Why I think L&D nursing really is best and hardest

[lovemyjoblandd]

I know this is probably going to make some other specialty nurses mad, but that's okay- this is our forum :). I respect all nurses, God knows I wouldn't want to do anything but L&D. Sick and/or old people, ng tubes, pressure ulcers, no thanks! I know every nurse thinks that their field is the hardest, but I'm going to put up an argument (in a fun way, this is not to be demeaning), as to why I think L&D nursing is the most challenging.

First, and most importantly I think, is that only a L&D nurse can do L&D nursing. One cannot simply float from another floor and perform no matter how many years experience one has in nursing. Now sure others can deliver a precip delivery, heck those babies deliver themselves! I'm not saying one cannot learn L&D, because that is just silly. I'm just saying that you cannot throw a nurse on our floor and expect them to be okay. On the contrary, I am confident that I could go anywhere in this hospital and perform in a capable way. Sure there would be some things I'd need to ask about, but for the most part I could nurse independantly. As L&D nurses, we are capable of scrubbing, circulating, multi-tasking, prioritizing, administering high risk drugs, handling emergencies, giving blood, handling psych patients, and dealing with difficult family members (haha).

Next, we are masters of charting! With the exception of ICU nurses and other patient's I probably do not even know of, we are the only specialty that must chart on our patients every 15 minutes, while performing hands-on nursing, and usually do it in multiple systems.

Lastly, we have babies! We are there for the beginning of a new life, and sometimes the end of a life. We get to work autonomously and make the experience of childbirth an amazing experience while keeping our patient calm and maintaining our own calmness- even in emergencies. It's amazing.

I love my job :) And L&D nurses are the best! Now please tell me why you think your nursing field is the best!

[klone, MSN, RN]

On the contrary, I am confident that I could go anywhere in this hospital and perform in a capable way.

I admire your confidence. I hold no such illusions.

Expect an influx of righteous indignation from others. I can't say it's not warranted.

I don't think OB (I am not L&D anymore) is the best. I think it's the best *for me*.

[SmilingBluEyes]

WOW really? HOOOBOY------I need some popcorn and sit back and watch the thread light up.

I think you may need to work in other areas and get some real experience. Only L/D RNs can do OB? WELL yea! They are trained to do so. ANYONE with ambition can do it, once learned, however. That is like saying "only a nurse can do nursing". Well, yea, of course.

I have worked other areas but OB myself so I have some comparisons to draw on. I have 17 years' nursing experience, having worked in OB/LDRP/Newborn, GYN surgical, dr office, Long term care and now, dialysis. OB is a challenging, rewarding, frustrating and heartbreaking specialty, all in one. But the "hardest" or "most rewarding"? I challenge that notion. What is one person's manna is another's poison. I can say with surety my days in LTC were much harder for me, having to manage giving multiple medications to 25-30 residents, supervise their wound care, and safety, as well as prevent falls and chart, chart, chart for medicare (another thread). The toughest thing about LTC was losing beloved residents, and watch others die slow, painful deaths. OB never came close when it came to heartbreak. I do know, in OB when things go "bad" they go very bad very quickly. I witnessed sudden death in the womb of babies when mom in labor. I witnessed a mom nearly die, hemorrhaging, and actually lose her womb at 16 d/t this rare situation. I have seen horrible situations in OB through the years, some of which almost made me quit nursing altogether. Losing a mom or baby is horrible, heart-wrenching and frightening. But again, I would challenge the notion it's "hardest" and that sure as heck ain't "rewarding".

Most rewarding? I challenge that too. For example, I find dialysis rewarding. You get to form amazingly close relationships with your patients, seeing them 3 days a week, day in out. You get to know them intimately (never happens in OB when your patient is discharged as soon as 12 hours' postpartum)---- you know their families, their hopes, fears, and get to celebrate with them when the long-awaited kidney transplant finally comes. You get to witness lives being transformed and have the privilege of helping others die with dignity and love. If that is not rewarding, I do not know what is. The thankyou's we receive in dialysis are also amazing, and keep us going in a very tough specialty. I can't count how many patients and families have personally thanked me for my participation in their loved one's care.

