U.S. flag

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

  • Publications
  • Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

  • Advanced Search
  • Journal List
  • Int J Environ Res Public Health

Logo of ijerph

Effects of S-PBL in Maternity Nursing Clinical Practicum on Learning Attitude, Metacognition, and Critical Thinking in Nursing Students: A Quasi-Experimental Design

Due to the coronavirus disease (COVID-19) pandemic, there are many restrictions in effect in clinical nursing practice. Since effective educational strategies are required to enhance nursing students’ competency in clinical practice, this study sought to evaluate the effectiveness of simulation problem-based learning (S-PBL). A quasi-experimental control group pretest-post-test design was used. Nursing students were allocated randomly to the control group ( n = 31) and the experimental group ( n = 47). Students in the control group participated in a traditional maternity clinical practicum for a week, while students in the experimental group participated S-PBL for a week. The students in the experimental group were trained in small groups using a childbirth patient simulator (Gaumard ® Noelle ® S554.100, Miami, USA) based on a standardized scenario related to obstetric care. The students’ learning attitude, metacognition, and critical thinking were then measured via a self-reported questionnaire. Compared with the control group, the pre-post difference in learning attitude and critical thinking increased significantly ( p < 0.01) in the experimental group. S-PBL was found to be an effective strategy for improving nursing students’ learning transfer. Thus, S-PBL that reflects various clinical situations is recommended to improve the training in maternal health nursing.

1. Introduction

With the recent advances in medical technology and improvements in the living standards and education level of medical consumers, the demand for quality nursing services has increased [ 1 ]. Therefore, it is essential for nurses to acquire specialized nursing knowledge and skills, and have the integrated nursing ability to solve the various health problems of their patients [ 2 , 3 ]. Nursing educators should provide students with a variety of nursing opportunities through the clinical nursing practicum, so that they can adequately assess patients and provide effective nursing care in a dynamic environment [ 4 , 5 ].

Nursing education is composed of two complementary parts: theoretical training and practical training [ 6 ]. A nursing clinical practicum is an essential nursing curriculum that serves as a bridge between theoretical nursing science and clinical practice [ 3 ]. It provides nursing students with opportunities to develop therapeutic relationships with a variety of patients. In addition, they are equipped with the ability to solve real patient problems based on the theoretical knowledge learned in the classroom, thereby increasing nursing competency [ 3 ]. Since nursing clinical practice is on-the-job training that is required for nursing students to acquire basic competency as professional nurses, effective training strategies have been continuously discussed in the field of nursing education.

Due to the coronavirus disease (COVID-19) pandemic, contact between nursing students and patients as well as healthcare workers in the nursing field practice has become more restricted. The resulting passive form of the nursing clinical practicum has led to issues in the quality of nursing education. Thus, educational alternatives are needed. In view of the development of patient rights and safety protocols, as well as a lack of clinical educators, the nursing clinical practicum has also increased in student observation as opposed to direct nursing opportunities [ 7 ].

When nursing subjects deal with labor pains and childbirth, it is difficult to predict the nature of delivery, and emergency situations frequently arise. Thus, the opportunity for nursing students to provide direct nursing in such cases is limited, and the maternity nursing clinical practicum is more difficult than other nursing practices. Moreover, the number of deliveries in South Korea—which are the key cases in a maternity nursing clinical practicum—has sharply declined due to the very low birth rate. As it is difficult to achieve nursing learning goals using traditional teaching, rote memorization, and limited clinical practicum, there is an urgent need for alternatives to supplement the clinical nursing practicum. For students to acquire nursing competency as nursing professionals, a variety of educational methods that apply nursing theories and knowledge to actual situations must be applied.

Problem-based learning (PBL) is an alternative educational method that was first suggested in the medical field to overcome one of the problems of traditional medical education—the failure to develop the problem-solving ability required in clinical settings [ 8 ]. Simulation problem-based learning (S-PBL), an educational method that allows nursing students to repeatedly experience the process of solving nursing problems through interactions with a human patient simulator in an environment similar to clinical settings, is particularly useful for improving nursing competency [ 9 ].

Simulations using a high-fidelity maternal simulator that can reproduce patient characteristics in a laboratory similar to a clinical setting are effective in improving nursing students’ competency through more practical experiences [ 10 , 11 ]. As nursing simulations have recently been recognized as an effective way to supplement the limitations of a clinical nursing practicum, the number of studies regarding the effects of nursing education using simulations has increased [ 12 ]. However, the current nursing simulation practicum is used to apply and evaluate only partial nursing skills in consideration of the characteristics of a respective clinical practicum. Since S-PBL needs to be further developed and applied, this study aimed to provide nursing students with opportunities to provide nursing care during delivery, from phase 1 delivery to phase 4 delivery, using a high-fidelity maternal birth simulator.

