Pros and Cons of L & D Nursing

CardioTrans, BSN, RN · May 26, 2004

Id like to know this as well.

SmilingBluEyes · May 26, 2004

Ok I will try to help here:

Pro's:

Well, you get to be there for the birth not only of an infant, but of new families, new parents, new sibs, new grandparents. THIS is POWERFUL STUFF. I love it.

Another advantage, at least to me, you deal MOST of the time with cogent, alert, oriented adults. Not a whole lot of confused folks and incontinence there......just of feces when pushing, which I can handle.

Most of the patients and their families are VERY grateful for our presence and part in their birth experiences and this frankly is why I continue to do what I do. It's the "thank-you's" and hugs that keep me going on!

It's never boring, doing OB. Sometimes, hectic, but never boring.

I find IV's easier to start in young women than little fragile old people; heck I would rather start an IV in a newborn than a 96 year old frail elderly gal with no veins. Granted, some women are tough sticks, but I usually know where to go w/o worry of nerve damage risks going there. There are usually PLENTY OF veins. I know this sounds silly, but as many IVs as we have to start, I appreciate the ease with which they can be started in MOST pregnant/young women.

Families often bring us GOODIES!!! I have been treated to pizza, cake, candy, popcorn, chocolates, breakfasts, muffins, Krispy Kreme's, WHOLE CHINESE DINNERs, you name it. Their gratitude sometimes is overwhelming.

I love my coworkers, does that count? I know this can be true in any unit, but it's been especially true for me in OB, I believe!

Most of the time, OB is a positive happy place to work. YES you have tragic losses, but they are the exception, not the rule. Someone is NOT always dying on the OB floor, unlike some other floors. I like that, frankly. I like seeing new life come, it gives me great hope.

Babies are usually great patients. All they want is their breastmilk, a clean diapie and to be held, MOST THE TIME. Unless they are sick, and even then, they are great patients. They don't complain.....woops wait a minute----- that can be a CON, really. THEY DO NOT COMPLAIN!! see below:

Cons:

On the other hand, babies are tough patients because they never COMPLAIN, meaning you have to be astute in your assessment skills, recognizing and treating changes REALLY REALLY early on! Often symptoms are LATE in illness in newborns!

Can you spell BLOOD? OMG what a mess some deliveries can be and you are in there, knee-deep in it. It can be something else. Even some nurses from other floors exclaim at it, can you believe it? It grosses them out often!

OB patients can go bad on a dime. But that is true in any unit. But when they go bad, they go down fast and you have to be QUICK on your feet and make split second decisions that may affect their very lives. Young women are usually healthy, and when they begin symptoms, like newborns, they are already going down REAL fast. They bleed massively in quick order, at times and DIC is a real danger in these women. All this can happen after a perfectly healthy and uneventful deliver, and that is totally unnerving for me.

And remember, in pregnant women you have TWO patients to consider and what affects mom affects baby, sometimes in an exaggerated way! Just watch what a small drop in maternal blood pressure as in epidural anesthesia, can do to fetal heart tones, if you doubt me.

FAMILY MEMBERS--- who think labor/deliver are spectator sports. visiting hours don't apply in OB and they come and go at all hours. IT is the MOST frustrating part of my job, dealing with family members and friends who insist on parking themselves in our hallways, doorways, everywhere, where we have to step over them, just to get a "peek" or hear "something"...........As much as I understand their desire to be there this can drive me nuts! Like I said, visiting hours are ignored on OB, no kicking em out unless they get truly hazardous or dangerous.

The doctors can be horrendous/heinous in their treatment of us........their hours are horrid and it shows. But then, this can be said of ANY unit, I would bet.

The WORST part of my job to me? Dealing with fetal/pregnancy losses, hands-down. It's the absolute most heart-wrenching and painful part of what I do. I recommend anyone considering perinatal nursing attend some REALLY excellent grief and infant/pregnancy loss workshops, esp for healthcare providers. You will NEED them. These cases sadden and break my heart even when I TRY to keep professional and personal life seperate. You will have to deal with these from time to time, and it never gets easier, ever.