The one thing that always got me about OB was the litigious nature of the specialty. Charting for the lawyers was the number one concern oftentimes, day in and out. And the "herd em, herd em out" mentality of the 4 units I worked on was distressing. The house supervisor or CNO would come up, look at our census board and actually demand to know how soon people would be discharged (got to make room for the next patients). There was very little for time for meaningful teaching or interaction with the patients when I was responsible for more than one laboring patient or had 5 or more couplets postpartum. There just was never time, unless we were extremely slow. I found the whole "get em in, get em out" and high rates of induction/unnecessary intervention and primary c-section rates pretty darn disgusting and disheartening.

I could go on and on and on. ( I already have). I will let some others put in their opinions here. I think you are bound to have stirred up a hornet's nest. I would NEVER claim my specialty was "more rewarding" "hardest" or "Best"..........that is only a matter of opinion and everyone has one. :-) Have a nice day.

[lovemyjoblandd]

That's the point of the the thread really, is to let everyone talk about their specialties and why it is the hardest or the greatest. I did not disrespect other fields of nursing, just stated why i think L&d is. I anyone to join in and describe why you think your field is the hardest or most rewarding, for ME its l&d.

[MrsICURN14]

I think it's pretty presumptuous to say you could go to ANY other floor and work and be fine, but other nurses can't float to L&D?

I think specializing in any area means losing skills. You can read a FHM like a champ, but what if you were floated to a CVICU? Do you remember everything CV nurses have to know about rhythms and the 5 million different cardiac drugs? Do you know how to manage a pt on ECMO?

I'm just trying to point out that if we go into specialized areas we become masters for those particular skills, and would be hard pressed to float to a different specialty without brushing up on things. I don't remember much from OB, and like anything else in nursing, if you don't use it, you lose it!

I'm so glad you enjoy L&D and think that it's the end all be all. But there are advantages and disadvantages to everything.

[lovemyjoblandd]

I did telemetry teching and worked on a cardio step down unit. I was in med-surg for a year. Yeah i need a tick to brush up on my rhthyms but thr basics are there and i can tell the difference between nsr, tachy, brady, afib, vfib, btach, heart blocks, pacemakers, etc. the heart drugs are familiar to me, but id hit a drug book up before giving any meds i wasnt sure of. Im not saying if be as proficient as those nurses, but i could do it.

[SmilingBluEyes]

Oh and when I was in OB, I floated to others area/units like ED, ICU/CCU and med-surg as well as ortho. I NEVER was able to take a full patient assignment, being so unfamiliar with the ins and outs of those specialities. Most of the time, when floating I functioned to perform basic nursing tasks like giving some meds, doing linen changes, answering call lights, etc. I can say, in most of these units, if all the fulltime experience you have is in OB, you would sink in a New York minute without the regular staff picking up the slack. That's right, when we float those places, those staff have to pick up our slack, because we don't know enough to actually be able to function independently in those areas. Each specialty, from med-surg to Long term care has a steep learning curve and no as an OB nurse, you are not going to be able to waltz up on those units and just jump in. What we do in is OB is varied and skilled, but highly specialized and a lot of those skills just don't transfer to other specialties.

Like I said, you have a lot to learn. If you actually worked in some of these other areas, you would already know enough not to say half what you are saying. But, again, I wish you well.

[MrsICURN14]

You're a rare breed then. I have talked to many nurses who have specialized for 20+ years and they've told me "throw me on another floor or something drastically different and I would be screwed"

Every speciality is "the hardest" in their own right.

We are all nurses, nursing in general is hard!

[SmilingBluEyes]

Being able to "function" basically is not the same as taking a full patient load and working independently. Just because I may be able to read some telemetry strips or give some meds does NOT make me able to take on the load and do it myself. You can't honestly believe you can take all your OB skills and automatically transfer them, to say, geropsych or CCU, or med-surg. It's not possible. Again, I have 17 years' varied experience, but I know well my limitations. And I respect nurses in all specialties enough to defer to their knowledge when I am on their units.

[SmilingBluEyes]

And your limited OR skills (c-sections and PPTL) do NOT make for a skilled OR nurse. You would be lost, say, in a total knee replacement.

[lub dub]

While it may be true that "one cannot simply float and perform" on L & D, the same can be said for ICU, ED, open heart units, etc., etc., etc.

Plus, last time I checked, childbirth is not an illness.

[lovemyjoblandd]

The whole point was for me to tell why I think my jon is the best and for people to tell me why their job is the best, not to slam anyone. You guys are uptight. I said that it was for fun and just opinion. I wasnt asking why you thought i am wrong, i asked for people to tell me why their specialty is the best and hardest.