New OB Nurses, Grads and Students, Please Feel Free to post your questions here:

Hi,

I'm a student nurse with 2 semesters to go Hurray!!! I received an externship for the summer in L&D and I'm thrilled because I love it! My question is to all of you..........I keep hearing that I should not go right into L&D after graduation because I need to build my med/surg skills and get a foundation before I specialize. I'd just like some feedback from all of you. Did any of you start in L&D right after graduation? Did you stay there? This has been my favorite rotation by far and I've always wanted to work in this area, but it's deflating to hear these comments because I thought I'd go right into this area after graduation if the opportunity presented itself. This is the main reason I applied for the externship, to gain as much experience as possible before graduation. Anyways, any insight is greatly appreciated. I can't wait to be where all of you are, I'm loving nursing school, even though it's difficult, it's bittersweet!

Medsurg vs. a specialty after graduation is sort of an ever-prestent debate.

The whole reason I went to nursing school was to work in L&D so I went straight there and haven't regretted it a bit. I can appreciate how maybe going to medsurg first would give you a lot of skills, but I haven't found that to be necessary for my work. I have never once wished that I went to another area first. I had doubts when I was at your stage, but it didn't take me long to be glad I went straight to L&D.

And you will do some medsurg work even in L&D... in my short time I've had patients with pneumonia, on insulin drips, liver problems, gallbladders, appendicitis, asthma, addicts/ recovering addicts on methdadone, ITP, hep c, MRSA, scabies, epilepsy, STD's, kidney, heart, thyroid...

Hi, this is my first post here. I have just finished my senior year of nursing school and am trying to find my niche. I found my OB rotation exhilerating. I especially enjoyed the postpartum teaching and the smaller patient ratios.

I one major problem while I was on this rotation, however. The hospital I was in is in a low socioeconomic climate and one in 4 babies were born with drugs in their system (no exaggeration). Mostly methamphetamines. I found this difficult to stomach. I felt such disdain for the mothers who would do such a thing to their child. When I would see some breast feed (which is adding neurotoxins into the newborn's system) I felt that I was witnessing unchecked child abuse.

Normally I am a person of great empathy. But I just couldn't find a line of logic to guide me through being nonjudgmental in this situation. I hate to admit this but when I looked at the babies all I could think of was the misery that lay ahead for them being raised by a drug addict and how they would likely be back in 15 years repeating this cycle.

How do you guys deal with this phenomenon psychologically? How do you administer care that you feel is appropriate without getting burnt out? How much do most birth centers deal with this- on a daily basis? A weekly basis?

I really want to be an OB nurse but this is something I need to work out first. Please let me know your thoughts and advice.

How do you guys deal with this phenomenon psychologically? How do you administer care that you feel is appropriate without getting burnt out? How much do most birth centers deal with this- on a daily basis? A weekly basis?

I deal by choosing not to work in a large city hospital. I could have worked in a larger hospital but knew that I would have to deal with more of these types of situations. Even at my small hospital I see some drug addiction/poor mom's giving birth. But most of our patient's are nice, married couples. We are close to a military base so we get 50% of our patient's from there. I would be like you and not able to deal with patient's like that on a daily basis. Once or twice a year is enough for me!!!

Could you change to a different hospital?

Yeah, I'm most likely going to be starting at a hospital in a different area entirely. The hospital I did this clinical is in the "big city" (a joke, it has 30,000 people, but it is the major city for over a hundred miles around) in very rural county. There are some very poor areas (and a few well to do areas) around and this is the largest/main hospital.

While there were only perhaps 4-8 women/couplets at a time, never a clinical day went by that one wasn't meth positive. There would also be women that were THC positive but that was not considered a big deal at all. The nurses were pretty casual about the meth moms because it was so common that they had to become callous. Child Protective Services would only take the child away if the mom was positive for meth and she was homeless or if she had a history of her other children being taken away (permanently) for abuse. These moms I actually felt compassion for because I could empathize without feeling I was taking part in something that is morally wrong.

I was really surprised that I didn't see any other posts about this since this probably the top reason nurses in other fields have for not going into OB.

