Switching from LDRP to Labor and Delivery

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I have a year of experience in PP and catching babies, and was then trained to include labor and delivery. I have been doing LDRP for two years in addition to my PP experience. I am strongly considering a labor and delivery only unit, but have some apprehensions.

1. I have only had to labor one patient at a time, or have 1-4 PP pts and do triage, or have a labor and a triage etc. I know I will have to handle 2 labor pts if I am strictly L&D, and I want to know how to handle that. What if they get active at the same time, or one starts having recurrent decels, or BOTH start circling the drain? Am I over thinking this?

2. Is my experience enough to be a travel L&D nurse or should I learn to labor two patients first?

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You have the opportunity to train in L&D but worry it might be too much, however you also ask if you have enough experience to do travel L&D?

Respectfully, why would you take a travel position for a job you aren't comfortable doing when you will be given NO training and expected to start working on day one, and you might be doing the exact things you are concerned you aren't capable of doing right now? I'm thoroughly confused how you have been doing LDRP for 2 years but have yet to have 2 laboring patients. My best advice based on what I am gathering here is....Get the training before you considering anything about traveling.

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The units I have worked in are small, around 400 deliveries per year. The opportunity just isn't there, I am often left with only couplets, or a labor and couplets, or labor and catch the babies of other labor pts. Have you ever worked in a small unit where you are possibly expected to labor a pt, have two couplets, take a triage or two, and catch a couple babies, all in the same night? That's where I come from. Our assignments are fluid.

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I might also add that by travel, I mean to a hospital an hour from me. Really just like a short term contract.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Hi there! Do you know if the L&D unit staffs per AWHONN guidelines? If so, then you should only have two labor patients in early labor. It's recommended that for high risk labors, or for active unmedicated labors, or second stage, that the staffing should be 1:1. If you have two patients and one starts to go bad, or go really active, then hopefully your charge nurse will adjust assignments so that you can provide 1:1 care.

Whether you are ready to travel, ask yourself this: Do you currently feel prepared to walk into any L&D department, with the only orientation being shown where the supplies are, and provide safe care? If the answer is yes, then you are ready.

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I am L&D trained. You did not read what I wrote, I guess.

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Specializes in LDRP.

What makes you think the staffing will be different on a Labor only floor? If you have labor experience, it should be the same with the added benefit of not having to be pulled to PP in the middle of your shift or vice versa.

I am not saying you will never end up with two active labor patients at once, have a labor patient and have to run to another pt's room to be baby nurse, or be triage and have to take a labor patient out while keeping an eye on the triage monitors, but that is not the norm. It is not a regular thing to have two active labor patients, it is only done when things get impossibly busy and there is just not enough staff. The vast majority of the time I have 1 labor patient, or two inductions. If one of my inductions progresses to active labor I give one away if there is staff available. AWHONNs standards say 1:1 for active labor and I think most units try their best to stick to that. That's why we have on call nurses.

I am trained for Labor, triage, antepartum, nursery and postpartum and can have my assignment changed midshift, but some nurses on my unit only do strictly labor or strictly PP. Most of the time I am giving up my couplet assignment to take a labor patient out. I don't think I have ever had couplets and a labor patient at the same time, that sounds unsafe.

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I don't get pulled to postpartum, I keep my labor and still do postpartum. It's the same unit. I keep my labor, and triage someone. Or keep my labor and catch a baby. There is no changing assignments, just adding more assignments. Lol. I do agree that I don't feel it safe to do so, thus the job change.

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Specializes in ICU.

I work in a labor and delivery unit. We also have antepartum.

Our hospital is pretty great about sticking to AWOHN standards and usually labors are all 1:1. Maybe 1 labor and 1 ante. Or 1 labor and 1 triage... but if the triage stays she goes to someone else.

find out how they staff and then decide from there.

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