An advantage of S-PBL is its ability to clearly identify and evaluate the learning transfer status of nursing students and provide them with feedback. In general, learning transfer is not limited to simply knowing, but also refers to putting knowledge into action. With nursing students, learning transfer refers to applying learned nursing knowledge to actual nursing situations. Kirkpatrick designed a conceptual framework for evaluating training programs. This training evaluation model provides an important systematic perspective regarding learning transfer, and is an influential tool that has been applied to many subsequent sub studies on the matter [ 13 ]. Kirkpatrick first published his model in 1959, updated it in 1975, and then again in 1993. This study intended to use Kirkpatrick’s evaluation model as the basis for its theoretical framework ( Figure 1 ). The theoretical framework consists of four stepwise evaluations: (1) the reaction evaluation, or the evaluation of the nursing students’ motivation for S-PBL participation and understanding; (2) the learning evaluation, or the evaluation of principles, facts, and skills gained by learners as the learners’ advance preparation; (3) the behavior evaluation, or the evaluation wherein learners self-reflect and the professor evaluates whether the lessons learned are being transferred to actual performance and used in S-PBL; and (4) the result evaluation, or the evaluation of changes in learning attitude, metacognition, and critical thinking based on the results of the learners’ change in performance in S-PBL [ 14 ]. As demonstrated in Figure 1 , the S-PBL employed in this study was designed to evaluate knowledge using a paper-based quiz and through “Questions & Answers” (Q&A) during the learning evaluation stage. Similarly, skill was evaluated using an S-PBL checklist during the behavior evaluation stage, wherein the instructor evaluated whether skills were being applied properly based on the learners’ self-reflection and acquired knowledge. At the result evaluation stage, the final results of the training were analyzed. Based on Kirkpatrick’s model, this study intended to evaluate learning attitudes, metacognition, and critical thinking in nursing students, and to confirm the learning transfer into S-PBL, and not simply ending with nursing knowledge. It is expected that short-term achievements will be linked to the nursing competency of professional nurses after graduation, which is a future achievement goal of nursing education for nursing students.

An external file that holds a picture, illustration, etc.
Object name is ijerph-17-07866-g001.jpg

Framework of simulation problem-based learning (S-PBL).

1.1. Aim(s)

This study aimed to investigate the effects of S-PBL, as part of a maternity nursing clinical practicum, on learning attitude, metacognition, and critical thinking in nursing students. More specifically, the objectives of this study were as follows:

First, determining the levels of learning attitude, metacognition, and critical thinking in nursing students;

Second, identifying the correlation between learning attitude, metacognition, and critical thinking in nursing students; and

Third, identifying the effects of learning attitude, metacognition, and critical thinking on learning transfer during the maternity nursing clinical practicum using S-PBL

1.2. Research Hypotheses

The research hypotheses that this study aimed to test were as follows:

First, the maternity nursing clinical practicum using S-PBL will lead to an improvement in learning attitude in nursing students;

Second, the maternity nursing clinical practicum using S-PBL will lead to an improvement in metacognition in nursing students; and

Third, the maternity nursing clinical practicum using S-PBL will lead to an improvement in critical thinking in nursing students.

2. Materials and Methods

2.1. research design.

This study used a quasi-experimental design with a control group to compare the differences in learning attitude, metacognition, and critical thinking between nursing students undergoing the traditional maternity nursing clinical practicum and those undergoing S-PBL ( Figure 2 ).

An external file that holds a picture, illustration, etc.
Object name is ijerph-17-07866-g002.jpg

Research design. Exp. group = experimental group, Cont. group = control group; S-PBL = Simulation problem-based learning.

2.2. Subjects and Setting

The participants in this study were third-year students at a nursing college located in S City, South Korea, and were selected through convenience sampling from 98 nursing college students participating in the maternity nursing clinical practicum during the semester. The participants must have completed a maternity nursing course, which is a mandatory subject, and acquired basic skills related to maternity nursing, before participating in this study. Those with insufficient literacy skills were excluded from this study because data were collected using a survey in which the participants were supposed to read and answer the questionnaire.

The minimum required number of samples for this study was calculated based on a significance level of α = 0.05, power of 0.80, and effect size of 0.8 [ 15 , 16 ] using the G*Power 3.1 program. The results revealed that the minimum required number of samples for this study was 52 participants, with 26 in each group. The number of nursing students participating in the traditional maternity nursing clinical practicum or S-PBL varied between 12 and 15 on a weekly basis. A convenience sample of 78 nursing students were randomly allocated to the experimental group or control group considering the discrepancy between clinical practicum period and data collecting period ( n = 20). The participants were collected considering the potential dropout rate during data collection. A total of 47 participants in the experimental group and 31 participants in the control group were included in the final analysis, meeting the minimum required number of samples ( Figure 3 ).

