Labor and Delivery Nurses
Labor and delivery nurses are there at the start of life. They care for mothers and newborn babies. They provide nursing assessment and interventions for mothers before, during, and after birth. They assess fetal health status and stabilize babies when they make their entrance into the world.
L & D nurses provide treatments to make the process more comfortable. They perform nursing interventions for complications. They also explain what’s happening to those who are not well-prepared and report changes to higher level professionals. Labor and delivery nurses need very good bedside manner. They may provide a level of support to others involved with the birth: reassuring family members and urging them to take care of their own needs.
Labor and delivery is an obstetric specialty. RNs attend both low and high risk deliveries. Hospitals may make a distinction between pre-partum, labor and delivery, post-partum care, and obstetric surgery. However, RNs may rotate between the different related units. Nurses may have a circulating or scrub role during cesarean deliveries. Labor and delivery is distinct from NICU as, in the latter case, the focus is on infants with serious needs.
L and D nurses work under ob-gyns. The nurse, though, is often the health professional that the mother sees the most of. A writer for Parents Magazine noted that while she had worried beforehand about which doctor would have responsibility for her delivery, she needn’t have –it was the nurse who saw her through. An RN quoted in the article compares the physician to the “relief pitcher who shows up in the bottom of the ninth inning when there’s two outs and two runners on base” (https://www.parents.com/pregnancy/giving-birth/labor-support/secrets-of-labor-room-nurses). Of course one sees more of the doctor when things are not normal and routine .
Labor and delivery nurses see plenty of blood and body fluids and a lot of pain. They also see a lot of happy endings. Professionals caution, though, that not everything ends this way; there are still births along the way. There can be other unexpected life changing news.
Ultimately, L&D nurses are a critical part of a life-changing time –one of the most memorable in a person’s life – and as such, they are remembered.
Becoming a Labor and Delivery Nurse: Labor and Delivery Nurse Schooling
Labor and delivery nurses start out their careers the way other nurses do: by completing nursing school and passing a licensing examination. Those who earn bachelor’s degrees will have the most options. The licensing examination is general.
Nursing students gain some experience with a wide range of populations. However, those experiences won’t all be equal. Some professionals recommend that prospective labor and delivery nurses do a senior practicum in that setting.
New graduates may have the opportunity for a residency. HCA Healthcare, for example, offers five months of preceptorship and hands-on training for select candidates willing to make a two year commitment (https://careers.hcahealthcare.com/pages/labor-delivery-nurse-internship-ladi-training). Candidates must have their BSN. Among the highlights are Centricity Perinatal Health Record and Meditech training, Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) Intermediate Fetal Monitoring Certification, and high-fidelity simulation.
Those who have some nursing experience may also have the opportunity for formal training. Swedish (Washington State) recently sought early career nurses who had at least a year of prior experience. Selected candidates would have both classroom and clinical training; they would receive one on one preceptorship. The BSN was a preferred qualifier, but RNs who had not yet earned their BSN could be considered.
Nurses who have made it into L&D are among the best sources of information. One RN recently blogged about how she tailored her nursing school experiences to land her dream job (https://www.nurse-clara.com/nursing/2018/9/26/sie6y46hcrm89gry4hg4spktakv8u7). She started making connections early, both at school and on social media. She selected a first, second, and third choice for her practicum that were all baby-related: L&D, NICU, and the admission nursery.
Specialty certification allows experienced nurses to validate their expertise – and in many cases, increase their earnings.
Certification in Inpatient Obstetric Nursing is available from the National Certification Corporation, or NCC (https://www.nccwebsite.org/certification-exams/details/2/inpatient-obstetric-nursing). Candidates must have 2,000 hours of experience in the specialty.
Examination content falls into the following categories:
• Fetal Assessment
• Complications of Pregnancy
• Recovery, Postpartum and Newborn Care
• Labor and Birth
• Professional Issues
Labor and birth is the single biggest category. It includes labor physiology, labor assessment and management, pain management and coping, obstetric and perioperative procedures, complications, and induction and augmentation. Complications of pregnancy, the next largest category, includes fetal and newborn complications, maternal environmental, and psychological factors, preterm labor, multiple gestation, and placental disorders. The fetal assessment category includes antenatal testing, electronic fetal testing, non-electronic monitoring, and acid-base interpretation.
Labor and delivery can be a step along the path to becoming a certified nurse-midwife. This is a graduate level nursing career that involves actually delivering babies. Nurse midwives assist with low-risk pregnancies and normal deliveries. They also provide other medical care for females.
Association of Women’s Health, Obstetric and Neonatal Nurses (https://www.awhonn.org)
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