Clinicians specializing in labor and delivery (L&D) often insist they are involved in the most appealing area of the healthcare profession. It has more to do with life than death, with miracle than struggle. Indeed, L&D has been described as an "affirmative" specialty, rather than a reactive one. Nevertheless, labor and delivery nurses and surgical technologists must rely on their expertise to ensure that nothing goes wrong in the birthing process. When issues do arise, these providers have to be able to respond quickly in a spirit of cooperation with members of the L&D team, from obstetricians, midwives, and anesthesiologists to other nurses and surg techs.

Strides in technology and more advanced protocols in the handling of difficult births have made a tremendous difference during the past couple of decades. Given this trend, more pressure is being placed on permanent and supplemental staff to keep skills sharp and to continue pursuing educational opportunities. As any mobile practitioner will tell you, a traveling career is the best way to stay on the cutting edge.

The Demand "The need for labor and delivery nurses is definitely greater today than a few years ago," notes Jack Swinney, a branch manager of Aureus Medical Group. "Despite that reality, facilities have not lowered their professional standards. In fact, hospital managers are requesting that L&D nurses have better qualifications and more experience than ever before. I think that's why they are turning to travel companies-to ensure continuity of the best possible care."

Traditionally, the majority of facilities request one year of experience in most specialty positions, but administrators have raised the standard significantly for L&D nurses over the past half-decade. Now, many hospital managers request that mobile practitioners have a minimum of two years of experience as practicing RNs, and some only accept travelers who have completed at least one assignment. Certifications for Cardiopulmonary Resuscitation (CPR) and Basic Life Support (BLS) are rapidly becoming prerequisites, and many facilities prefer mobile professionals who have met Neonatal Advanced Life Support (NALS) and Pediatric Advanced Life Support (PALS) requirements.

Although demand has remained steady at larger medical centers, there is a noticeable increase in the number of rural community hospitals requesting L&D travelers. "As more nurses in rural areas discover traveling, they are leaving their permanent positions to pursue assignments at urban institutions," he explains. "That creates a vacuum back home, and travel companies can satisfy that need."

While facilities attempt to fill vacancies, salaries are on the rise. These professionals now earn an average income of $46,000. The pay scale is even better for healthcare travelers, whose hourly wages are slightly higher. Add to this sign-on and completion bonuses, plus free housing and travel reimbursement, and it is easy to see why more L&D practitioners are hitting the road.

Since labor and delivery is highly specialized, providers who select this area of expertise do not often float to other parts of the hospital. According to Mr. Swinney, "While these nurses are fully capable of floating to med/surg, they would require additional education to transition into the intensive care unit (ICU), emergency room (ER), or telemetry, for example. The same would be true for critical care specialists considering a move to L&D."

Nursing's Miraculous Specialty Since Angela Douglas, RN, had well baby and some neonatal intensive care unit (NICU) experience, she was not sure whether she could handle the responsibilities of being a labor and delivery provider. Today, however, she is happy to make L&D the focus of her career. In more supportive clinical environments, she was able to hone her skills to the point that she preferred L&D over NICU. Since becoming a traveler with Club Staffing Inc., she has enhanced her expertise even further, completing assignments in Indiana, Vermont, New Hampshire, Oregon, and Nevada. She travels with her husband, who is a radiologic technologist, and their two dogs and cat.

While Angela has done her share of med/surg nursing as a traveler, nothing is more satisfying than helping to bring a new life into the world. In fact, she has discovered that L&D is every bit as intense and exciting as NICU. "Without a doubt, I'd say 'quick deliveries' do the most to test the skills of L&D providers. One of my first involved an infant with a prolapsed cord-it had dropped below the baby, threatening to cut off his oxygen and blood supply and placing the delivery in jeopardy. The condition required a fast cesarean section. Looking back on it, the rewarding aspect of that delivery-other than the positive outcome-was the extraordinary teamwork required to complete the procedure quickly and successfully. There is no greater thrill than when each member performs his or her role in a calm and efficient manner."