OB nurse in training

tablefor9, RN · Mar 27, 2011

Hmmm...Real OB nursing.

I've worked in a variety of units, some small volume rural hospital, some crazy large volume metro units. Here are some typical "day in the life" shots:

Couplet care: In for report, 4 couplet assignment. Report, Walking rounds, during which I ask families what needs are/what I can bring on my next trip. I jot these down. Any Stat orders completed at this time, also any pressing needs. Then, assessments of couplets, usually 15-20 min vitals/assess/teaching and plan of care review with each family. Initial feeding assess at this time, as well. After that, care based on family needs, breastfeeding assist, weights, discharge teaching, PKUs and TCBilis, lab draws, whatever.

LABOR: who knows>? Some nights I'm the triage queen, and may have an outpatient clinic cooking. Other nights, I may labor one or two and do the labor-delivery-recovery-postpartum or pass off dance. Sometimes, as the charge RN for Women&Children's, it's for me to do triage and assist in newborns or couplets or on GYN (IV, anyone?) or hang a unit of PRBCs for a peds RN on a non-infectious patient.

Time and experience are necessary to give you clinical excellence in whatever you do. BUT, you can be or become the KIND of nurse that will do well in L&D.

1. Be flexible, and as laid back as you can manage. This doesn't mean you don't pay attention when problems crop up, it just means you are the one that can deal with them quickly and effectively without scaring the bejeezus out of your families.

2. Bathe yourself in a knowledge of normal birth, because what you'll see day in-day out isn't normal. It's a parody that pushes the idea that women's bodies have turned into lemons in the last 100+ years and that birth is bad news waiting to happen.

3. Become a supporter of women's rights and family rights and patient rights...these births aren't about us, they are about the families we serve. Paternalism has no valid place here, so fall in love with being an advocate, a steward of birth and parenthood. You don't have to sell out any religious/personal values, here, just know that it's about them not us and we can't afford to judge others harshly.

4. Read, read, read the books on the sticky list.

5. Remember to acknowledge what you don't know...and keep a respect for this kind of nursing. As a L&D Rn that came from ICU, I'll tell you that nothing is worse than a mom stepping off the elevator w/ an abruption, or a cord prolapse, or deep in HELLP.

6. Trust your gut. Believe what they tell you in AWHONN, but trust your gut. If the hair is standing up on the back of your neck, don't just go brush your hair.

Good luck to you!

T