Four things I’ve learned my first year as an L&D nurse

Today marks my one-year anniversary of becoming a labor and delivery RN. If you had told me when I was in nursing school that I would someday be a labor nurse, I would have laughed at you. It was never something I thought I wanted to do. I was convinced in nursing school that I wanted to be a mental health nurse because of my own personal struggles with treatment-resistant depression.

When I graduated nursing school, I took a job in long-term/rehabilitation care, working as a charge nurse on night shift for a year. I relocated and took another job in long-term care, this time as a nursing supervisor. I realized after about a year I didn’t really enjoy supervision or long-term care and started looking for a hospital position. I took a job working as a med/surg nurse at a local hospital in 2013 and told myself that I’d give it two years, then decide what I wanted to do.

November 2015 rolled around and I realized I’d hit the two-year mark. I knew there was no way in hell I wanted to do mental health nursing because I hated floating to the inpatient psych unit in our hospital. I also realized I still didn’t know what I really wanted to do. So, because it was comfortable, I stayed. But I didn’t have a passion for my job. I was good at it – I could easily manage five complex patients on a busy unit on day shift – but going to work didn’t excite me and I knew I wanted to find something that did.

How I got where I am

One day in March of 2016, I was talking with a friend who had worked at the same hospital I did but left a few months earlier to take a position as a labor and delivery nurse at another local hospital. She raved about her new job and how much she loved everything about it. She told me they had an opening and I should consider it. And I did.

I thought about my experience years earlier, nearly delivering my neighbor’s baby and how exciting and rewarding it was to be a part of that child’s birth story. I thought about how being an L&D nurse was something I thought I could handle now that my child-bearing days were behind me, as I knew I couldn’t have dealt with my own infertility, loss and difficult deliveries while working with pregnant women all the time. I thought about how rewarding it must be to get to be a part of one of the most important moments in a family’s life. I thought about how the good days in L&D would far outweigh the bad ones and I thought I was in a place mentally where I could handle the bad days. So, I applied and what do you know, I got the position.

If you know me, you know that change is difficult for me. This was a huge change and I was prepared to struggle with things – simple things like learning where to find equipment on the unit and difficult things like realizing just how much there was to learn in a specialty. It was overwhelming and I questioned my decision to change career paths many times those initial months. I had huge anxiety issues about the change. But I stuck it out. I remembered how someone had once told me that it would take me a good year to feel comfortable as a med/surg nurse and they had been right. One of my new coworkers told me it would likely take me twice as long to feel that way about OB nursing as it was a specialty and that I just needed to give it time. And I believe she was right too. (Thanks Chris!)

One year in, I have learned a tremendous amount and grown so much as a nurse. And I realize there is so much more to learn, so much more to master, and I look forward to the day I can say I truly feel comfortable in my role as an L&D nurse. I no longer have anxiety about going to work as my confidence has increased greatly from those first few months and I can say that I am passionate about what I do and love going to work. So, what have I learned during my first year?

I am constantly learning

It’s okay that I don’t know everything. (This has been hard for me.) Due to a huge turnover of staff, we have a largely new crew of L&D nurses at work. Three of our 12-staff unit have been there longer than five years. A handful have been there longer than a year and the majority of us were hired within the last year. We have a saying “You don’t know what you don’t know.” And it’s true. I’ve been trained on many different scenarios, but you don’t know what it’s going to be like until you’ve been in it. I feel like I have the basics down, but the unknown is just that – unknown. And for me, the unknown is anxiety-provoking.

I’ve seen so many things this past year that I’d never been exposed to before – a 28-week preemie delivery, severe internal bleeding post-op resulting in a hysterectomy, hemorrhages, stat c-sections requiring emergent delivery of the baby, retained placentas, resuscitation of newborns, newborns with congenital abnormalities and conditions …Ā  And from every experience, I’ve taken away so much – things that will make me better, faster, more efficient the next time around.

I have to give a huge shout out to the three OB physicians I work with – they are amazing. I’m sure it’s challenging dealing with a largely new staff at times, but they are always ready to teach, to impart their knowledge on me and my coworkers. They work hard to not only take excellent care of their patients but make us better nurses in the process.

It’s taken a year, but I go to work now confident that I’ll be able to handle what comes my way because I’ve received great training, had so many great learning experiences and because I work with an amazing bunch of women who I trust have my back just as I have theirs.

I have amazing coworkers

Part of what makes this job so wonderful is that I am surrounded by an amazing group of women. This is the first job I’ve had where I can honestly say I like everyone I work with and I enjoy working with each and every one of them. There is no pettiness, no back-stabbing, no underhanded misdeeds with our crew. We’re solid. Our supervisor is wonderful as well, always making sure we have what we need and going to bat for us when we need her to.

