What does it take to work in L&D and Post Partum?

[PeepnBiscuitsRN]

I am a new grad- new grad meaning I graduated last may and have just now gotten a job at the hospital I wanted so badly to work in. I'm on the cardiac/tele/general med-surg floor (it's just everything) and will be expected to float to general med-surg, ccu, and ortho. Now, I know there's good in that. I need to dig in and get my feet wet with everything before I narrow in on one thing.

I keep coming back to L&D and Post Partum as that "one thing" I want to do. I also want to become a lactation consultant. I can put into words the why's of why I want to work in this field- but there are parts of me that think I might just be high on baby vibes because I had a baby (at that hospital I work at) in January and it was a great experience and the staff were so good and nice compared to where I had my actual L/D/PP clinical.

I had an instructor tell me, way back when I was in school for my LPN, that I could never be an L&D nurse. I was "too nice", and L&D nurses have to be mean and aggressive. That women in labor are irrational and need a firm hand. For the record, not one of the nurses I had were ever mean or stern. Even when I was digging my heels in about being induced with my son, 3 years ago- they stood behind me even though now that I'm on the other side of things I'm sure I would have agreed with the doc's that I needed to be induced (the poo hit the fan 26 hours later anyway with an emergency c-birth).

Then there's the reality that not all experiences are good, or have happy endings. Not all patients are reasonable and agreeable. How would I handle a stillbirth? How would I handle sending a baby home with parents that I know are going to treat the baby like a novelty and then set it aside like an old toy? Honestly, I can handle the attitudes, the babies having babies and irresponsible parents having babies. Saw it all the time as an LPN when I worked in pediatrics. It's the stillbirth thing that gets me. That and apparently I'm not stern and firm-handed enough.

So please, tell me- does it take a certain type? What type would that be?

[tablefor9, RN]

You don't have to be "mean or aggressive" to be an excellent L&D/PP RN. That's a load of crap, as is the idea that women in labor need a "firm hand". Ridiculous. Those are ideas that will not serve anyone well in the day of reimbursements being driven by consumer (PATIENT) satisfaction.

You do, however, need to be assertive, compassionate, and willing to work hard and to do difficult things. You need rock-solid assessment skills, the ability to handle rapidly changing situations with aplomb, and be able to prioritize appropriately. The fact is, not everyone IS cut out to be a L&D nurse. I think it's the best job in the WORLD, except when it's not. Demise is hard. Sending babies home with crappy parents is hard. Losing mom or baby, hardest.

The fact that you have a desire to do women's health is the first step. Becoming comfortable in basic nursing is the second. Maybe see if you can float over to PP, take some lactation classes, do some reading (starting with the recommended reading in OB forum and all the posts there). Get a doula certification, and use it. All those things will give you a view of the day in-day out while you keep your eyes open for a position.

Good luck to you in your first year of nursing, and all that comes after.

[Double-Helix, BSN, RN]

L&D/Postpartum is one of the most difficult specialties to find work in, particularly with no experience in the area. Nurses tend to stay in these jobs for awhile, there isn't a huge turnover. So first, I'd say it takes a fair bit of luck or a connection to an OB unit.

Are you an LPN? I think you'll find that most major hospitals require an RN license for these jobs, as there is so much assessment and teaching that occurs. So if you are really interested, you'll probably want to go back and get your RN license.

As far as personal characteristics, there isn't anything unique to L&D that isn't needed for any other area- caring, empathy, critical thinking, teaching skills, and an ability to keep one's personal feelings seperated from the situation.

[iteachob, MSN, RN]

Your LPN instructor was an idiot. If there's anything that OB doesn't need, it's nurses who are "stern and firm-handed."

[darkangel83]

I am an RN and work in post partum and in the ER. Although I cannot speak to what is needed for L&D, post partum can be a very challenging area. Assessment and prioritizing skills are a MUST! When I started, I found the largest challenge was the newborn babies. They can change very quickly and being able to respond to these changes appropriately and quickly is important.

'Stern' and 'firm-handed' are not qualities I would associate with being a post partum nurse. Post partum nurses must be patient, compassionate, persistant, have strong critical thinking skills and be assertive. When my patients go home I want them to feel confident in the skills they have learned and have the information they need to get assistance, should they need it.

I also work directly with patients who have experienced fetal demise (inductions and stillbirths) and it can be very difficult. There may not be easy answers to their questions, they are angry, and they could have a lot of anger towards the healthcare system. Qualities important here: empathy, compassion, being a good listener and assertiveness in getting the families in touch with the appropriate resources.

Moral of the story- nobody can tell you what kind of job you are suited for except you :) Give it a shot and see if it is for you!

Good luck to you!

[PeepnBiscuitsRN]

I was an LPN for 4.5 years, I'm an RN now- associate, completing my BSN. I'm hoping to float over to LD and PP, but I won't request that till I'm off my orientation (that would look pretty bad if I were looking elsewhere before my 6 month probation was up!)

I appreciate the feedback. I didn't think I needed to be harsh. All my LPN instructors were sort of very very old school. They type who would stand any time a doctor walked into a room. My RN profs were a lot more lax, even the one's who were RN's for 35+ years.