An external file that holds a picture, illustration, etc.
Object name is ijerph-17-07866-g003.jpg

Research flow.

2.3. Interventions

The research procedure was as follows: The participants were randomly assigned to either the control group or the experimental group, and participated in the traditional maternity nursing clinical practicum (1 week) or S-PBL (1 week), respectively.

In the traditional maternity clinical practicum, nursing students participated in maternity nursing clinical practice in the delivery rooms, obstetrics-gynecology ward, and operating rooms at a general hospital so that they can experience nursing care for pregnancy, delivery, and postpartum nursing, or surgical operations, such as cesarean section and myomectomy, for one week. Two to four nursing students per training department were assigned, and they participated in the traditional maternity clinical practicum by observing clinical nurses’ nursing activities, analyzing nursing cases, and reviewing the lessons learned during the clinical practice at conferences.

With the S-PBL, nursing students were provided with nursing knowledge in a simulation room at the university for one week, and performed simulation-based nursing activities in small groups. Three to four students were randomly assigned per group, after which they were instructed to analyze the clinical cases presented by the instructors, derive nursing problems, and directly apply the lessons they had learned in nursing care using a high-fidelity simulator (Gaumard ® Noelle ® S554.100, Miami, USA) that reproduced nursing situation. In particular, they were instructed to apply basic skills performance based on the nursing care case scenarios of phases 1, 2, 3, and 4 delivery. The basic skills performance included height of fundus measurement, abdominal circumference measurement, Leopold’s maneuvers, fetal monitoring, fetal heart sound auscultation via fetoscope and Doppler, nitrazine test, nursing care for uterine contraction and delivery pain, vertex delivery mechanism, Ritgen’s maneuver, fetal and placental expulsion, umbilical ligation, postpartum uterine contraction, and bleeding risk assessment. The S-PBL was developed by the researcher, based on the educational content that was delivered to students through a maternity nursing course intended for preview. While developing the S-PBL, consultation was sought from a nurse with extensive clinical nursing experience. Each group was instructed to perform the basic skills performance using the high-fidelity simulator based on clinical cases, with a running time of approximately 15–20 min. The instructor evaluated the learning transfer of the basic skills performance, which was learned through the operational use of maternity nursing simulations and the maternity nursing course using a structured evaluation checklist. During debriefing, after the group activities had been completed, the participants were also asked to complete an evaluation sheet consisting of a self-evaluation and self-reflection on the group activities. After those in the control and experimental groups completed the maternity nursing clinical practicum and the S-PBL, respectively, for one week, as well as the post-test, they were instructed to interchangeably participate in the S-PBL or the clinical nursing practicum regardless of this study.

2.4. Assessments

2.4.1. learning attitude.

In this study, learning attitude was measured using a scale modified by Hwang and Kim [ 17 ] from a Learning Attitude Measuring Scale developed by the Korea Educational Development Institute [ 18 ]. At the time of its development, the Learning Attitude Measuring Scale consisted of a total of 40 items, with 10 items regarding self-concept about concerned courses; 15 items regarding attitudes, such as interest, sense of purpose, and achievement motivation; and 15 items regarding learning habits, such as attention, self-learning, and exercising learning skills. The scale was then modified into a 16-item scale for nursing courses by Hwang and Kim [ 17 ]. The 16-item scale is a 5-point Likert scale ranging from 1 for ‘not at all’ to 5 for ‘always,’ with the total score ranging from a minimum of 5 points to a maximum of 80. A higher score indicates a better learning attitude in nursing students. The reliability of the original 40-item scale was Cronbach’s α = 0.83 [ 18 ], while the reliability of the scale by Hwang and Kim was Cronbach’s α = 0.84 [ 17 ], and its reliability in this study was Cronbach’s α = 0.82.

2.4.2. Metacognition

Metacognition refers to nursing students’ awareness of their thinking processes in the learning process and their resulting ability to plan, check, and control the whole learning process [ 19 ]. Metacognition is a key element in the strategic aspect of the problem-solving process [ 20 ]. In this study, metacognition was measured using a tool that was originally developed by Klein [ 21 ] and later modified by Lee and Son [ 22 ]. This tool consists of three subdomains (cognitive strategy, planning, and self-checking), has 15 items, and is a 4-point Likert scale ranging from 1 for ‘not at all’ to 4 for ‘strongly agree.’ A higher score indicates a higher level of metacognition in nursing students. The reliability of the tool was Cronbach’s α = 0.91 in the study by Lee and Son [ 22 ], and its reliability in this study was Cronbach’s α = 0.86.

