3 Essential Skills a Labor and Deliver Nurse Must-have
By Leigh Morgan, Contributor
Labor and delivery nurses are present for some of the most important moments of their patients' lives. Although working with moms and their newborn babies is rewarding, it is also one of the most challenging nursing specialties. An uneventful pregnancy can quickly turn into an emergency, causing a labor and delivery nurse to jump into action to protect the lives of the patient and her baby. To succeed in this specialty, you must possess the following skills.
3 Essential Skills of a Labor and Delivery Nurse
In the labor and delivery unit, several medications are used to stop premature labor, ease the pain of contractions and prevent complications caused by conditions such as gestational diabetes and preeclampsia. One of the most important skills of a labor and delivery nurse is the ability to choose the correct route of administration and follow the ordering physician's instructions regarding drug dosages.
Labor and delivery nurses must also understand some of the most common medication errors and how to prevent them. For example, in a practice brief on the administration of oxytocin to control postpartum hemorrhaging, the Association of Women's Health, Obstetric and Neonatal Nurses indicates that oxytocin should never be administered by IV push. To prevent this error, bags of premixed oxytocin should be labeled clearly and stored away from bags of plain IV fluid to prevent confusion.
Skill 1: Excellent communication
As a labor and delivery nurse, you play an important role in helping women expand their families. When a woman is in labor, she needs an encouraging nurse who can act as a coach and support her through the process of giving birth and meeting her baby for the first time. Nurses for a Healthier Tomorrow reports that a labor and delivery nurse must also be able to communicate effectively with family members and other medical professionals. In addition to communicating orally, you must be able to communicate effectively in writing, as labor and delivery nurses are expected to keep detailed patient notes.
If you're confident in your communication skills and interested in getting paid to travel, search our job openings for labor and delivery nurses.
Skill 2: Patient assessment
Patient assessment is one of the key skills of a labor and delivery nurse, and it's a skill you must possess if you want to succeed in this specialty. Complications such as excessive bleeding and abnormal fetal heart rate can develop quickly, so it's essential that labor and delivery nurses assess their patients at regular intervals. According to CRICO, a risk-management organization affiliated with the Harvard medical community, L&D nurses should discuss each patient's progress and plan of care once every hour. During an assessment, a labor and delivery nurse should determine the position of the fetus, assess the patient's pain level and perform an examination to assess cervical dilation.
Skill 3: Prioritization of patients
Like nurses in other specialties, a labor and delivery nurse typically cares for more than one patient at a time. Therefore, one of the most important skills of a labor and delivery nurse is the ability to prioritize the needs of multiple patients. Effective prioritization starts with a thorough assessment. During this assessment, pay close attention to the patient's acuity, as acuity level typically dictates how much time and attention a patient is likely to require.
In a committee opinion issued in 2016, the American College of Obstetrics and Gynecology notes that gestational age, medical condition and delivery status should also be considered when triaging obstetric patients and determining which patient to see first. When you assess a patient, look for these abnormal vital signs:
- Maternal heart rate greater than 130 beats per minute or less than 40 beats per minute
- Maternal oxygen saturation of less than 93 percent
- Fetal heart rate less than 110 beats per minute for more than 60 seconds.
Your patient may need immediate attention if she has of any of the following:
- Sudden changes in mental status
- Respiratory distress
- Potential uterine rupture
- Potential placental rupture
Whether you're a brand-new labor and delivery nurse or an obstetric nurse with 20 years of experience, it's important to develop and maintain these essential skills. Once you have the right combination of obstetric nurse skills, you have the option of working in a hospital, birthing center or obstetrician's office.
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