine newborn care, may have feeding issues, don't sleep when you want them to (they don't know what naptime is!), and that these assignments include new admits which happen at any time (you can frequently get more than one new admit per nurse per shift), and that you have to work not only with the babies but with their parents (issues like breastfeeding/basic education/discharge education/etc.) and I think most would agree that it's no easier. Babies need healthcare, too!

Have you done your maternal/child rotation in school yet?

Have you considered working as a volunteer, tech, or CNA on one of these units to get your foot in the door and get some exposure?

Just things for you to consider while you're in school.

SmilingBluEyes · Jun 24, 2003

I know just the trick:

YOU want a job in Post partum nursing then. Yes, that would fill the bill for you. A large or semi-large hospital where there is a separate post-partum or mother-baby unit would be for you, I think.

HOWEVER, *first * get through nursing school, all your rotations, and THEN decide. It will happen as it is supposed to.

Like the poster before me said, there is a world of experiences in our archives in the OB/GYN nursing boards. Take the time to peruse them. There is so much interesting reading there.

I wish you well in your schooling and future career!

NICU_Nurse, BSN, RN · Jun 24, 2003

Oh, Deb, good point! I was totally gung-ho about L&D until my rotation in nursing school, and then I realized it wasn't really for me. I entered nursing school planning to become a CNM, but found my niche along the way and abandoned that for something better suited to me. Get thee to the OB/GYN forum!

webbiedebbie · Jun 24, 2003

Dear wannabe...we work just as hard in Postpartum. Some mothers are sick and need IV antibiotics, etc. We had two patients with NG tubes. (We also take GYN patients). Some come to us after surgery, so we are responsible for frequent vital signs, assessments, Foleys, IV's, etc. We do a lot of teaching, too!

I agree with the above posts. Good luck and I look forward to seeing you in the OB/GYN forum!

SmilingBluEyes · Jun 24, 2003

No unit is "easy" ---

If you are looking for "easy" , don't go into nursing, period. Personally, I LOVE LDRP. It provides the variety I want and need. I also do GYN surgical nursing. never boring this way, doing labor, delivery, pp, and baby as well as surgical is never boring --

Or "easy".

Hardknox · Jun 24, 2003

This was posted in the "Would you ever strike" thread and gives another perspective about who might be taking care of well mother/baby couplets in the future if administration can get away with it.

Quote

Our hospital informed us about a month ago that we would be undergoing a "restructure" in which more nac's would be hired to work as care pairs with RN's. The RN load would be increased and some positions eliminated. LPN's will be hired to work with healthy mother baby couplets in CBC and RN positions would be eliminated there as well....there is much more to this story....The hospital in an article in the local paper insists that excellent patient care will continue...we were told that there is a budget shortfall and this is being done to save money...tempers are flaring the union is involved...and we are waiting for what will happen next.

I know our hospital was thinking of doing this when I left.

wannanbnurse · Jul 8, 2003

I just got these responses, so I just want to say thanks to all that responded....No I havent went through my training yet, but I will be soon!!!!

mother/babyRN, RN · Jul 8, 2003

Try everything once and after you graduate and have experienced all levels of nursing, or at least many, then figure it out...Working post partum or a well nursery does NOT guarantee a healthy baby..They can crash at any time at all times...Believe me, WE can attest to that, so if the nursery is something you want to do, even now be aware that you have to be acutely aware of the things that can and often do, go wrong...I hope you enjoy nursing and eventually end up where you want to go....

Tiki_Torch · Jul 8, 2003

Dear Wannanbnurse,

You've received some excellent responses to your thread!

Warning, this post got a bit lengthy as I typed...sorry... :rolleyes:

Here is a little bit about my experience~~~

I worked many years on a Mother-Baby Unit as an RN. We encouraged Moms to keep their babies in their rooms as much as they felt comfortable doing to facilitate bonding and newborn baby care learning, etc. Our nursery was usually staffed by a nursing assistant who was present int he nursery anytime a baby was there. If no babies were in the nursery, the assistant would come out onto the floor to help with vital signs, passing ice, and other nursing assistant duties.

Each RN or LPN was assigned between 3-5 Moms and babies (called couplets). We also had Moms who were stable undelivered Moms so they didn't have babies yet. The RNs and LPNs were responsible for assessing the babies and Moms assigned to them each shift and to do any nursing care and certain treatments for each Mom and her baby. If the baby is on IV or other meds, the RN or LPN is responsible that these meds are given. On our unit, the LPNs couldn't give IV meds to babies but they were to make sure the RN in charge was aware and gave the medicine on time. If a Mom and baby were having difficulties learning to breastfeed, it was up to the nurse assigned to that couplet to assist them. We of course helped each other, but let me tell you, this one intervention can take up a LOT of time! Also you never know when a call light will ring and all of a sudden you are in the middle of a Mom's life threatening hemorrhage. The Mother-Baby unit (Postpartum Unit) is not all "easy" or "fun" as many people tend to think. There are medical emergencies of all kinds, tons of emotional issues to deal with, and more things than I can begin to tell you about here. I'd often smile to myself when folks would get all drippy sweet and say something like, "Oh, you get to sit around and feed babies all night." They had absolutely no clue of what all went on during a shift! I'd answer with a smile and say something like, "Yes, we do get to feed a baby once in a while and that's the highlight of our night, but we do accomplish a lot more than that during our shifts."

