NICU to L&D/MB and Vice Versa

nursejessica16 · Apr 7, 2018

I've been a RN for about 2 years now and I started as a new grad in Nursery, did Mother/Baby for a few months, and now currently working in Transition and Level 2 NICU. Though not impossible, I honestly think it would be hard to transition from NICU to L&D just because, even though they are interconnected, they are both highly specialized in different ways. The L&D RN focuses on the mom, laboring of mom, baby in utero, delivery of baby (vag or c/s), monitoring of mom post-delivery etc etc. The NICU RN focuses on caring for the sick baby whether it's preemies, feeder-growers, babies on O2/ventilators, phototherapy, needing IV medications, etc etc. As you can imagine the two fields require highly different types of training and certain skill sets and assessments... a mom can tell you how she's feeling, a baby can't. I would imagine in most hospitals a RN moving from NICU to L&D or vice versa would require the same amount of training a new grad RN would receive going into either speciality due to how highly specialized those areas are.

Likewise, I have seen a lot of nurses move from Mother/Baby to L&D and/or Mother/Baby to NICU which is what I would recommend! Caring for the post-partum mom is a good stepping stone to L&D because you'll know certain medications, doing fundal checks, and monitoring for HTN/spinal headaches/bleeding, etc. Also caring for well-babies in Mother/Baby is a good stepping stone to NICU because you'll get a good of understanding of how to help moms with breastfeeding, breastpumping, drawing blood, and assessments. Knowing what a well-baby looks like is key into assessing and knowing what to look for in sick babies.

If you're interested in babies and L&D, another alternative is being a Transition nurse. This is the RN that attends and "catches" the baby during deliveries and is primarily responsible for stabilizing the baby once it is born per NRP protocol, assigning APGARs, doing the initial assessment, monitoring baby post-delivery, eyes & thighs, etc. Definitely can be nerve-wracking but also a very exciting and rewarding experience at the same time.

Hope this helps :) Good luck in your future nursing endeavors!

Lizziepooh · May 22, 2018

Following because I am wanting to do the same! I have been working my first nursing job in an OB unit that does labor and delivery and postpartum care for about 11 months now and I am wanting to switch to a NICU! I agree with nursejessica16 in that I think it would be better to start in an OB unit and then going to NICU even though I haven't done it yet. I think OB gives you a mix of the specialized while you still use some med/surg knowledge. I think it has given me a good foundation to build upon when I get the opportunity to further specialize in the NICU.

labordude, BSN, RN · Jun 4, 2018

I was a NICU nurse for 10 years prior to moving to L&D. I found that even though there was a mindset change (other than the fact that you can't see your 2nd patient - the baby), having the foundational understanding of neonatal physiology and the impacts of labor/delivery related events really helped. What I would recommend is learning fetal monitoring, it will open up your eyes to a new understanding of intrapartum physiologic impacts to the baby and how you can prepare while in the NICU. Ask to shadow the L&D nurses and attend as many deliveries as you can. It can be done, it just requires a different thought process.

starlight88 · Sep 1, 2018

labordude, can you talk more about moving from NICU to L&D? How were you able to make a successful transition to L&D? I'm really interested in going to L&D, but there is an opening in the NICU. What other recommendations do you have to make the transition?

labordude, BSN, RN · Sep 2, 2018

labordude, can you talk more about moving from NICU to L&D? How were you able to make a successful transition to L&D? I'm really interested in going to L&D, but there is an opening in the NICU. What other recommendations do you have to make the transition?

Is "because I'm awesome" an answer?

^^^That's definitely true, but I really didn't find the transition hard at all. I was actually able to spend less time focused on learning about the baby (I was already comfortable caring for them) and more time learning about caring for the mom and reading strips and helping bring the tiny human out of the big human. If you are NOT currently in NICU and you want L&D, I would not switch to NICU. It takes about 2 years to get comfortable in the NICU (as well as L&D) and your med/surg background is helpful when it comes to moving to L&D as well. For one, you likely have great time management skills which are more important in L&D than you would think. My recommendation for making the transition once you have the position are listen up and pay attention. You work med/surg and L&D is a totally different mindset, even though some of your skills might transfer. It is a world unto itself, but it's crazy cool and fun 99% of the time. The other 1% sucks. Get a preceptor that matches you. Not everyone that has experience should be or can be a good preceptor, there really is a mindset that they need too. If you end up at my hospital, I'll train you up right!