Hope this helps some. They are just MY opinion, of course as a 7 year OB nurse, one who is also a mom and suffered some pregnancy losses.

BRANDY LPN · May 26, 2004

I am going to try to challenge myself to only list the best and worst parts of OB.

The best part is helping a women become a mother, encouraging her through the difficulties of childbirth and watching her rise to the task at hand watching as she tells you she cannot do it and then with the next breath pushing out a brand new life, or watching her tearfully go to the OR in pain and fear then seeing her in tears again as you hand her her baby, watching new fathers break down in tears the first time they see the perfect miracle that they have created and watching grandmothers worry and fuss over their grown children during the whole ordeal.

The worst part is fetal demise, or god forbid the demise of a mother (which I have thankfully not encountered) When those tears are all pain and fear and never turn into tears of joy.

Energizer Bunny · May 26, 2004

THank you for your insightful response Deb! I really appreciate it! Brandy, no offense but I kinda had to LOL at your response because those are basically what I figured would be the two poles of the spectrum. Are there any pros and cons in dealing with these specific patients that don't have to do with the birth of a new life or the death of a patient?

TammyWilson808 · May 26, 2004

Ok I will try to help here:
Pro's:
Well, you get to be there for the birth not only of an infant, but of new families, new parents, new sibs, new grandparents. THIS is POWERFUL STUFF. I love it.
Another advantage, at least to me, you deal MOST of the time with cogent, alert, oriented adults. Not a whole lot of confused folks and incontinence there......just of feces when pushing, which I can handle.
Most of the patients and their families are VERY grateful for our presence and part in their birth experiences and this frankly is why I continue to do what I do. It's the "thank-you's" and hugs that keep me going on!
It's never boring, doing OB. Sometimes, hectic, but never boring.
I find IV's easier to start in young women than little fragile old people; heck I would rather start an IV in a newborn than a 96 year old frail elderly gal with no veins. Granted, some women are tough sticks, but I usually know where to go w/o worry of nerve damage risks going there. There are usually PLENTY OF veins. I know this sounds silly, but as many IVs as we have to start, I appreciate the ease with which they can be started in MOST pregnant/young women.
Families often bring us GOODIES!!! I have been treated to pizza, cake, candy, popcorn, chocolates, breakfasts, muffins, Krispy Kreme's, WHOLE CHINESE DINNERs, you name it. Their gratitude sometimes is overwhelming.
I love my coworkers, does that count? I know this can be true in any unit, but it's been especially true for me in OB, I believe!
Most of the time, OB is a positive happy place to work. YES you have tragic losses, but they are the exception, not the rule. Someone is NOT always dying on the OB floor, unlike some other floors. I like that, frankly. I like seeing new life come, it gives me great hope.
Babies are usually great patients. All they want is their breastmilk, a clean diapie and to be held, MOST THE TIME. Unless they are sick, and even then, they are great patients. They don't complain.....woops wait a minute----- that can be a CON, really. THEY DO NOT COMPLAIN!! see below:
Cons:
On the other hand, babies are tough patients because they never COMPLAIN, meaning you have to be astute in your assessment skills, recognizing and treating changes REALLY REALLY early on! Often symptoms are LATE in illness in newborns!
Can you spell BLOOD? OMG what a mess some deliveries can be and you are in there, knee-deep in it. It can be something else. Even some nurses from other floors exclaim at it, can you believe it? It grosses them out often!
OB patients can go bad on a dime. But that is true in any unit. But when they go bad, they go down fast and you have to be QUICK on your feet and make split second decisions that may affect their very lives. Young women are usually healthy, and when they begin symptoms, like newborns, they are already going down REAL fast. They bleed massively in quick order, at times and DIC is a real danger in these women. All this can happen after a perfectly healthy and uneventful deliver, and that is totally unnerving for me.
And remember, in pregnant women you have TWO patients to consider and what affects mom affects baby, sometimes in an exaggerated way! Just watch what a small drop in maternal blood pressure as in epidural anesthesia, can do to fetal heart tones, if you doubt me.
FAMILY MEMBERS--- who think labor/deliver are spectator sports. visiting hours don't apply in OB and they come and go at all hours. IT is the MOST frustrating part of my job, dealing with family members and friends who insist on parking themselves in our hallways, doorways, everywhere, where we have to step over them, just to get a "peek" or hear "something"...........As much as I understand their desire to be there this can drive me nuts! Like I said, visiting hours are ignored on OB, no kicking em out unless they get truly hazardous or dangerous.
The doctors can be horrendous/heinous in their treatment of us........their hours are horrid and it shows. But then, this can be said of ANY unit, I would bet.
The WORST part of my job to me? Dealing with fetal/pregnancy losses, hands-down. It's the absolute most heart-wrenching and painful part of what I do. I recommend anyone considering perinatal nursing attend some REALLY excellent grief and infant/pregnancy loss workshops, esp for healthcare providers. You will NEED them. These cases sadden and break my heart even when I TRY to keep professional and personal life seperate. You will have to deal with these from time to time, and it never gets easier, ever.
Hope this helps some. They are just MY opinion, of course as a 7 year OB nurse, one who is also a mom and suffered some pregnancy losses.

