Career Series: Spotlight on Labor and Delivery Nurses


By Megan Murdock Krischke, Contributor

Labor and delivery nurses love their jobs so much that there tends to be very little turnover in L&D units.

“What’s not to like?” began Jamie Lomber, RN, BSN, RNC-OB, a staff nurse at Providence St. Vincent Medical Center in Portland, Ore. “It is amazing to share in such an intimate experience in people’s lives.”

“During labor there is not time for patients to put up walls,” she continued. “You get to see people for who they are and get to experience caring for people during a really wonderful time of their lives.”

“Even in times where things are really challenging--in a high-risk birth, or when a more sad situation is occurring--there is something beautiful you find in these women. Even in difficult situations you can still get down to the basic needs of that mom and baby to help them connect and bond,” added Jenny Prible, RN, BSN, RNC-OB, a charge nurse at St. Vincent. “It is different than in other units--you are connecting at a totally different level.”

Jenny Prible and Jamie Lomber, labor and delivery nurses.

Experience counts

Though Prible had dreamed of being an L&D nurse since high school, she started her nursing career with two years of working in the med–surg unit of a VA hospital, and Lomber began hers with one year in the postpartum unit. Both nurses agree that any clinical experience you can have before starting in L&D is beneficial. At St. Vincent it is typical for nurses to work in postpartum before moving on to L&D so that they can become familiar with working with mothers and infants.

“The L&D unit is unique because it is like an ED because we are triaging patients, it is like an OR because there are often surgeries, and it is like an ICU because we can have critical patients,” explained Prible. “It tends to be fast-paced at the nurses’ station, but the delivery room is a slower-paced, sacred space.”

Helping patients through the unexpected

Amy Hiebert, RNC-OB BSN, an L&D charge nurse at Swedish Medical Center First Hill in Seattle, Wash., said, “It is important for a nurse to be able to live in the ‘grey’ of L&D. There are a lot of protocols and practices that are not black and white and you have to make judgment calls in the moment. It can also be a very physically and emotionally challenging job--you have to be fully emotionally present with your patient and also able to turn to help epiduralized patients or provide continuous labor support to a non-medicated patient.”

“Every woman and family comes in with some expectations and our job is to honor their hopes and dreams around their delivery while also adapting with the reality of the situation,” noted Lomber. “We try to always communicate with kindness and help them see the beauty of the experience even if it is different from what they plan.”

Prible notes that labor and delivery nursing isn’t a specialty for someone who loves routine.

“While you can expect to spend the day assisting births, no birth is the same. You have to be willing to change and flex,” she stated. “One thing that is unique is that you are caring for two patients--both the mom and the baby.”

Various RN jobs in labor and delivery

There are a variety of roles in which a nurse can work in a labor and delivery unit

Some of the key responsibilities of those performing L&D nurse jobs are monitoring and interpreting fetal monitoring tracings and keeping the physicians updated.

There are a variety of roles in which someone who works in one of the nurse specialties such as L&D can work. The three main roles include: triage, labor nurse, and nurses who are assigned to scheduled C-sections. There are, however, many other niches a nurse may fill including scrubbing into surgeries, managing a unit, teaching birthing classes, or serving as a nurse educator, a quality control specialist or a lactation consultant.

The average labor and delivery nurse salary is around $60K/year, but can vary based on experience and location. OR and PACU experience can increase labor and delivery nurse salaries by over 20 percent. L&D travel RN jobs are also plentiful for those who may want to try out different facilities or work in another part of the country.

“L&D is a highly sought after RN job because it is typically a very happy place to be,” explained Hiebert. “We have one-to-one patient care and generally healthy patients. Nurses should be willing to work night shift for several years once they apply for an L&D RN job since nurses tend not to leave because it's so amazing! When I applied there were 10 spots and over 300 applicants.”

Lomber mentioned that once when she got home from a shift, her four-year-old daughter took Lomber’s face in her hands and said, “When you get home from work, you smell like a miracle.”

“She was so proud of me. And she is right, I look forward to going to work because I get to be a part of miracles,” she said.

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