OB rotation

RN2Bn2006 · Apr 3, 2007

Well, I can give my my experience. I graduated last May, and was very fortunate to start in OB - as that has always been my goal - the whole reason I went to nursing school in the first place. Anyway, to answer you question, for the most part - when a patient is in labor - the ideal scenerio is 1:1. It is very time consuming - I spend most of my time at the patients side - one reason - is because we are required to chart FHT's & CTX, etc. q 15 minutes, and I do alot of my charting at bedside - as we have computer charting. If it is an induction, and takes awhile to "get going" your aren't so busy, but I work the night shift, so my patients are usually admitted in active labor, somtimes advanced dilation, so I have to jump in and get busy, and basically are in and out of their room the whole time. Sometimes immediately prepping them for an epidural, etc.... and sometimes getting ready for a precip delivery - I had one the other night - from the time I got her to the L/D room, she delivered in 17 minutes. I only had time to start IV, get EFM on pt (didn't make it with the toco) and quickly set up delivery table - calling the doctor, getting help in our depart (we are a rural hospital - I was only RN, I had an LPN in nursery with a baby on 02, IV - so we had to get another nurse to quickly come to the nursery to watch the baby while the LPN helped with delivery) Of course - this is a rural hospital, so settings are not always this way.

Sometimes we take 2 patients in labor at the same time. At our hospital - this usually only occurs on day shift - when there are planned inductions, and plenty of RN's. I can labor 2 patients, and keep up with charting, etc.... but it is NOT ideal - because someone can go from 5-10 in a matter of a few minutes, leaving you in a stressful situation - if you are the only RN. I have to play it by ear - I call another RN in if I have two in "ACTIVE" labor with cervix changing.....just because you never know!

Now because we are a small hospital - our post partum & nursery are all one department. So on slow nights, it will just be me and another nurse - usually an LPN - she stays in the nursery - I manage the PP floor, do all assessments, and take care of any "walk-in's". The good thing about post-partum, is most are stable patients who do not require much care, therefore if I do get one in active labor, I can usually manage, but I can always call my on call nurse in.

As a student - my OB was very boring, I bascially just got to watch a delivery, I was following the nurse manager - who had to take a patient because they were so busy, and she was not a teacher - she didn't explain anything to me - basically just wanted to get the girl delivered, and back to her office, so she didn't have time to mess with me. I was very disappointed. My pospartum was more fun - because you spent alot of time with the new mom - teaching, etc..... I enjoyed that. The nursery was fun -because there is always something you could be doing in there - either assessments, drawing PKU's, rocking, bathing, etc..... As far as now, I enjoy L/D the best. I love the excitement - the unknown, just the miracle of birth in general, but let me tell you - things can go from bad to worse in just a few seconds......I've seen it happen. You have to be on your toes every minute, and not leave the monitor for any reason without someone actively covering it for you.

I hope you have a better clinical experience than I did. L/D is an awesome department to work in. 99% of the time - it is a happy place to be!

Good Luck!

meri29 · Apr 3, 2007

It depends on where you live. I'm a new grad nurse at one the the busiest L&D units in the country. We are expected to manage two active labor patients once we're off orientation. However, we have a team leader who covers one patient while you do an epidural, delivery, etc in your other room. The place is VERY organized - so the system works.