2.4.3. Critical Thinking

Critical thinking refers to the personal disposition and habits that nursing students use to solve problems and make decisions. In this study, it was measured using a tool developed for nursing courses by Yoon [ 23 ]. In most domestic nursing studies, critical thinking was measured using the California Critical Thinking Disposition Inventory (CCTDI), or the tool developed by Yoon. However, the use of the CCTDI is restricted due to copyright issues, and the reliability in most previous studies that used the tool by Yoon was reported to be good [ 24 ]. The tool consists of a total of 27 items on a 5-point scale ranging from 1 for ‘not at all’ to 5 for ‘strongly agree.’ As the scores for two items (nos. 4 and 14) are inversely summed, the total score ranges from a minimum of 27 points to a maximum of 135. A higher score indicates a higher level of critical thinking in nursing students. The reliability of the tool in Yoon’s study was Cronbach’s α = 0.84 [ 23 ], and its reliability in the present study was Cronbach’s α = 0.87.

2.5. Data Collection

The nursing students participated in the traditional maternity nursing clinical practicum or S-PBL from 1 June to 17 July 2020, and the effects of the interventions on their learning attitude, metacognition, and critical thinking before and after their participation were measured using structured questionnaires. The researchers explained the contents of this study to the participants before the study began. After the nursing students who agreed to voluntarily participate in this study provided their written consent, they were made to answer the survey questionnaire. All of the participants were given a token of appreciation (school supplies worth KRW 1500).

2.6. Statistical Analysis

Data analysis was performed using IBM SPSS Statistics version 22.0 (IBM Co., Armonk, NY, USA). The general characteristics of the participants were analyzed using descriptive statistics. The reliability of the measurement tools used was analyzed using Cronbach’s alpha coefficient. The correlation between the variables was analyzed using Pearson’s correlation coefficient, and the effects of the intervention were analyzed using a t-test. The correlation between factors was analyzed by effect size for the correlation coefficient, and the statistical significance level was set at a p -value < 0.05.

2.7. Ethical Considerations

This study was approved by the Institutional Review Committee of the nursing college to which the researcher belongs (EUIRBN2020-010). All participants voluntarily decided to participate in this study, which was conducted in accordance with the Declaration of Helsinki. Prior to the commencement of the study, the participants were fully informed that their personal information would be kept confidential and would not be used for purposes other than this study, and that they could stop participating at any time during the study. They were also fully informed that there would be no disadvantages caused by their refusal to participate in the study, eliminating any unnecessary tension related to study participation. The survey answered by the participants took around 10 min, and there were no side effects caused by their participation other than minimal fatigue. After the participants in the control and experimental groups participated in the traditional maternity nursing clinical practicum and the S-PBL, respectively, for one week, and completed the post-test, they were given the opportunity to interchangeably participate in S-PBL or the clinical nursing practicum regardless of this study.

3.1. General Characteristics

The general characteristics of the participants are shown in Table 1 . The mean ages of the experimental and control groups were 22.06 years (1.97) and 22.10 years (3.13), respectively. There were 30 female students (63.8%) and 17 male students (36.2%) in the experimental group, and 28 female students (90.3%) and three male students (9.7%) in the control group. In terms of motivation for their choice of nursing major, the number of those who reported that they chose their major of their own will was the highest, with 30 (63.8%) and 20 (64.5%) in the experimental and control groups, respectively. In terms of major satisfaction, the number of those who reported that their major satisfaction was high was the highest in both groups, with 27 (57.4%) and 19 (61.3%) in the experimental and control groups, respectively. In terms of satisfaction with clinical nursing practicum, the number of those who reported that satisfaction with their clinical practice was high in both groups, with 23 (48.9%) and 19 (61.3%) in the experimental and control groups, respectively. In terms of academic achievement in the preceding semester, the number of those who reported that their academic achievement was moderate was the highest in both groups, with 21 (44.7%) and 16 (51.6%) in the experimental and control groups, respectively. Regarding academic stress, the number of those who reported that academic stress was high was the highest in both groups, with 25 (53.2%) and 19 (61.3%) in the experimental and control groups, respectively. The general characteristics of the participants were found to be homogeneous at pre-test between the two groups, except for gender ( t = 3.93, p = 0.004) ( p > 0.05). In addition, the variables in this study, such as learning attitude ( t = 0.26, p = 0.799), metacognition ( t = 0.13, p = 0.901), and critical thinking ( t = 0.64, p = 0.522), were also found to be homogeneous between the two groups.

General Characteristics.

