OB CRITICAL CARE

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I can't believe some of the answers to "Is Labor and Delivery " considered a specialty ! People believe we just sit around and hold babies? Really! I have been a surgical Scrub for 15 years in labor and delivery and it is ABSOLUTELY! A specialty, if it wasn't ER wouldn't panick and send PT's up ASAP! Because they don't want to deal with it! I have seen many many normal pregnancies and deliveries go bad real quick! And you better hope your nurse is skilled enough to handle not one but 2 patients! There are so many things that can go wrong . It is a very highly skilled department! Which takes years to feel confident in this field, which is why we have such a high turn over rate with new nurses, the nurses who believed it was an easy job and thinking all they would be doing is delivering happy healthy babies with happy healthy mothers. I PRAISE our L&D nurses Doctors and Techs!!

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Specializes in Nurse Leader specializing in Labor & Delivery.

Who says L&D is not a specialty?

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Specializes in L&D, OBED, NICU, Lactation.
Who says L&D is not a specialty?

I've never heard anyone say that it's not a specialty. On top of that, everywhere I work it's considered critical care right up with ER, ICU, and OR.

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I do not consider OR or OB critical care overall.

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In some high acuity cases nurses are taking care of pregnant women along with all their co morbidities, the antepartum(pre-delivery) patients come with all their med-surg issues with pregnancy on top of that. Heart conditions, long term illnesses, psychiatric, pregnancy induced diseases you will find them all in a labor and delivery department. I'll admit that the L&D is not as acute as ICU; however, there have been so many times where the L&D nurses have to know how to stabilize a very sick patient before transporting to more critical care areas. People seem surprised when nursses mention women with insulin drips and PICC lines in some of the high acuity L&D units.

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Specializes in Nurse Leader specializing in Labor & Delivery.
I do not consider OR or OB critical care overall.

I beg to differ. L&D absolutely is critical care. Staffing is 1:1. Statistically, birth is the most dangerous "normal" event that a person will ever encounter in their life (both as an infant and as a birthing woman), as far as the risk of morbidity and mortality.

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I beg to differ. L&D absolutely is critical care. Staffing is 1:1. Statistically, birth is the most dangerous "normal" event that a person will ever encounter in their life (both as an infant and as a birthing woman), as far as the risk of morbidity and mortality.

Staffing does not determine critical care. Neither does high stakes. A circulator in a heart room isn't doing critical care anymore than an L and D nurse is and that is 1:1 and "dangerous" for the patient too. But they're both doing important jobs, so, there's that.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Fair enough. I still disagree that L&D is not critical care, but you're free to disagree with me. :)

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I beg to differ. L&D absolutely is critical care.

Not in my opinion. L&D is not critical care.

The labor RN is not titrating multiple vasoactive medications at a time maxed out at the highest dose with constant labile blood pressures. Those nurses could not tell me a single thing about ventilator settings as their patients are never on one. They do not draw or interpret blood gases. They are not doing Q15 min, Q30 min neuro checks after a TPA infusion. They do not have arterial lines, rarely central lines or CVP measurements. They are not on CRRT, ever, or crashing with sepsis. Nor are they on balloon pumps, fresh transplant recipients, or a recent code blue/cardiac arrest.

They have the potential to become unstable, but that is not practicing in critical care. If they were truly critical, they'd be moved to the intensive care unit. They would not remain in L&D, as those RN's are not able to provide that type of care. I have taken care of labor patients in the ICU. I manage all their nursing care aside from the maternal side. The accompanying labor RN manages the maternal/fetal side, NOT critical care.

Further, the COA (accrediting body for CRNA programs), does NOT recognize labor and delivery experience as acceptable for admission to an anesthesia program. Clearly L/D does not substitute for true critical care.

The key difference is that they *may* occasionally manage unstable and critical patients, but it is certainly not routine, nor do those units and nurses have the capability to provide continuous care in those situations. ICU RN's do this all day, every day.

The hospitals in my area even list L/D positions as RN, Noncritical, OBGYN/L&D.

Enough said.

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