I work night shift and I have five co-workers on nights. We’re the newest of the crew (everyone with seniority is on day shift) and we’re all still learning together. We each have our strengths and we each have things we need to get better at, but we all work together to maximize everyone’s strengths to take the best care of our patients. There is no “she is my patient/she is your patient” mentality, we all pitch in and help one another.

Just the other night, I was recovering a mom who had delivered earlier in the evening when a triage walked in, preterm and actively contracting. One of my co-workers took over my mom so I could focus on the triage and while I took orders from the physician over the phone, two of my co-workers were in the room with the patient, collecting a urine sample, starting an IV and getting a fluid bolus started … I know I am never alone when I work with my crew and I know I can count on them when I need them and that’s huge.

The bad days are bad

I knew going into this that not every day was going to be a joyous occasion. The sad reality is, sad things happen in the world of obstetrics. Loss happens, in many different ways.

I’ve had a patient bleed out internally due to unexplained uterine rupture (which is extremely rare) resulting in a hysterectomy to save her life. I’ll never forget the sadness I felt, standing in the room while the physician explained to the woman’s husband that she had tried everything she could to save her uterus – even called in another surgeon for a second opinion and another set of hands – but they were rapidly transfusing the patient and the only option left to save her life was to do a hysterectomy. I’ll never forget when she awoke from surgery and her husband explained to her that she’d never be able to have more children. I brushed away my own tears standing in that room. I grieved with her for her loss.

I’ve stood in a triage room, trying in vain to find a baby’s heartbeat only to have ultrasound confirm that the baby had died in utero. I watched while the physician held the mother’s hand and told her that her second-trimester baby had likely suffered a cord accident and died weeks earlier, despite her insisting that she had just felt the baby move. I’ll never forget her cry, her tears or the expression on her face as she processed what he was telling her. I brushed away my own tears in that room. I went home and sobbed that morning.

I’ve recovered mothers who miscarried, unable the pass the products of conception on their own and required a D&C in the wee hours of the morning. I’ve held their hand, acknowledged their loss, cried with them. I’ve given them information packets on miscarriage, infant loss and support groups and I’ve gone home feeling empty.

It’s hard. I’ve lost two pregnancies myself and while mine were early and years ago, I know what it’s like to grieve the loss of something you wanted very much. I know that hollow, empty feeling you get inside. I know the questions you ask yourself that have no answers. And every time I’m confronted with a loss at work, it brings back that raw emotion that I don’t think ever really goes away. I’m careful to grieve with the mother over her loss, to make it all about her while I’m with her. But I go home and a part of me grieves mine all over again.

I have decided that I don’t think this is something that gets easier with time. I think it’s just something you have to be able to accept if you work in this field. I’m a strong person and I know my personal experience in this area only helps me provide better patient care, as difficult as it is. This again is where having amazing co-workers helps – they’re a great source of support – and the physicians are wonderful at debriefing staff when this happens as well.

I’ve learned to set my judgments aside

Over the last year, I’ve learned to set aside my own judgment of a patient or a situation and just focus on giving the best care I can provide. This hasn’t come easy, but it’s getting easier with every new patient I care for.

I see it all in my line of work – the teenage mother, the drug-addicted mother, the single mother with no support, the mother giving her baby up for adoption, the mother with an extremely dysfunctional family situation, fathers in jail, the woman who is pregnant as a result of rape or incest. And I also see married couples, couples who have tried for years on their own to get pregnant, couples pregnant through in vitro or other assisted reproductive technology, and couples adopting the baby another mother gave up.

I try very hard to not judge others – I have no idea where they come from, what motivates them, what they’ve been through in their lives. Some people are products of the environment in which they grew up while others made poor choices, either way, it’s not my place to judge. It is my place to provide the most compassionate care I can while I take care of them.

I was married when I had my first baby. I was young (in my eyes) at 24, but my then-husband and I both really wanted and felt ready to have a child. We were young professionals, homeowners, active in the community … the type of home you think of as idyllic for a child.

When I had my second child at 30, I was single, unemployed and in nursing school full-time. My now-husband and I were not married yet, our relationship was very new and I had no idea what our future held. I was on medical assistance and food stamps. It was not a stable home situation at all, yet I wanted that baby more than I had ever wanted anything. I can only hope that the nurses that took care of me in the hospital following my c-section didn’t judge me for my situation and make assumptions about me based on my socioeconomic or marital status.

When my third child was born at 36, my husband and I were married, both professionals working in our chosen fields and actively raising our other children.

So, when it becomes tempting to judge someone based on their current situation, I try really hard to remember my own journey and put those thoughts aside. Everyone deserves the best care I can provide, period.

The next year

I am looking forward to what this next year brings for me professionally. I look forward to continued growth in my skills, improved confidence in my abilities and the friendship of my co-workers. I look forward to providing the best care I am able to mothers during their labor and their families postpartum. This past year has been amazing and rewarding in so many ways and I’m sure the coming years will hold more of the same. Being a part of the birth of someone’s child is truly an honor and I’m so glad I took a chance on this career opportunity.