CharacteristicsCategories/RangeMean (SD)/Frequency (%)t/
Exp. ( = 47)Cont. ( = 31)
Age (years) 22.06 (1.97)22.10 (3.13)0.05 (0.959)
Gender female 30 (63.8)28 (90.3)2.98 (0.004)
male17 (36.2)3 (9.7)
Motivation
for major choice
employment9 (19.1)5 (16.1)0.20 (0.840)
other’s recommendation8 (17.0)6 (19.4)
one’s own will30 (63.8)20 (64.5)
Major
satisfaction
very high9 (19.1)7 (22.6)0.72 (0.476)
high27 (57.4)19 (61.3)
moderate11 (23.4)5 (16.1)
low0 (0.0)0 (0.0)
very low0 (0.0)0 (0.0)
Clinical practice satisfaction
very satisfied14 (29.8)4 (12.9)1.51 (0.135)
satisfied23 (48.9)19 (61.3)
moderate10 (21.3)7 (22.6)
unsatisfied0 (0.0)1 (3.2)
very unsatisfied0 (0.0)0 (0.0)
Academic achievement very high3 (6.4)5 (16.1)0.32 (0.751)
high10 (21.3)3 (9.7)
moderate21 (44.7)16 (51.6)
low11 (23.4)4 (12.9)
very low2 (4.3)3 (9.7)
Academic
stress
very high8 (17.0)1 (3.2)1.43 (0.156)
high25 (53.2)19 (61.3)
moderate13 (27.7)10 (32.3)
low1 (2.1)0 (0.0)
very low0 (0.0)1 (3.2)
Learning attitude 60.87 (6.51)61.26 (6.55)0.26 (0.799)
Metacognition 46.89 (6.15)47.06 (5.46)0.13 (0.901)
Critical thinking 103.66 (8.71)105.13 (11.42)0.64 (0.522)

Exp. group = experimental group, Cont. group = control group.

3.2. Correlation between Variables

The correlations between the variables are shown in Table 2 . Learning attitude was correlated with metacognition ( r = 0.669, p < 0.01) and critical thinking ( r = 0.678, p < 0.01), and metacognition was correlated with critical thinking ( r = 0.629, p < 0.01).

Correlation between variables.

r ( )
Learning AttitudeMetacognitionCritical Thinking
Learning Attitude10.669 (0.000) **0.678 (0.000) **
Metacognition 10.629 (0.000) **
Critical Thinking 1

** p < 0.01.

3.3. Effects of S-PBL

The effects of S-PBL compared with the traditional maternity clinical practicum are shown in Table 3 . Learning attitude ( t = −3.94, p < 0.001) and critical thinking values ( t = −2.78, p = 0.008) in the experimental group were significantly higher post-training, as compared to pre-training. Meanwhile, there was no significant change in learning attitude, metacognition, and critical thinking in the control group. In particular, post-training critical thinking was lower in the control group than in the pre-test critical thinking ( t = 0.26, p = 0.798).

Effects of S-PBL.

CharacteristicsMean (SD)
Exp. ( = 47)Cont. ( = 31)
PretestPosttestt/ PretestPosttestt/
Learning Attitude 60.87
(6.51)
63.36
(6.58)
−3.94 (<0.001) **61.26
(6.55)
62.23 (6.04)−1.01 (0.319)
Metacognition46.89
(6.15)
48.15
(5.92)
−1.91 (0.063)47.06
(5.46)
48.74 (5.40)−1.52 (0.140)
Critical Thinking103.66 (8.71)106.30 (10.51)−2.78 (0.008) *105.13 (11.42)104.65 (11.38)0.26
(0.798)

* p < 0.05, ** p < 0.01, * Exp. group = experimental group, Cont. group = control group.

4. Discussion

In order to verify the effects of the S-PBL, this study compared the learning attitudes, metacognition, and critical thinking of the nursing students that participated in the S-PBL and those that participated in the traditional maternity nursing clinical practicum. The results showed that nursing students who had participated in the S-PBL had significantly better learning attitudes and critical thinking post-training, as compared to pre-training.

In a study by Hwang and Kim [ 17 ], no significant difference was found in the learning attitude and critical thinking of nursing students that used PBL compared to traditional lecture-based learning. However, the results of this study showed that the practice-oriented S-PBL significantly improved learning attitudes and critical thinking in nursing students. During the clinical practice period, the scope of nursing students’ nursing experiences varied depending on the training department and patient cases. Considering the limitations of the clinical practicum, S-PBL with the use of a high-fidelity maternal simulator, which is designed to reproduce the characteristics of various patients in a simulation laboratory that is similar to clinical settings, can provide nursing students with more practical nursing cases and direct nursing experience; as such, it is more effective in improving nursing competency than the traditional clinical practice method [ 10 , 11 ]. Additionally, our study had considered the effect of the learning style such as the participants’ self-reflection and instructor performance skill checklist during the behavior evaluation stage of S-PBL. Further study should evaluate the effect of various learning styles using a high-fidelity simulator.

This study showed that S-PBL improved critical thinking in nursing students. The ultimate goal of improving critical thinking is to nurture nurses who are critical thinkers, with critical thinking skills and disposition [ 24 ]. According to the results of previous studies, critical thinking in nursing students was closely correlated with nursing competency [ 25 ], which is consistent with the goal of nursing education. In other words, critical thinking is an expected outcome of a nursing education program and an essential component of baccalaureate nursing education [ 2 ]. Since there is a need for the integrated education of critical thinking, problem-solving, leadership, and teamwork in nursing students with various learning style [ 26 ], various learning methods that reflect such needs, such as S-PBL, should be considered in nursing education.

