I’m going to come right out and say it; maternal-newborn nursing is, in my opinion, hands down the most worthless class/rotation of nursing school. Obviously there are going to be some colleagues in my cohort and eventual practice who strongly disagree, but before you girls (and maybe guys) jump down my throat at the next lecture, hear me out. Perhaps a more polite way to sum up my position is this: OB is a giant elephant attempting to hide under NCLEXs bed. Think about it this way: According to U.S. Bureau of Labor Statistics (2008) there over 2.6 million practicing RNs in the United States. In contrast, according to the most recent National Sample Survey of Registered Nurses (NSSRN) conducted in 2008, only 5% of respondents identified Maternal-Child as their primary specialty, while an additional 2% identified Women’s Health as their primary specialty. Similarly, Illinois surveyed their RN workforce in 2015 and found 4% of respondents identifying Maternal-Child as their primary specialty and 2% of RNs identifying Women’s Health as their primary specialty. Admittedly it is problematic to extrapolate results from a national survey of RNs or one state’s findings as the status quo for the entire national nursing workforce. However the simple ugly truth of the matter is that the NCLEX considers questions regarding maternal newborn nursing fair game, and because we must pass the NCLEX to become an RN, we must study and know (at least temporarily) the ins and outs of our OB rotation. To consider this from the perspective of our investment in our nursing program, we are forced to spend roughly 8.5% of our time and money on a specialty that 4-5% of us will end up working in. It’s no secret that nursing school is just the first step towards a career as a nurse. There is too much to know and it is impossible to pick it all up in school. Hospitals know there is going to be a gap in knowledge and that they will have to onboard new grads and invest in them to bring them up to their full potential. In my opinion it doesn’t make much sense to spend 8.5% of our program focused and dedicated to learning information that is by and large going to go out the window for most nursing students within the first couple months or year after school, or even worse within weeks after the rotation. Nursing and healthcare are fields that pride themselves on being on the forefront and cutting edge. Medicine and nursing are constantly looking to innovate and move forward in the most positive direction, Furthermore we are learning how to become agents of that change through evidenced based practice by paying attention to not only the patient side of things, but the financial and institutional wellbeing of our future organizations. In my opinion, the OB rotation of nursing school is a glaring example of a lingering ugly appendage of nursing when it was a profession explicitly dominated by women wearing white shirts and skirts with a nursing cap sporting the red cross. It’s a relic from the days when the men were doctors who smoked on the unit and the women nurses were forced to give up their seats at the nurses’ station for those doctors to do their work. It curious to me that the profession has come so far and continues to evolve in so many positive ways yet has stayed so archaic on this particular front. How great would it be if this portion of the semester was spent allowing students to have focused independent or small group study in a specialty that interests them? The 2008 NSSRN reports the top five employed nursing specialties as follows: Other (20%), Acute/Critical Care (17%), Medical Surgical (13%), Geriatric (6%), and Pediatrics/Neonatal, Maternal-Child, and Home Health all tied for 5th (5%). Statistically speaking that time would be invaluable if there were say five tracks to cover the most in demand and common specialty tracks of nursing. Students would be more engaged with the material, hospitals would receive graduates who are better prepared for the positions they need, and hypothetically patients would have better outcomes by receiving an elevated standard of care from inexperienced nurses. Sadly the first major roadblock to any change like this has to be monetary. Such a change would require anywhere from 5-8 different versions of the NCLEX as one blanket version for all prospective RNs would be insufficient. Strain would also be put on educational institutions to create curriculum and provide adequate staffing for the various tracks. As it stands nursing students are likely stuck with the current academic model of the educational RN mill that preps students to pass the NCLEX as it is today, when the potential reality could be so much more. To be clear, I don’t hate my OB rotation. I am actually excited that we get to spend a day in the NICU, which ironically (and more appropriately) would fall under the potential Pediatrics/Neonatal track. I will also be prepared to attempt to deliver babies or at least care for mom and baby when the apocalypse strikes or at the very least if a precipitous birth and I ever cross paths. All joking aside I respect all nursing specialties and know that each type of nursing provides a valuable service. And honestly I'm a bit jealous of my classmates whose jam might be Maternal-Child health. They get to spend half a semester focused on what they want to really do, while I on the other hand contemplated buying a critical/intensive care nursing textbook off of Amazon, only to decide I was too busy learning OB and PEDs this semester to have that sort of distraction on my radar. Everything in good time I guess right? It would be silly to waste half of a semester not engaging in the material and the silver lining I’ve been able to find is that if I can learn and dedicate myself to OB, there is absolutely no reason I can’t learn the ins and outs of trauma and critical care nursing when the time comes. It’s one step at a time on the journey and right now that step involves learning everything there is to know about moms, babies, and birth, and vaginas. Please take the survey below or leave a comment. I’d love to hear if you feel OB has a place in BSN curriculum or if its outdated. Keep chasing your dreams and enjoy the ride. Happy studying to everyone out there.
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Alexander McNaChronicles of my journey into the nursing profession. Archives
September 2018
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