23 Comments

  • Dara

    I think it’s amazing what you do! It must be a hard yet fulfilling job. Aside from the losses, you must have one of the most happy nursing jobs there is!

    • Jen

      Yes, most days are really happy and I love going to work! Even the days with losses are rewarding in their own way, especially if you’ve made a connection with the mom.

  • Lisa Clark

    Thank you SO much for sharing your story. It’s fantastic what you do. I’ve had 5 babies and I can tell you stories with each one of how a L&D nurse going the extra mile made everything so much better for me. It’s truly a special role you have. Thank you!

    • Jen

      I’m so glad to hear of your experiences, that’s wonderful! I hope I make a difference in my patient’s lives and leave a good impression!

  • Lindsey

    Loved reading your story. I’m an oncology nurse but think L&D has to be such a rewarding field…patients are lucky to have you because it seems like you’ve lived through a lot of their experiences…so glad you have found your passion!

    • Jen

      Thank you! I consider myself extremely blessed to do what I do. Oncology is a hard field too, although I wasn’t an oncology nurse, I worked on a floor with oncology patients so I’m familiar with their care. Thank you for doing what you do – it’s a calling!

  • Alexandra Hammer

    It’s so hard to read about the hard parts šŸ™ I know that the good outweighs them, but still heartbreaking! It takes a special kind of person to be able to go through those tough situations; I’m not sure I could!
    Xo, Alexandra Christine Blog http://www.alexandrachristineblog.com

    • Jen

      The hard parts are that – hard. But I’ve learned that it’s okay to show I’m grieving with them too. Wiping a tear away just means I feel for them and I know they can see that.

  • Leah

    What a moving and positive post. My sister-in-law is a L&D nurse too. It’s a tough job, but also very rewarding.

    • Jen

      Yes, definitely stressful and nerve-wracking. I had no idea how complex L&D was until I was immersed in it. Thankful I’m done having my kids cause I would have been a wreck otherwise!

  • Julie Hoag

    Loved reading about your journey! I’m a nurse too but I’m not working as a nurse now, but when I worked in the hospital I worked in peds. Thanks for sharing!

  • Kseniya Gershberg

    You are AMAZING for doing all that you do! Labor and delivery nurses are so important and your job is very hard. Thank you for serving all of the moms. It is so sad and hard to see loss but at least you are there with them. Very touching and great blog!

    • Jen

      Thank you!

  • Vicki @ Babies to Bookworms

    Wow, you are amazing. I can’t imagine the immense joys and terrible heartbreaks you have witnessed.

    • Jen

      Thank you. This is the most rewarding job I’ve had and I’m so glad I took a chance on something a little out of my comfort zone.

  • Maya @ FilteredFamily.com

    Wow, I loved reading this, and even shed a few tears. Really connects us to each other in such a simple human way.

    • Jen

      I’m glad you enjoyed it! It’s amazing the connections you make in this field, that’s for sure!

  • Patricia

    Wow, I had no idea you are an L & D RN! Thanks for all you do!! That final lesson is sooooooo important in life!!

    • Jen

      Yes, I don’t blog a lot about work on here, but I spend three days a week there! šŸ™‚ Thank you – yes, the last lesson is SO important.

  • Amanda

    L&D nurses are such a god send! I had a postpartum hemorrhage with my third baby, & I am so grateful for the amazing nurses that were by my side through that. I can’t imagine being put in the painful scenarios that you described; trying to walk patients through such loss. But thank God you and your fellow L&D nurses do it, because it is such important work. Thank you for everything you do.

    • Jen

      I’m glad you were okay and you had a good experience during a scary time. Thank you for the kind words!

  • Chesney

    Iā€™m so glad I found your blog. Literally I feel like God directed me to you. Iā€™m on orientation at a birth center coming from NICU/Newborn/Mother-Baby prior experience. I feel like a post grad RN all over again. My confidence is at an all time low, but your post brings new hope in that self-confidence will return. New job along with a demanding 9 month old and no childcare options is stressful to say the least. His daddy cares for him when I work but we have to work opposite of each other for that to work.

    • Jen

      Hi! Thanks for reading – I’m so glad you found it helpful! It does get better, just give it some time. I really hit my groove at the one year mark but then I ended up on disability and off work from April to October and now, being back very part time, I am feeling all those feelings all over again. I’ve got little ones at home too and it’s hard to balance it all. Take each day at a time and just do what you’ve got to get thru it for now. Eventually you’ll all find your groove! I wish you the best of luck in your new career! Ever want to chat, just let me know and I can message you on Facebook if you like. Always happy to help another RN! Hugs … you got this girl!

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