Questions about L&D

jalarms · Jan 30, 2004

I wouldn't give up yet. You say that you work as a student right now? It takes a while to really be able to perform on a unit, and that is after you graduate and actually take on the full responsibility of being the RN. It takes time to become organized and develop as a nurse. Like I siad, don't give up. If the charge nurse is having a problem, it most likely is due to other issues like lack of staff, her own burn-out , etc. Take Care!

Dayray, RN · Feb 1, 2004

Welcome to my nightmare =P.

L&D is tough and you won't ever feel like you have it all under control .. if you do then your wrong and need to get out!

I'm still pretty new (almost a year now) to L&D and instead of feeling like I have it nailed, I have experienced various levels of feeling incompetent and inadequate. I do feel better now then I did a month ago but I don't think I'll ever be completely comfortable. The people I work with say I'm doing well and I just have to trust them I guess.

I can now handle things that would have scared the hell out of me before and I don't go looking for help nearly as often but that feeling of being challenged hasn't gone away and I hope it never does.

To answer your questions.

I wouldn't go to a smaller hospital. Having started at a smaller hospital and then moving to a bigger one, I can tell you that the bigger place has been a better learning environment. Big units go like crazy all day and night. The smaller place was slow sometimes but when it got busy I had to shift gears quickly. Also the hospital couldn't afford to have a full staff sitting around waiting for it to get busy so when it did we were way understaffed. At the bigger place there are more people around to help and they are used to training people. You also get too see more action which teaches you faster.

Going to nights won't help, nights in L&D can be some of the busiest times.

Postpartum might be a good idea. starting out there allows you to work on you basic skills before having them tested on L&D and you can learn allot about mom's and babies. I will warn you though that it might be hard to get hired onto L&D so if you have a position promised to you at graduation it might be smart to take it.

Anyway, good luck ! and let us know how it goes

SmilingBluEyes · Feb 1, 2004

I agree with dayray.

start out on in MOTHER/BABY or POSTPARTUM THEN go to L and D.

It would be the best route for a new grad. Best wishes.

kastas, BSN, RN · Feb 1, 2004

I would always say to start in postpartum. You did get to go at a some-what slower pace and masters those skills. You will be more confident as an L&D nurse as you will already have dealt with breastfeeding, baths, recovery (bleeding, fundal massage), IV's, and charting. It will give you a chance to concentrate on the labor and delivery part of it after you have learned postpartum.

punim1974 · Feb 1, 2004

i realize this thread wasn't started by me, but i appreciate the advice too, since i'm planning on going into L&D/postpartum nursing as well :)

BSN_student2004 · Feb 2, 2004

Just wanted to thank everyone for their input. I kind of suspected that I should start out at postpartum because, as mentioned the pace is fairly steady. I do want to develop my skills and gain confidence, as well. Thank you, thank you, thank you for all of your support and wonderful advice!! :)

rpbear · Feb 4, 2004

I just accepted a job in L&D as a new grad. The NM that hired me said that it takes a special kind of person to want to do L&D. It is the reason that I started nursing school so why would I work on a unit that I don't want to just to gain experience? It is so different than any other unit, so you will need lots of orientation anyway. Why put yourself through that twice?

Just my 2 cents. Don't flame me!

tn_sunshyne · Feb 5, 2004

Originally posted by BSN_student2004
I am a nursing student trying to find a unit that may be a good match for me when I graduate. I love the diverse experiences you can get at L&D, being there when new life is born, Or exposure, triage, I enjoy the pt population. However, I fear that I won't be able to keep up. I really, truly believe that L&D is where I am meant to practice nursing. But, I work as a student on a L&D floor and I just don't seem to move fast enough for the busy hospital I work in. I feel like a disappointment to the charge nurses. It's not just me, this facility does have a pretty high turnover rate. Would the pace be different in a hospital that also did postpartum? Should I try starting out in a smaller hospital? Perhaps, I should start out on night shift, or should I just give up and find a different unit? Would postpartum be a better starting point since the pace is steady instead of feast or famine? Any advice would be GREATLY appreciated. Thanks for reading, have a gread day! :)

I was a new grad 3 yrs ago and started off in L&D (my dream job) at a busy university hospital, was told by many that I needed to work med-surg for 2 or 3 yrs to gain experience. I was fortunate enough that my department had an awesome 3 week orientation for new grads which consisted of "class work" studying fetal monitoring strips, learning about PIH, GDM, PTL, high risk pregnancies, fetal demises, learn about medicines that were used in pregnancy etc... We had to take "test" to show our understanding. Then we were placed with a preceptor for 10 weeks out on the floor where we learned how to bring all this information together and practice our skills. We learned how to care for laboring pts, pre-op c/s, circulate in the OR, recover c/s and tubals, take care of PIH and PTL pt's, work in triage. By the end of my orientation I had learned a lot and felt overwhelmed. A fellow nurse told me it usually takes about 2 yrs to feel comfortable in L&D. She was right. It has been 3 years now and I don't regret the path I chose, I love my job as an L&D nurse, it is the most rewarding job I could ever imagine having. I truly feel this was my calling in life, you are a part of a very intimate moment in a families life. I think until you feel comfortable with the knowledge and the care you give you will always second guess yourself, but in time it all comes together. Good luck and best wishes!

kastas, BSN, RN · Feb 5, 2004

Wow! What a great orientation. I wish I had received a fraction of that back when I was orienting. It was very hard trying to learn all of the "classroom" stuff you learned at the same time as the "hands-on" skills. I think I will bring this up with my director.

L&D_RN_OH · Feb 5, 2004

I think you would get the most experience in a bigger facility on days. Of course, most new hires end up on nights, but orienting on days, would give you the opportunity to learn with scheduled cases, instead of the emergent cases we get on the night shift. It's much easier to learn circulating for a section if you knew it was coming, rather than running down the hall to the OR, KWIM? And I think in a larger facility, you will have more opportunity to see more high risk cases, which is where you will learn the most.

As far as starting in PP, it depends on what you want and the facility you will work in. If your facility does LDRP's, then orienting to M/B would be helpful, but like someone else mentioned, it can be hard to get back to L&D, so don't let the opportunity pass you by if it's there. I don't necessarily think a new grad needs med/surg or PP experience before starting L&D. You will learn what is specific to your area. And if you are lucky enough to be in a teaching facility, you will have ample opportunity to learn.

If it's available in your area, I would look for an internship or residency program. I went through a 20 wk internship that rotated through L&D, PP, SCN, and GYN/URO as a new grad, then took a FT position in L&D. I always knew that is where I wanted to be though, so I wouldn't have considered going somewhere else when I had the opportunity to start there. All the L&D nurses have been oriented to MB here as well, so I don't think you have to start there.

In the end, you need to consider where you really want to be, and how comfortable you think you will be there. If you think you will struggle with L&D, then maybe it's not the best place to start.