However, in this study, no significant difference was found in metacognition post-training, as compared to pre-training. Metacognition refers to learners’ awareness of their thinking process as they learn so that they can plan, check, and control the entire learning process [ 19 ]. Metacognition is a key element in the strategic aspects of the problem-solving process [ 20 ], and is closely related to problem-solving ability [ 27 , 28 ]. It has been found that metacognition is learned and enhanced by learners in practical problem-solving situations [ 20 ]. Considering that the nursing students in this study were exposed to S-PBL for the first time, and participated in S-PBL for a short period, it is thought that nursing students’ long-term and repeated experiences of S-PBL in nursing curricula can improve metacognition in the whole learning process and the problem-solving process. In other words, nursing students monitor the process of solving nursing problems through S-PBL, which goes through the process of developing new metacognitive knowledge or modifying existing metacognitive knowledge in another S-PBL. Through this self-regulated learning, metacognition is acquired. Therefore, further studies are needed to develop and apply various learning strategies using S-PBL in nursing education.

Since S-PBL-related studies are scarce in Asian countries compared to Europe and North America [ 1 ], the study of this S-PBL approach in the Republic of Korea is of great significance to nursing education and studies. In particular, this study is meaningful for having demonstrated the use of S-PBL in improving learning transfer in nursing students through the provision of comprehensive simulation experiences of nursing, during stages 1 to 4 of childbirth. Considering the difficulties and risks involved for nursing students in gaining direct experience of working with patients during the COVID-19 pandemic, the nursing simulation used in this study may offer an opportunity to gain the necessary nursing skills while also ensuring the safety of both the patient and the student. A lot of care went into planning how students will be placed and for how long, and informed consent was obtained from them before they started clinical practice during the study [ 29 , 30 ]. Furthermore, based on the results of this study, it is necessary to apply S-PBL using systematic and integrated maternity nursing simulations, so that nursing students can learn a variety of maternity nursing cases.

5. Limitations

This study has several limitations. Nursing students’ self-assessment of learning attitude, metacognition, and critical thinking using the structured questionnaires poses limitations such as subjectivity. In addition, it is uncertain whether the difference between the intervention group and the control group comes from the learning styles such as learners’ self-reflection or instructor’s performance skill checklist or the use of a high-fidelity simulator. However, this study was based on the most widely used training evaluation model in the world. Considering the problem of the short-term program, this study finally suggested a long-term S-PBL program with a variety of nursing cases specially tailored to get nursing students to transfer learning in nursing curricula.

6. Impact Statement

This study suggested that nursing colleges incorporate S-PBL into the learning process so that nursing students can strengthen their learning attitude, metacognition, and critical thinking in their practical nursing education.

7. Conclusions

In maternity nursing, where the delivery process and outcome are difficult to predict and emergency situations frequently occur, the direct nursing care provided by nursing students is limited. In view of the fact that the birth rate in South Korea is very low, it is necessary to apply systematic and integrated maternity nursing simulations through which nursing students can learn various cases of maternity nursing as alternatives to supplement clinical practice. Under the circumstances where the development and application of S-PBL is required, the results of this study confirmed the effects of S-PBL-based nursing practicum on learning attitude, metacognition, and critical thinking in nursing students using a high-fidelity maternal birth simulator related to the main nursing care to be provided during delivery from phase 1 to phase 4 deliveries. Through its findings, this study provided evidence for promoting S-PBL. Finally, to promote nursing students’ learning transfer through S-PBL, it is suggested to determine various aspects of the knowledge, skills, and attitudes of nursing students in more objective ways, and to consider various learning methodologies in practical nursing education.

This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean Ministry of Science, ICT & Future Planning (No. 2020R1G1A1010895).

