Where should I work to prepare for L&D?

[emmjayy, BSN, RN]

I will be graduating nursing school next year but have to make a decision on where to do my capstone/preceptorship before then, of course. I spoke with my OB instructor about my desire to work in L&D and she strongly recommended NOT going directly into that specialty upon graduation. Now that I've learned a thing or two about it in class, I don't feel comfortable going there right away and would rather work elsewhere for a few years to hone all of my skills prior to going into a specialty that requires so much in addition to solid fundamental skills.

My OB instructor suggested the women's health floor or med-surg. I just can't work in med-surg. I really can't. I float in the hospital right now as an aide, and every time I get sent to the heavy med-surg floors, my stomach sinks. It's not that I don't like dealing with critical patients, it's that med-surg is super-depressing for me. Most patients have very poor prognoses and are REALLY struggling. The thought of having to go in and deal with that every day for at least a year or two is difficult. However, I don't just want to pin my hopes on getting a job on the women's health unit and would like a back-up unit to apply to as well. I really enjoyed my time on the hospital's cardiac floor where we care for patients who need observation, are on cardiac drips, who've had cardiac catheterizations, or are waiting for heart surgery. The nurses on that unit monitor their patients on telemetry directly (so they are trained to read/interpret strips). The floor has its moments (more cart calls than normal, for example), but it has a nice routine and is "boring" but a good place to develop those assessment skills and build up confidence as a new nurse. Do any of you think that working on a floor like that would help me at all with applying to L&D later if I don't get an offer from the women's health unit?

[quazar]

ER nurses transition very well to L&D. Mother Baby nurses, too. Best of luck to you with your pending graduation!

[klone, MSN, RN]

Wait, are you asking where to WORK, or where to do your capstone? If your interest is in L&D, I would try to get your capstone in L&D.

For what it's worth, I went into OB right after graduation (the unit was combined L&D and postpartum). I don't agree with the school of thought that you need to have a year in med/surg or some other area before specializing in OB.

[emmjayy, BSN, RN]

Wait, are you asking where to WORK, or where to do your capstone? If your interest is in L&D, I would try to get your capstone in L&D.

For what it's worth, I went into OB right after graduation (the unit was combined L&D and postpartum). I don't agree with the school of thought that you need to have a year in med/surg or some other area before specializing in OB.

At my school, where you capstone is usually where you transition into a job, so I kind of blurred the two together in my post. I was thinking I might try to get into the postpartum unit and then transition to L&D rather than working in med-surg like everyone keeps telling me to do.

[klone, MSN, RN]

Oh, so your L&D and postpartum are separate units? Then yes, I think mother/baby is an excellent position to start while trying to figure out if you want to work in L&D.

[ashleyisawesome, BSN, RN]

I think your instructor is wrong. I work with a lot of L&D nurses who started in L&D as new grads and they did fine. I did three years of med/surg before doing L&D, and while it certainly helped, it wasn't necessary. There is a lot in med/surg that isn't applicable to L&D and vice versa. I basically felt like a new grad again when I switched specialties anyway, with the exception of being decent at IV sticks and foleys, and having experience with time management and basic assessment skills. I actually had a hard time in the beginning trying not to think like a med/surg nurse and instead thinking like a labor nurse.

That being said, L&D is hard to break into as a new grad. Postpartum, well baby nursery (if a hospital around you has one, they are phasing them out in a lot of places), or a GYN floor would be a good place to start if you can't get right into L&D. ER is good for teaching you to think fast in an emergency and manage your time well (plus get great triage skills!)

[emmjayy, BSN, RN]

Thank you, everyone, for the input! This has been really helpful! I think I'm going to try to get into the mother-baby unit and go from there.