Topics to Review for New L&D Nurse

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I just graduated and got hired as a new nurse on L&D. In my program we took our OB class in the second semester (so over a year ago) and I feel VERY rusty. I'm really excited about this job and I want to be prepared but I know I wont have time to re-read everything before I start orientation. I know book knowledge will only get me so far, but do any of you experience L&D nurses have any suggestions for important topics to review before I start my new job?

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Specializes in Obstetrics, M/S, Family medicine.

First, I would like to say....I am not an L&D nurse, but I am in L&D right now, and I asked my instructor a very similar question, so I thought I would share what she said ....

- Know GTPAL

- know normal pregnancy lab values (hgb, crit, rubella titre, what normal in the urine for preg women, know what AFP tests for

- know what changes are normal in a woman during preg (eg, cholasma, linea nigra, edema, varicose veins, pelvic instability/click, carpal tunnel, syncope, increased coagulability, constipation, nasal/sinus stuffiness, nose/gum bleeds, earaches, murmur (d/t increased blood volume), heartburn, hemorrhoids, gallstones (higher incidence), increased UO)

- Know where fundus should be for different gestational ages (12-13 wks at symph pubis, 20 at u, 36 at xiphoid process....from 13-40 weeks, height should equal gestational age in weeks)

- Stages/phases of labor - what to do during each of these stages/phases, what the preg woman commonly see/feel during these stages/phases

- know the 5 P's and what you can do to augment each of them

- Know the initials used for presentation

- know the very basics of reading a FHM strip (accel, variable, early and late decels) what causes them and what interventions you perform when they occur, know how to read the contraction (frequency, duration, intensity (if using an IUPC). know the causes of fetal brady/tachycardia and what can cause a woman to contract besides true labor (infection, dehydration)

- know the basic physiology of labor like what is happening to the uterus during contractions (how the muscles work, etc)

- know fetal responses to labor (this helps you picture fetal descent (engagement, descent, flexion, internal rotation, extension, restitution, external rotation, expulsion)

- know maternal responses to labor (increased WBC)

premonitory signs of labor (lightening, braxton hicks, energy spurt, weight loss, loose stools, ROM, bloody show, mucus plug)

- Know what a BPP shows, NST, CST...there aren't a ton of tests for L&D, I would try to know all of them well.

- Know common meds given and why they are given (mag, pit, terb, pain meds) and side effects for them

- know non-pharmacological pain management techniques

- neonatal assessment (and apgar)

Are you going to be rotating to nursery or pp? I'm very excited for you. I hope to get into L&D as well.

Good luck...and let me know if you have any useful tips for me after you have been there for a bit!

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Thank you very much. Your post was really helpful!

As far as going to other units...I don't believe that the L&D nurses at my hospital are floated to other units. At least I've never seen them do so. I wouldnt be suprised if I will spend a day or two in NSY/NICU and PP during my orientation to the unit just to see the whole spectrum though.

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