Precepting in Postpartum - pros and cons?

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I just learned that I've been approved for a postpartum preceptorship. This is exciting news because it's been my dream ever since first stepping onto a PP unit and loving it, especially because I haven't loved any other specialty except peds.

However, my excitement is tempered by a little bit of concern about not being able to practice some of the broader nursing skills. I've been told on numerous occasions that if I want to work in postpartum, the best place to precept is in postpartum, and of course, this makes complete sense. At the same time, there will be very little, if any, starting of IVs, using IV pumps, giving/preparing injections/meds, etc. and although I know these skills aren't the crux of nursing, they are important general knowledge. Especially where IVs are concerned (all aspects), those are such a widely-used skills that being out of practice would be...embarrassing? (I can't even put my finger on how it would feel - bottom line, it would be bad.) Plus, my exposure and experience with the common diseases/disorders/conditions/medications would be very limited.

My end goal is to work on a PP unit, BUT at some point, I can foresee myself wanting to move around to either the NICU or L&D. How feasible will that transition be if I start my career in postpartum? Come to think of it, how feasible will it be to transition into something like med-surg after working for several years in postpartum?

I really am excited, but my nervous Nellie nature is starting to take over and cloud my mind with doubts.

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Specializes in Prior military RN/current ICU RN..

"told on numerous occasions"

Ok..by who?

If you want to learn IVs then ask to go to the med surg unit or something and learn IVs. Just be proactive. If you wait around for people to show you nothing will happen. When I worked med/surg I would always be asking to get hands on and get in it. I would volunteer to work other units. I work psych now, but I still float to the ER and Med/surg on occasion.

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I precepted in PP and now work in PP. I hung ivs and antibiotics, prepared meds, gave IM to mom and baby, saw cultures drawn and ivs started by PP nurses. I couldnt insert IV or draw because I was a student. The opportunity will come along, just maybe not as frequent as in M/S. Besides you will learn other skills pertinent to the area, how to latch a baby, swaddling, glucose checks for infants, newborn hearing screening, circumcision checks, infant suctioning, strong assessment skills for mom and baby, time management....I could go on but I think you get the picture :) Best of luck!

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"told on numerous occasions"

Ok..by who?

Nursing instructors (my OB clinical instructor has been a big repeater of this fact), nurses on the PP floor, and... my mom. :cheeky: To be fair, my mom has worked for Kaiser for 40+ years in several departments, so she knows a bit about who's getting hired where, and why.

I actually didn't know that it was an option to ask to go to the med-surg unit while on a preceptorship for a specialty, so I hadn't considered it at all. I'm guessing that may be school/program/preceptor-specific, or done on a case-by-case basis, but it's definitely something I'll keep in mind going forward. Thanks for mentioning it!

I precepted in PP and now work in PP. I hung ivs and antibiotics, prepared meds, gave IM to mom and baby, saw cultures drawn and ivs started by PP nurses. I couldnt insert IV or draw because I was a student. The opportunity will come along, just maybe not as frequent as in M/S. Besides you will learn other skills pertinent to the area, how to latch a baby, swaddling, glucose checks for infants, newborn hearing screening, circumcision checks, infant suctioning, strong assessment skills for mom and baby, time management....I could go on but I think you get the picture :) Best of luck!

Thanks for the input! I was hoping for some personal insight. :) I'm glad to know that there are, in fact, IV meds being run, and IVs being started, etc. I don't know how it happened that I made it through my whole OB rotation without running into a PP pt without a drip, but it did. Do you feel like you'd be comfortable transitioning over to med-surg if you wanted to (not that you'd want to)? Or do you think you'd feel ill-equipped after being in PP for a while?

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I think it would be a struggle because:

1. I never liked med surg

2. Patients are on MANY meds and it can be hard to keep track.

3. Isolation is annoying.

I think you should lose the thinking that because you are not doing typical hands on tasks, you arent using "nursing skills". Hands on tasks are easy to pick up on if you were to transfer depts and if you can't do it, then you ask for help. I think time management and critical thinking as a nurse is the hardest thing to work on as a new grad.

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And OB rotation didn't teach me anything about L&D, PP, or nursery. We only spent a day or two in each area so of course it may seem like no one has IV access or drips. However, in my preceptorship, I had several pt on the floor who had chorioamnionitis, meaning iv antibiotics for mom and baby q 4 hours. C section pts are post op pts so they had Foley catheters, IVs, a wound to care for...

You will get your fill. It's not med/surg for sure but I feel that I learned so much. I really do love the area aND my facility has offered to crosstrain me to L&D and special care nursery in 6 months!

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Ahh, that is exactly what I was hoping to hear. :inlove: I guess I'm a little stuck in the mindset that if I'm not precepting in the ICU or ED, I'm doing it wrong, but those are two places I have never wanted to be, so I don't know why I'd spend any time precepting there. It was really a struggle for me when I was choosing what specialty I wanted. It felt like I was making some kind of life-altering choice, and even though I could rationalize that that wasn't the case, I couldn't shake it. I am genuinely happy that my instructors thought enough of me to grant my request though.

Congratulations on getting to cross-trained in the other OB specialties! That's incredibly exciting! I really loved L&D, but my feet and knees, not so much. I'm hoping that after becoming better conditioned to be on my feet all day, the physicality of L&D won't seem so daunting.

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Thank you and Congrats! It's just your preceptorship! If it turns out you are bored or hate breastfeeding and peri care, then you can work in another area easily after graduation. If you love it, then start here. I felt the same way when I found out I was assigned to Women's Health. I always wanted L&D....HATED ICU AND ER. was worried mother/baby would bore me. Now, I love it and if I get bored, I will leave. But for now, I'm good :)

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Post-partum is a steal of a deal. You make just as much as any other nurse in the hospital without all the stress. I remember my gf worked nights in PP and literally had time to txt all night. In a busy ICU you are lucky if you get lunch. I am not downplaying PP but it does kind of box you in skill wise, however if that's what you want as a career, then why not? Many of the nurses move on to labor eventually but if you have aspirations of OR/ICU/ED down the line it will be like starting from scratch in many aspects.

In PP there are some meds (ABX/fluids usually) but rarely IV starts. In my experience they would always call labor or the IV team to place them. Hooking up IVs is a basic skill and running one thing is no big deal, it's when you have 17 drips running with vasoactive/cardiac/sedation drugs that things can get hairy. :yes:

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I've started wondering if being in PP for 3 months is going to affect what I retain from previous quarters/rotations, and adversely affect my performance on the NCLEX. This Doubtful Debbie thing is stressing me out!

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-__-

Nothing from clinicals (NONE OF THEM) helped me pass the NCLEX. I did fine. Passed first try, 75 questions. Studying for the nclex helps you pass the nclex.

YOU ARE WORRYING yourself sick. You aren't obligated to work PP after graduation. If you miss those hands on skills, apply for med/surg, ICU, or whatever will make you feel like a "real nurse".

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