I mean I could handle it sometimes, it comes with the territory, but I'd rather not EVERY day.

What type of facilities would you think have the least/most of this. You mentioned big city hospitals as one... (I'd imagine specialized birth centers would be entirely free of this issue, but I don't think they take newbies.)

Thanks for your response. Obviously this is something big in my mind and I appreciate you taking the time.

Can someone tell me what licensure/schooling I would need to work in the postpartum area?

Nursing student- I would think birthing centers would be pretty free from drug abusers. Since most of those mom's tend to be au natural/married women. I work in a small town (18,000) but it is also a university town so our population doubles when school is in session. And like I said we do have our share of drug users but most are marijuana. I have NEVER (5 years) seen a meth user.

I guess you need to decide what is important to you. The experience of the big city hospitals or the slower pace of the more rural ones. There are perks for both.

Good luck and I hope you can find a place that makes you happy/comfortable where you can give great care to your patients.

Rileysmom- We use LPN's to do some of our postpartum care. I know a lot of hospitals do not use LPN's and only RN's. And then we are required to have NRP and BLS for PP nurses.

Can I ask what are NRP & BLS?

Hi all, I'm new to this forum--just graduated with my BSN and passed my NCLEX and now beginning my REAL job on Tuesday on the L&D floor in a Level 1 Trauma Center Hospital.

My question is (and forgive me if it's already been posted on this thread...but 48 pgs of comments is a little much to try and read thru lol :) ) what advice do you have for a BRAND NEW RN beginning in L&D?

My orientation is 6 weeks, our patient ratio is 2:1--and everyone I know who has done clinicals or worked on that floor think the RNs there are an amazing team and train others well....and the nurse I'm precepting with I've heard is AMAZING (YAY!)

I'm so excited--and humbled I'm starting in my favorite specialty--and want to be the best L&D nurse

So....suggestions? Thanks for taking the time to answer this....

My question is (and forgive me if it's already been posted on this thread...but 48 pgs of comments is a little much to try and read thru lol :) ) what advice do you have for a BRAND NEW RN beginning in L&D?

My orientation is 6 weeks, our patient ratio is 2:1--and everyone I know who has done clinicals or worked on that floor think the RNs there are an amazing team and train others well....and the nurse I'm precepting with I've heard is AMAZING (YAY!)

You'll be on orientation for only 6 weeks?? As a new grad???

Sorry, but IMO, that's not nearly enough. Maybe if you had a strong nursing background...but not as a new grad. No way.

This is nothing against you, so please don't take it the wrong way.

Post this in the OB forum (not in a sticky) and see what the others think. Maybe I'm just over tired and cranky.

You'll be on orientation for only 6 weeks?? As a new grad???

Sorry, but IMO, that's not nearly enough. Maybe if you had a strong nursing background...but not as a new grad. No way.

This is nothing against you, so please don't take it the wrong way.

Post this in the OB forum (not in a sticky) and see what the others think. Maybe I'm just over tired and cranky.

I agree that 6 weeks is too short, but when I got to talk with the nurses during my interview they assured me it is more of a team effort. It is a teaching (University) hospital, with interns always on the floor...and one of the nurses who had been on "her own" for about 2 months stated also it felt more like a team, and never did she feel like she was on her own....

Anyway...you didn't really answer my question about what your suggestions for me would be as a new grad...moving on...??

Thank you so much for this thread. I have just completed my OB rotation and semester of class, and I think this is a wonderful thread. I think I have found my calling in nursing. Mother/baby is where I belong. :) I was in L&D (labor and delivery) and in the OB OR and I have to say, the beginning of life out of the womb is amazing. This rotation makes me happy to have picked nursing as my career. :)

Hi all,

I am a student nurse currently doing a project on prenatal alcohol exposure. I was looking for any information that can be shared about experiences caring for mothers with known alcohol abuse during pregnancy. Also, I would like to know about the care of infants born after prenatal alcohol abuse.

Are there any special services offered to help the mother with her addiction?

Are there services that help keep mother and baby together or, from your experience do the majority of mothers loose custody of their child?

Any information would be greatly appreciated