Travel Nursing as a Labor and Delivery Nurse
Labor and Delivery (L&D) nurses care for and monitor mothers and babies during labor and birth. L&D is regularly considered one of the most in demand travel nursing specialties. However, there are several issues regarding the L&D travel job market that L&D nurses interested in travel nursing should be aware of in order to properly set expectations and plan accordingly.
Labor and Delivery Travel Nursing Job Outlook
L&D was listed as one of Healthcare Traveler Magazine’s 7 most in demand specialties for 2013. This is no surprise as L&D is a highly specialized unit. Therefore, experienced nurses can be tough to come by. However, high demand doesn’t necessarily equate to stability.
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Industry insiders interviewed by Healthcare Traveler were quick to point out the volatility in the L&D travel job market. In short, demand for the specialty tends to experience peaks and valleys. My personal experience as a recruiter indicates the same. There were times when my old company would have hundreds of L&D openings nationwide and others when we would be lucky to have 10. I’ve heard a lot of speculation as to why this volatility exists. Some contend that demand spikes are consistent and cyclical based on some event that happened 9 months prior. For example, some people point to Valentine’s Day or wedding season as the culprits. However, there really doesn’t seem to be any consistency based on my experience.
Interestingly, it’s very possible that the volatility drives demand for L&D travel nurses. Hospitals may realize that they’re going to experience major spikes throughout the year. They then staff for the slower period and utilize travelers for the peaks as a measure to cut down on overall staffing costs.
In any case, L&D nurses should game-plan for this volatility. Flexibility is always the key to solving this problem. There may not be an assignment available in your most desired location when you’re ready for your next assignment, but there will definitely be opportunities available elsewhere. We highly recommend reviewing our article on deciding where to travel as a travel nurse for some helpful ideas on forming a strategy.
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Experience requirements are another issue that potential L&D travelers should be aware of. Many hospitals have very specific requirements. For example, some hospitals require experience with high risk deliveries. Others require 3-5 years of experience which is higher than the standard 1-2 years of experience for other specialties. And many rural facilities will require experience in a similar setting.
Moreover, different hospitals organize their L&D units in different ways. Some hospitals take an all-inclusive approach in which their L&D nurse might be responsible for Postpartum and Mother/Baby care. Others separate these care regimes from the L&D unit and assign different nurses to the various stages of the childbirth process. As a result, hospitals tend to seek candidates with experience in units organized similar to their own. Of course, the stringency that hospitals exhibit with regard to their experience requirements will ebb and flow with job market.
Labor and Delivery Travel Nursing Job License and Certification Requirements
License and certification requirements for L&D travelers tend to vary quite a bit. However, as with all specialties, it’s standard for hospitals to require that candidates be licensed in the hospital’s state prior to being submitted for an assignment. There are some exceptions, most often in states that have a walk-through licensing process, but these opportunities are rare.
In addition to the appropriate state RN license, L&D assignments almost always require NRP certification. BLS certification is another standard requirement. Others will require a PALS certification. And, believe it or not, it is becoming more and more common for L&D assignments to require ACLS certification. As always, your best bet is to attain all of these through the American Heart Association.
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Finally, more and more hospitals are requiring an AWHONN Advanced Fetal Heart Monitoring (AFHM) certification for their L&D nurses. This certification is pretty much a standard requirement in California and it is growing in popularity nationwide. The most important consideration regarding AFHM certification is that it can be difficult to obtain. AWHONN is certainly offering more certification classes these days, but it can still be difficult to find classes in certain locations. Moreover, there are a limited number of dates, and classes tend to fill quickly. Planning in advance for this certification is in your best interest.
It’s a good idea to obtain all the certifications listed here prior to starting your travel career. Landing the best assignments, and your most desired jobs, has a lot to do with being ready when the opportunity strikes. Having all of the certifications helps ensure that you are maximizing your potential with respect to the pool of available assignments at any given time.
Labor and Delivery Travel Nursing Pay
Labor and Delivery almost always falls under the “Specialty Bill Rate” category. This means it is in the category of specialties for which companies bill the hospital the higher rate specified in their contract. Moreover, there are some hospital/agency contracts that specify a specific rate just for L&D. This rate is typically a bit higher than the rest. However, none of this means that L&D travelers make tons more money than everyone else. The differences tend to be between $1 to $3 higher per hour.
As with bill rates for all specialties, there is a broad range from the lowest to the highest bill rates for L&D. Bill rates for L&D can range from roughly $54 per hour on the low end to roughly $75 per hour on the high end. It’s important to remember that lower bill rates are predominant in regions with a lower cost of living while higher bill rates are predominant in areas with a higher cost of living. However, there can be large variations within a specific region as well.
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While the job market volatility for L&D travel nurses can present some problems, it’s also one of the reasons that the specialty tends to see the most crisis rates. When demand spikes, the surplus of available jobs relative to the number of L&D travel nurses in the market tends to force hospitals to initiate their crisis rates. These rates can be anywhere from $5 per hour to $20 per our higher than the normal rates. These rates tend to motivate recruiters to aggressively recruit for the openings. The rates also tend to persuade L&D nurses who might not otherwise be interested in the assignment to consider it.
As with all specialties, bill rates for L&D travel nurses tend to fluctuate with the labor market. When the labor market is tight (more jobs than people) rates can get forced up, and when it is slack (more people than jobs) it can get forced down. Overall though, bill rates for L&D travel nurses tend to be higher relative to most other specialties.
L&D Travel Nursing Job Considerations
Unit organization is perhaps the most important consideration that L&D travel nurses should account for when evaluating a potential assignment. As mentioned previously, different hospitals organize their L&D units in different ways. This means that some hospitals have their nurses focused on specific aspects of the process while others have their nurses involved with all aspects of the process.
You can attempt to find out about how the unit is organized prior to being submitted for an assignment. However, you should always inquire about it during the travel nursing job interview regardless of whether or not your recruiter has provided you with the information. This is because recruiters often rely on boiler plate unit descriptions provided by the hospital which offer very little detail. Moreover, recruiters and agencies are rarely able to contact the hospital unit directly to inquire about specifics. Therefore, recruiters are often uninformed about specific unit organization issues.
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L&D travel nurses should also consider the type of hospital when evaluating an assignment. Specifically, is the hospital urban or rural? Rural hospitals tend to have lulls in births. However, they are still going to want the travel nurse to contribute during periods when there is no L&D work. Some rural hospitals will require floating to the Medical Surgical unit. Again, this is an issue you’ll want to address during your travel nursing interview.
L&D is an in demand specialty for. However, you’ll want to be sure that you have the appropriate licenses and certifications as well as flexibility in order to weather the down times in the overall L&D travel job market. In addition, always be sure to evaluate hospitals during the interview to ensure that their unit is a good fit for you.
