Evaluation of the Labor and Delivery Nurse
Beth Cornelius
Jacksonville University
October 16, 2018
1. What is the current job availability of the role? How does one get promoted in this role?
There is a large availability of jobs for labor and delivery nurses. From 2012 to 2022, the growth of all nurses nationally is expected to increase by 19%. The growth of nurses in the field of labor and delivery specifically is expected to be even greater. Regionally, Florida is a very prominent state in the field of nursing being in the top five states with the highest nurse employment rates. Florida is accompanied by New York, Pennsylvania, California, and Texas. In the field of labor and delivery, there are multiple ways to be promoted. First, if an L&D nurse passes the National Certification Corporation exam, they will acquire the credential for Inpatient Obstetric Nursing, allowing them to increase their salary. Also, the nurse’s pay can be boosted if they opt to specialize in obstetrics where high risk is involved. Next, some labor and delivery nurses choose to go down the path of becoming a midwife or even starting their own practice, which again would lead to an increase in compensation. Finally, if a masters degree is acquired, further education is pursued, or the nurse has become a nurse practitioner, promotion and an increase in salary are likely to occur.
2. What is the salary associated with the role? Are there any fringe benefits such as insurance, sign-on bonuses, productivity bonuses, tuition reimbursement?
Labor and delivery nurses earn a very respectable salary with a national average of around $73,550 a year or $35.36 an hour. Working overtime can allow for a large increase in hourly pay reaching around $60.50. However, an L&D nurse’s salary can vary due to education level, where they live, experience, and the specific description of their job. Florida is on the upper end of the pay scale in terms of the salary of labor and delivery nurses, however the state is still slightly below the average. The salary of L&D nurses in Florida typically ranges from around $59,000 up to $72,000 depending on the education and certification level of the nurse. When labor and delivery nurses pursue graduate education, financial assistance is often times provided by their employers to help cover the tuition.
3. What are the specific job responsibilities of the role? Where is the usual employment setting? What is the chain of command for the selected role?
There are many responsibilities that come along with the role of being a labor and delivery nurse because the care of their patients takes place in four stages. An L&D nurse is first exposed to patients in the pregnancy stage during prenatal visits where they monitor the fetal heartbeat. They play a large role in the delivery stage by determining the strength and timing of contractions, monitoring vital signs, inserting and maintaining IV medication or fluids, providing support by coaching the women, and much more. After delivery, the nurses continue to play a role in the postpartum and neonatal stages. Labor and delivery nurses will then perform tests on the newborns in order to determine the health of the baby and begin to monitor vital signs. They may even help with getting the newborn to breastfeed. Labor and delivery nurses will mostly be found in hospitals and birthing centers. However, they may also be present in doctor’s offices, maternity centers, and clinics. The chain of command is a system put in place in order to protect the nurse and the patient, and to provide the best possible solutions to issues that arise. The chain of command starting with the least responsibility to the most goes as follows: nursing assistant, charge nurse, nursing supervisor, assistant director of nurses, director of nurses, and administrator. This is the order in which conflict is approached, staring with the nursing assistant and ending with the administrator.
4. What are the pros and cons of this nursing role?
The role of being a labor and delivery nurse is extremely rewarding, for they experience the most joyous moments of a women’s life with her, having a newborn baby. On the other hand, the experience could be extremely devastating if complications were to occur, and labor and delivery nurses need to be prepared for both extreme ends of the possible outcomes. Labor and delivery is an extremely popular specialty which means that they will have to work night shifts typically towards the beginning of your career. The plus side of night shifts is higher pay. Also, a nurse can start their career immediately in an obstetrics unit because this specialty provides training while you are working in that unit. There is no extra certification or education needed. There will be times when emotional support will be needed by the patients that is particularly difficult for the nurse to give due to trauma of losing a newborn or the mother when it was supposed to be such a happy time.
5. What are the specific educational requirements?
The educational requirements of a labor and delivery nurse start off with a Bachelor’s Degree. Typically, a Bachelor’s of Science in Nursing, or BSN, will take four years to acquire. After attaining a BSN, the National Council Licensure Examination must be taken. If the NCLEX is passed, then according to your state’s licensing board, you will be certified as an RN. Neonatal resuscitation and fetal monitoring are also two things that one must be trained in when becoming a nurse in the field of labor and delivery. Continuing education courses are required as well for labor and delivery nurses. Although it is not mandatory, many nurses will apply to graduate programs in order to elevate their education. Becoming a nurse practitioner or specializing at a higher level in a certain field can both be achieved through the attendance of graduate school.
6. What is the history associated with this nursing role?
The field of labor and delivery is something that has been around since ancient history. In biblical times, midwives are seen delivering babies in the Old Testament. As time went on, the assistance of the delivery of babies went back and forth between midwives and male physicians. However, midwives continued to aid in at-home births into the 19th century. Between 1890 and 1920, also known as The Progressive Era, the involvement of hospitals and physicians with delivering babies became very prevalent. The increase of industrialization and urbanization greatly decreased the sanitation of cities which lead to a new burst of hospital openings. The American Board of Obstetricians and Gynecology was introduced in 1930. This allowed for breakthroughs on the improvement of how women give birth and how to facilitate it. Finally, the first opening of labor and delivery rooms occurred in 1980.
7. What are some ethical dilemmas associated with this nursing role?
Labor and delivery is a difficult subject when it comes to ethical dilemmas. As an L&D nurse, you have to look out for the needs of two patients not one, the mother and the fetus. There are ongoing debates over many ethical issues related to pregnancy such as abortion. On a similar note, another dilemma is what sorts of actions are to be taken when disorders or issues are discovered in prenatal screening. The rights of the mother versus the rights of the fetus is a topic that is very sensitive. Also, a conflict about prematurely-born babies is what their quality of life will be like depending on the severity of their circumstances. As a labor and delivery nurse, you have to be supportive of the decisions of mothers even if you do not ethically agree.
8. What are the specialty certifications or organizations that are associated with this
role? What are the fees, testing procedures, length of time certification is
effective, and renewal process?
The National Certification Corporation is one organization that is associated with labor and delivery nurses. They are an organization that allow for the acquirement of more advanced certification related to labor and delivery. A few of these certifications are maternal newborn nursing, inpatient obstetric nursing, and low-risk neonatal nursing. The NCLEX usually costs around $200 nationally to take. In Florida, the initial fee for licensing is $175 and this must be renewed every two years which costs $80. Also, continuing education hours are required for labor and delivery nurses, but more specifically every third renewal of your license requires a two hour course on domestic violence education.
References
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Grading Rubric for Scholarly Paper on Selected Nursing Role
Detailed response to each of the eight questions (8 points each) 64 points
APA format to include grammar, spelling and punctuation. 11 points
75 points