Thinking of leaving OR for OB (L&D) ?

[Seattle WA]

Hi all, 

I work in the OR, but have been thinking about trying out OB L&D (labor and delivery) . I'd like to expand and diversify my nursing skills and learn more about OB and women's health/ L&D. 

 

Just a few questions I had: 

Has anyone else transferred from the OR to OB, and if so what was your experience like?

What is a typical day in the life of a L&D nurse? 

Is OB (L &D) stressful? 

How are OB doctors to work with compared to surgeons in OR? 

What is the patient to nurse ratio? 

What do RN's do for C-sections? 

 

Thanks for any advise and insight! ?

[NurseGuru]

The biggest difference between OR and OB is a huge curve in patient interaction. 

The similarities is that you get to work autonomously - lots of standing orders, you drive the birthing process in most cases depending on how much time you spend at the bedside. You also will still do alot of standing plus more additional physical activity especially if the patient does not have a support person or doula.

L&D is stressful. There is 'good' stress like the baby coming out and everything going well, but there is alot of other stress because you are constantly on edge, paranoid, anxious because you will spend time monitoring the patient for a while before that happens. And, once the baby is out, there is still ALOT that can go wrong. 

L&D lifestyle requires hardcore self-care. You have to really know yourself and love your self constantly. Lots of adrenaline rushes, cortisol increase, and hormones. It is hard to explain in words, but the Labor part is real- it means hard work. You have to eat smart, sleep right, exercise on your time off to keep up your stamina, you have to be emotionally available, etc. 

OB surgeons and MFM (complicated maternal fetal medicine docs)are divas. I will tell you, honestly from my opinion, its like if you cross a trauma surgeon with a neuro surgeon. But- if you really know your stuff, you won't be fazed.

Your ratios are generally 1:1 if you patient is in active labor without an epidural, Cat 2 tracing, actively pushing, and after the first hour of delivery. Otherwise it is 2:1. Triage depends on the facility you're working but look up the guidelines. Unless there is a designated baby nurse, you also have to take care of both patients (who will have very frequent v/s and assessments.)

Typical day is 12h shift, you will either be assigned or pick your own patient. If you don't take a patient then you are on stand-by duty for triage. 

L&D nurses are expected to circulate their own cases if they crash for cesarean- that was and still will be your patient even if there is an OR nurse you can still go and help. Scheduled cases go to the OR team but if you are experienced you can do it. You need to get fetal heart tones in the OR before they cut. You may also be asked to perform a 'lady partsl hand', place PR cytotec, or be on stand by for massive transfusion or NRP. 

Hope this gives you a better idea of the job.

Feel free to PM.