Michellelizz

My hospital does about 5500k births/year. We can honestly have anywhere from 5 to 20 inductions for a day and we have 13 labour rooms. We don’t give our patients an actual day for inductions, we now give them a range of days since it’s so insanely busy on the unit.

Honestly, it takes a lot of time to get comfortable working in L&D. In terms of tasks, when I was new I found carrying a tiny notepad with checklists really helpful. For emergencies, it will take time to get confident and know how to react and how you can help. In emergencies, pick one thing you can do - whether it's moving the patient to the OR, watching the FHR strips, getting drugs etc... I know older nurses who are still not great in emergencies or when things don't go exactly as planned and I know fairly newer ones who are amazing, it just depends.

I think you should go for postpartum/mother-baby over L&D. We don’t do much breastfeeding in L&D besides for a bit right after birth. When I worked postpartum, most of my time was educating about breastfeeding, pumping, formula etc. And you can probably work with a LC on postpartum to get some insight.

I work L&D at a hospital that does around 400-500 births/month. Our charge nurse attends all deliveries with the primary L&D nurse just to make sure any resuscitation isn’t needed. The primary L&D nurse does all immediate baby care including assessment and meds.

When I worked postpartum before moving to L&D, it was a 1:5 ratio but the babies stayed with mom in room, we did not have a well-baby nursery. So that’s up to 10 patients, including babies. I found it manageable but busy so good time management was needed. We also didn’t have techs or HCAs so we did all the vitals, blood sugars, ambulatory and baby 24h tests. We also did not have mag patients and where I work L&D now, we keep the mag patients 1-on-1 in L&D because they’re considered unstable.

Is 4 in a row not common where you guys all work? Our full time lines are 4 on, 5 off....

I wish we had 2 OBs but we just call in the second on-call if we need. We’re a teaching resident so we tend to have a lot of residents which can also be helpful. We have 3 ORs on our unit. In terms of booked c-sections, we usually have 3 or 4 in the morning every day and just do them back to back. If there are multiple emergency c/s at the same time, we just figure it out. We also have our own anesthesiologist.

I work at a high volume hospital, doing around 5000 births/year with an OB in hospital 24/7 and a 2nd on-call. And yet, us RNs do deliver babies pretty often, mostly due to the OB being in another delivery/or in the OR and women coming in fully dilated and there’s no time. We obviously try not to since an OB is trained better for complications but it happens.

Hi, I’ve been working L&D since I graduated nursing school so it’s possible to get hired without much experience. You’re qualified for the jobs in that you’re a RN but the L&D world is much different than stroke step down. My biggest suggestion would be to try and take some courses to show that you’re serious. Where I was applying, I took a Neonatal Resuscitation course, a breastfeeding course and started my perinatal certificate college program which I believe all really helped me get hired.

I’m confused by the “haven’t had the sex to seal the deal” comment. The urine tests they’re using say “1-2 weeks pregnant” as in they conceived around 1-2 weeks ago. It’s measuring the hCG in the urine. It is not the same as the first two weeks of your pregnancy for dating purposes - this would be 2 weeks from your last LMP. In the case of using LMP, the first 1-2 weeks would be before/at ovulation. But like I said the urine tests aren’t dating that way, they say how many weeks estimated from conception based on hCG levels. Blood tests can pick up hCG earlier in a pregnancy than urine tests can. Blood tests can tell if you are pregnant about six to eight days after you ovulate. Meaning if they got a positive urine pregnancy test, they very much should get a positive blood test.

I also made the switch from postpartum to L&D after a year in postpartum. I found that the experience helped with the postpartum part of L&D and newborn assessments but not with a laboring mother. It is a move to critical care and so it’s going to take some time to get comfortable! I wasn’t comfortable at all in my skills until a year into working L&D and even then I’m still nervous/stressed and need help some times. This is normal! It is a stressful specialty! My biggest advice is to just keep practising everything - IV insertions, lady partsl exams on epiduralized patients, interpreting yours and your colleagues’ FHR strips etc. For me, scrubbing in the OR is what really still stresses me out and so I try to volunteer for it whenever there’s an opportunity (which is stressful since it’s always during Code OBs as we have RPNs scrub for our booked c sections). There’s a lot of autonomy in L&D, at least where I am and that makes a huge learning curve but hang in there and you’ll get more comfortable/confident.

L&D and postpartum are very different environments. I’ve worked both and don’t see how you can float every 4 hours if you have a labouring patient? L&D is definitely more stressful in my opinion but if you enjoy critical care, I’d go that route.

I hate when nurses say this. There is absolutely no reason to be doing med surg for 2-3 years when your goal is to be in an area like L&D or NICU. I’d argue that training a new grad, who isn’t set in any specific ways, may be beneficial to certain specialties.