Conflicts of Interest

The author declares no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

critical thinking in labor and delivery nursing

Labor & Delivery Nurse

What is a labor & delivery nurse a labor and delivery nurse is a specialized healthcare professional who works primarily in the labor and delivery units of hospitals or standalone birthing centers. they have the important role of caring for and supporting expectant mothers and their babies throughout the labor, delivery, and immediate post-childbirth period. their duties cover every aspect of the birthing process, from early labor to postpartum recovery, with a primary focus on labor and delivery. they work alongside other medical staff to ensure a safe and smooth delivery process, monitoring vital signs, administering medications, assisting with epidurals, and providing support during childbirth. in addition to their clinical responsibilities, labor and delivery nurses also have the role of educating and supporting parents about newborn care, breastfeeding, and recovery after childbirth. they are an essential source of emotional support, comforting and guiding patients through what can be both a joyful and stressful experience. they answer questions, address fears, and empathize with the expectant mother throughout the journey. while they work closely with obstetric nurses who oversee the woman's gynecological health more broadly, labor and delivery nurses have a more concentrated focus on the childbirth process itself. this rewarding nursing specialty is a great career path for those interested in a hands-on, patient-focused role in healthcare. what does a labor & delivery nurse do labor and delivery nurses perform a wide range of duties related to the care of pregnant women and their newborns. their responsibilities typically include: assessing the patient: they monitor and assess the condition of mothers before, during, and after labor. this includes tracking contractions, checking dilation, monitoring vital signs, and interpreting fetal heart rate patterns. administering medications and treatments: labor and delivery nurses administer pain medications, including epidurals, and other necessary treatments. they also prepare patients for c-sections when needed. assisting during childbirth: they work alongside doctors or midwives during delivery, providing assistance as needed. they might help guide the mother during pushing, perform episiotomies, or assist with vacuum or forceps deliveries. postpartum care: after delivery, these nurses continue to monitor the health of the mother and the newborn. they help mothers initiate breastfeeding, perform newborn assessments, provide wound care, and manage postpartum complications if they arise. patient education: labor and delivery nurses provide valuable education to new parents on topics such as infant care, breastfeeding, and postpartum recovery. emotional support: aside from the physical care, these nurses also offer emotional support to families during the birthing process, addressing their concerns and reassuring them throughout the experience. emergency response: in the event of complications during labor and delivery, these nurses are equipped to respond swiftly and effectively. they may assist with emergency c-sections, neonatal resuscitation, and manage other obstetric emergencies. the role of a labor and delivery nurse is demanding and dynamic, requiring a strong knowledge base, skilled technical ability, and a compassionate and empathetic approach to patient care. it offers the opportunity to participate in a key moment in a family's life, making it a deeply rewarding specialty for many nurses. { "@context": "https://schema.org", "@type": "faqpage", "mainentity": [{ "@type": "question", "name": "what is a labor & delivery nurse", "acceptedanswer": { "@type": "answer", "text": "a labor and delivery nurse is a specialized healthcare professional who works primarily in the labor and delivery units of hospitals or standalone birthing centers. they have the important role of caring for and supporting expectant mothers and their babies throughout the labor, delivery, and immediate post-childbirth period." } },{ "@type": "question", "name": "what does a labor & delivery nurse do", "acceptedanswer": { "@type": "answer", "text": " assessing the patient: they monitor and assess the condition of mothers before, during, and after labor. this includes tracking contractions, checking dilation, monitoring vital signs, and interpreting fetal heart rate patterns. administering medications and treatments: labor and delivery nurses administer pain medications, including epidurals, and other necessary treatments. they also prepare patients for c-sections when needed. assisting during childbirth: they work alongside doctors or midwives during delivery, providing assistance as needed. they might help guide the mother during pushing, perform episiotomies, or assist with vacuum or forceps deliveries. postpartum care: after delivery, these nurses continue to monitor the health of the mother and the newborn. they help mothers initiate breastfeeding, perform newborn assessments, provide wound care, and manage postpartum complications if they arise. patient education: labor and delivery nurses provide valuable education to new parents on topics such as infant care, breastfeeding, and postpartum recovery. emotional support: aside from the physical care, these nurses also offer emotional support to families during the birthing process, addressing their concerns and reassuring them throughout the experience. emergency response: in the event of complications during labor and delivery, these nurses are equipped to respond swiftly and effectively. they may assist with emergency c-sections, neonatal resuscitation, and manage other obstetric emergencies. " } },{ "@type": "question", "name": "what skills does a labor & delivery nurse need", "acceptedanswer": { "@type": "answer", "text": " medical knowledge and technical skills: a deep understanding of obstetrics, women's health, and neonatal care is essential. this includes being proficient in various medical procedures and using medical equipment related to childbirth. critical thinking and problem-solving: given the unpredictability of childbirth, labor and delivery nurses need to think on their feet and make swift decisions. they need to quickly assess situations, analyze patient data, and identify any potential complications. communication skills: clear and empathetic communication with patients, their families, and the medical team is crucial. nurses need to explain complex medical information in a way that patients can understand and must also be good listeners. patience and stamina: the labor and delivery process can be long and physically demanding. nurses must have the physical endurance for long hours on their feet and the patience to provide care during extended labors. emotional resilience: the labor and delivery ward can be a place of great joy and, sometimes, significant sorrow. nurses need to cope with high-stress and emotional situations, including complications or loss. attention to detail: precise documentation and careful monitoring of the mother's and baby's vitals are essential parts of ensuring safe and effective care. teamwork: labor and delivery is usually a team effort, involving doctors, nurses, midwives, and often anesthesiologists and pediatricians. nurses need to collaborate effectively with a diverse team. empathy and compassion: providing emotional support to patients during labor and delivery is as important as the physical care nurses provide. they must be able to empathize with their patients' situations and deliver care with compassion and sensitivity. adaptability: every patient, baby, and birth is unique, so labor and delivery nurses need to adapt to different situations, patient needs, and potential complications. advocacy skills: nurses often act as advocates for their patients, ensuring their needs, wishes, and rights are respected throughout the labor and delivery process. " } }] } what skills does a labor & delivery nurse need.

