Which is more import: lower section rate or supportive management ?

[ArreisBSN]

I was offered a L&D job at a huge facility in town. I was also told from another smaller facility that they would tell me in a week or two when a position opens up.

The smaller facility has an interim manager, and told me that there were 4 nurses orienting to L&D and that 2 had just put in their notices. This facility has a lot of CNMs and had a lower (although still high at. Almost 40%section rate). It is where the natural birth folk recommend people go. Having my history in homebirth, one can see why I am interested there... But there are huge red flags such as high turn over and new management.

The huge facility manager told me that she just interviewed 2 RN's from another facility in town that said they just wanted to be able to practice evidence based nursing care.... But this huge facility is nearing a 50% section rate. The nurse manager is very verbally pro evidence based care and said that she was instrumental in kangaroo care policy.

Seasoned vets: where would you work? What is your gut telling you???

[Alaskan_RN]

I am a new nurse, so not the seasoned advice you're looking for, but I would go with the larger facility. I'd take a 10% section rate increase with great management over poor management and a facility that can't keep employees any day.

Congratulations on the job offers and good luck with your new adventure!

[klone, MSN, RN]

Um...move?

Where do you live where they have 40-50% C/S rates?? That's awful!

[Katie71275]

I would go to the bigger facility for the experience. But is also make sure to read a lot about positioning and movement for patients to hopefully keep your own personal section rate down.

[Alikatz08]

And also implementing evidence based practices. As the poster noted above, do your research and present it to the unit, etc. For example in my experience the Peanut Balls have been successful so far on laboring patients that I have had with epidurals. :)

[LibraSunCNM, BSN, MSN, CNM]

Um...move?

Where do you live where they have 40-50% C/S rates?? That's awful!

In New York, particularly in Westchester County and Long Island, and in various parts of New Jersey, there are multiple hospitals with C/S rates like this. Horrendous.