During the night shift nearly all babies returned to the nursery for baths, weights and usually a very thorough assessment was done at this time. Some babies returned to the Mom's room... usually breastfed babies and a few bottle fed ones. Interestingly, by around 3 am, most parents had sent their babies back to the nursery because they felt they could sleep better that way. Most parents kept their babies in their rooms for the first 24 hours because they were so excited and all, but by the time they had been basically awake for about 30 hours, they were exhausted and we would recognize this and would encourage them to let their babies return to the nursery for a few hours so they could get some rest to help their bodies heal. Often they simply needed a nurse to let them know that it's ok to let the baby spend some time in the nursery.

Anyway, the most fun time for hanging out with babies was in the middle of the night. By the time we had "put the Moms to bed", we had most of our charting done and had eaten our lunch, nearly all of us would go to the nursery and help by feeding babies. The nursery was exactly across from our nurses station so some of us would bring a bassinet with a baby and bottle out to the nurses station and we'd sit around feeding babies. Yes, it was wonderful joy as you can imagine. Of course it wasn't all a piece of cake mind you! Newborns often are very poor eaters because they are still learning to suck-swallow-breathe and often full of mucus they need to vomit before they get the hang of eating. Also, we need to be on constant alert for any abnormalities which often don't show up until the baby is a few hours or days old. Some of these abnormalities can be life threatening too, as you'll learn in school. By the way, the nursing assistants needed our help to feel all those babies too.

As the Charge RN, I had to be sure that not only were my patients (couplets) cared for, but that all other nurses and assistant's shifts were going well, and if not, I was responsible for making any necessary changes to see that whatever needed to be done to help was done. We all stayed quite busy all shift! Often we had shifts where we didn't get much of a lunch and maybe went to the rest room once. I hear this is often true of nurses who work on Med-Surg floors as well as all other floors and intensive care units.

All in all, I loved the Mother-Baby unit because is was incredibly emotionally rewarding to help parents and their babies bond. My story is just one example of one Mother-Baby unit nurse's experience.

We had several student nurses working in our unit too and if this is an option for you I'd highly suggest you look into it. There is nothing like actually being in the trenches to let you know how you'd enjoy the work. If you do this, while you are working, take time to observe the other nurses as they work so you can realistically see what your future would entail. I wish you all the best in your nursing career and joy in whatever position you choose! :)

I just wanted to add that, in my experience, the L&D nurses didn't get to enjoy the babies much because they only got to spend up to 2 hours with the babies before they were sent to the Transition Nursery for observation in route to the Mother-Baby Nursery. The best of both worlds, I believe, would be the LDRP Units where the Moms are admitted to one room where they go through labor, delivery, recovery and postpartum care and stay there until they are discharged home. Often when a nurse is assigned to the Mom on admission, they get to be her nurse until discharge. This is really rewarding and a fine example of "primary care nursing" because you are able to really know your couplet and their care is not as easily fragmented. Unfortunately our hospital was too large (had too many deliveries) to be able to do the LDRP thing. I found my true love in the NICU after working on the Mother-Baby unit but you must understand that these are usually sick babies or babies that need to gain weight in order to go home... they need more care than normal healthy newborns. I know of one Well Baby Nursery in our area which has a separate Postpartum Unit. This nursery is staffed by Nursing Assistants and has one RN assigned to each shift. The RN transitions the new babies for a few hours and helps Moms with breastfeeding and answers any baby-related questions the parents have as well as doing all assessments and medicines, etc. for the babies. The Assistants do to bulk of the feeding, diapering and bathing. The RNs in that Well Baby Nursery have been there for YEARS and don't plan on leaving anytime soon. I'd imagine most Well Baby Nurseries are run in a similar manner.

Ok, I'll shut up now! :chuckle

wannanbnurse · Jul 9, 2003

Thank you Tiki_Torch for the response you gave me and to everyone else i forgot to mention.I really want to work with babies only.....but I know that I'm too soft hearted to work with sick babies, or babies with facial malfunctions, etc....I dont know if i could handle all that , thats why i wondered about the well baby nursery.Im aware that things could go wrong with healthy babies, just like a healthy adult, but anyways, before i go yapping i'll end this ....thanks, I'll definitely look into trying it out first.