Aloha,

I totally agree with your assessment! I am an L&D RN and proud of it! An old timer RN told me once dealing with fetal demises is the price we pay for the most awesome job in the world we have to do. I had to think about that one, and am inclined to agree.

Aloha,

Tammy

palesarah · May 26, 2004

Pro's:
Families often bring us GOODIES!!! I have been treated to pizza, cake, candy, popcorn, chocolates, breakfasts, muffins, Krispy Kreme's, WHOLE CHINESE DINNERs, you name it. Their gratitude sometimes is overwhelming.

Y'know, sometimes I think that belongs unders the "cons" :chuckle

I'm having such a hard time keeping the extra pounds off with all those goodies available!

Energizer Bunny · May 27, 2004

I was kinda thinking the same thing about the goodies, since I have lost 34 pounds (just weighed today!!! wooohooo!) and have 50 more to go! LOL

CardioTrans, BSN, RN · May 27, 2004

Well, I guess I will get to see the pros and the cons soon enough! I went and talked with the nurse manager about the position she had called me about the other day. I was offered the position, 7/7, 3-11, and get this: at almost $5/hr MORE than what Im making now as a supervisor in home care! She gave me the rate, and asked if that was comparable with what I was making and if that would be acceptable. I must have had this shocked look on my face because her next words were "Please dont tell me thats more than you make as a supv." Im excited and nervous all at the same time. The position will cross train between post partum, L&D, and the nursery. All of which I have never done before, but have been a nurse for almost 11 yrs. Now if I can find some resources to be looking over while Im working out my notice. Anyone know of any???????

BabyRN2Be · May 27, 2004

Since it's late, I'll list my pros and cons tomorrow when I'm not so sleepy. But I'll give you an idea now, CNM - why not think of becoming a doula? You'll get a good look at OB practices. No, you won't have the prestige associated with an RN or a CNM, but the training is fairly inexpensive, not as time consuming, and you'll get a front row view of what labor and delivery is really like. It's not a lot of money down the drain, and it looks good on applications later on. PM me if you want more info.

Shed13911 · May 27, 2004

Way to go on the weight loss! We all know how hard that can be! What did you do diffrently? Care to share your secrets? LOL!!!!!! :rotfl:

Energizer Bunny · May 27, 2004

Thanks...simple....just healthy eating and exercise. REally, that's it. I was obsessive about it at first but now I have relaxed and I am still losing...so that's my story and I'm sticking to it! LOL!