The Great L&D/PP Divide: AKA, Bikers vs. Puritans

Wow, what a very long time it’s been since I last managed to post!

Let’s just say business has been good and I’ve been preoccupied with delivering babies over the past few months.  Unfortunately, that has precluded me from writing as much as I’d like to.  It has, on the other hand, given me a lot to write about!

So let’s talk about a phenomenon that is pretty much universal in inpatient OB nursing…the difference between L&D and postpartum (PP) nurses.

If you work on a unit like mine where L&D and PP are split, it is easy to spot the personality differences between L&D and PP staff, and sometimes, this difference can cause a bit of a rift between the units as a whole.

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Generally speaking, the beef that each side has with the other is due to the basic functions of L&D nurses vs PP nurses and the differences in personality that often coincide with each sub-specialty.

The Postpartum Nurse through the eyes of the L&D Nurse

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A PP nurse tends to stick to a schedule and a well-laid plan, sometimes to the point of seeming inflexible.  One might say they’re sticklers for tradition (cue the Fiddler on the Roof music!).  Nevertheless, this down-to-the-minute timing is important.  They often have 3-4 couplets (moms and babies) to care for, scheduled and PRN medications to keep up with, and round-the-clock teaching, especially for new moms and dads, to contend with at all hours of the day and night.  So on that note, it’s no wonder you’d think someone spit in their cheerios when you ask them to take a fresh C-section patient in the middle of their midday assessments.

PP nurses also have the added responsibility of helping parents establish a pattern for feeding, sleeping and caring for baby, which ideally begins to take root before baby goes home.  PP nurses try to maintain some semblance of a routine so that when mom and dad are cut loose with baby in a few days, they aren’t left floundering at home, wondering how the heck they’ll ever survive without Nurse Annie rounding on them every hour.

Now, keep in mind this isn’t every PP nurse, but some carry the “it must be done my way at precisely this time” attitude beyond the point of reason.  Thankfully, the vast majority can ignore the subtle, insignificant differences in practice amongst their colleagues and adapt to the changes as they come. It’s the ones who can’t move past the fact that the L&D nurse told them the baby’s weight before their APGAR scores in report with whom you’ll most often see trouble.

The L&D Nurse through the eyes of the Postpartum Nurse

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L&D nurses typically enjoy being busy.  They are adrenaline junkies in hiding.  Unlike the ER nurse, who wears her love for the rush of a trauma on her sleeve, L&D nurses quietly thrive on the occasional thrill of the unexpected–a prolapsed cord, a crash C-section, a laboring woman who comes through triage dilated to 10cm at 1am screaming for Jesus and stopping 2 feet short of her delivery room to push out a baby in the middle of the hall–y’know, that kind of thing.

As such, L&D nurses can be perceived as disorganized, harried, rowdy, rude/outspoken, and at times, even a little bit crazy.  While I’ll give you a bit of room on that last descriptor, disorganized and harried aren’t common traits of L&D nurses…at least, not good ones (and trust me, it’s usually very obvious very quickly if an orientee can’t roll with the punches in the heat of a delivery).  Because there can be so much chaos inherent in our jobs, a good L&D nurse keeps a level head no matter what is going on.  She is likely very organized, but not off-put if she doesn’t have time to dot her i’s and cross her t’s.

As for rowdy, rude, and outspoken…again, the very nature of L&D nursing is likely to attract a more lively crowd, so don’t be too surprised if you hear your L&D nurse swear under her breath at the **** IV pole as she’s trying to prime her pitocin line as her patient is swearing at the doctor, the doctor is yelling at the surg tech, the surg tech is yelling at the nurse, and the nurse is venting her frustration on the technological advances of modern medicine.

As long as the charting is done, her report sheet is (relatively) complete, and her patients are alive and well, your L&D nurse is a happy nurse.

The Bottom Line

It’s a pretty straightforward one…L&D nurses are different from PP nurses, and for a very good reason.  If you work on an LDRP unit where L&D and PP aren’t separate, see if you can pick out the differences between those coworkers who prefer to care for the laboring and those who tend to prefer postpartum patients.

At any rate, those with strong skills in either department are indispensable assets to mothers and babies.  Because if you ask any given L&D nurse and any given PP nurse if they want to trade places for the day, your answer will invariably be…

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Or, in the vernacular…”NO!”