Becoming a successful labor and delivery nurse requires a variety of skills. These include:

  • Medical knowledge and technical skills: A deep understanding of obstetrics, women's health, and neonatal care is essential. This includes being proficient in various medical procedures and using medical equipment related to childbirth.
  • Critical thinking and problem-solving: Given the unpredictability of childbirth, labor and delivery nurses need to think on their feet and make swift decisions. They need to quickly assess situations, analyze patient data, and identify any potential complications.
  • Communication skills: Clear and empathetic communication with patients, their families, and the medical team is crucial. Nurses need to explain complex medical information in a way that patients can understand and must also be good listeners.
  • Patience and stamina: The labor and delivery process can be long and physically demanding. Nurses must have the physical endurance for long hours on their feet and the patience to provide care during extended labors.
  • Emotional resilience: The labor and delivery ward can be a place of great joy and, sometimes, significant sorrow. Nurses need to cope with high-stress and emotional situations, including complications or loss.
  • Attention to detail: Precise documentation and careful monitoring of the mother's and baby's vitals are essential parts of ensuring safe and effective care.
  • Teamwork: Labor and delivery is usually a team effort, involving doctors, nurses, midwives, and often anesthesiologists and pediatricians. Nurses need to collaborate effectively with a diverse team.
  • Empathy and compassion: Providing emotional support to patients during labor and delivery is as important as the physical care nurses provide. They must be able to empathize with their patients' situations and deliver care with compassion and sensitivity.
  • Adaptability: Every patient, baby, and birth is unique, so labor and delivery nurses need to adapt to different situations, patient needs, and potential complications.
  • Advocacy skills: Nurses often act as advocates for their patients, ensuring their needs, wishes, and rights are respected throughout the labor and delivery process.

What skills does a Labor & Delivery Nurse need? Becoming a successful labor and delivery nurse requires a variety of skills. These include: Medical knowledge and technical skills: A deep understanding of obstetrics, women's health, and neonatal care is essential. This includes being proficient in various medical procedures and using medical equipment related to childbirth. Critical thinking and problem-solving: Given the unpredictability of childbirth, labor and delivery nurses need to think on their feet and make swift decisions. They need to quickly assess situations, analyze patient data, and identify any potential complications. Communication skills: Clear and empathetic communication with patients, their families, and the medical team is crucial. Nurses need to explain complex medical information in a way that patients can understand and must also be good listeners. Patience and stamina: The labor and delivery process can be long and physically demanding. Nurses must have the physical endurance for long hours on their feet and the patience to provide care during extended labors. Emotional resilience: The labor and delivery ward can be a place of great joy and, sometimes, significant sorrow. Nurses need to cope with high-stress and emotional situations, including complications or loss. Attention to detail: Precise documentation and careful monitoring of the mother's and baby's vitals are essential parts of ensuring safe and effective care. Teamwork: Labor and delivery is usually a team effort, involving doctors, nurses, midwives, and often anesthesiologists and pediatricians. Nurses need to collaborate effectively with a diverse team. Empathy and compassion: Providing emotional support to patients during labor and delivery is as important as the physical care nurses provide. They must be able to empathize with their patients' situations and deliver care with compassion and sensitivity. Adaptability: Every patient, baby, and birth is unique, so labor and delivery nurses need to adapt to different situations, patient needs, and potential complications. Advocacy skills: Nurses often act as advocates for their patients, ensuring their needs, wishes, and rights are respected throughout the labor and delivery process. Learn More About Labor & Delivery Nurses Work settings for Labor & Delivery Nurses Labor and delivery nurses work in various settings from bustling urban hospitals to smaller rural ones, each presenting a unique pace and resources. Some may opt for standalone birthing centers prioritizing a holistic childbirth approach, while others work in academia or public health, offering educational support. Experienced labor and delivery nurses may even become travel nurses, undertaking temporary assignments across the nation.  Common Cases Labor & Delivery Nurses Encounter Normal labor and vaginal deliveries Assist in cesarean sections (C-sections) Care for women with high-risk pregnancies, such as pre-eclampsia, gestational diabetes, and preterm labor Situations demanding neonatal resuscitation  Manage complications like postpartum hemorrhage How to Become A Labor & Delivery Nurse Begin your journey by earning a degree in nursing, either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). Upon graduation, prepare for and pass the National Council Licensure Examination (NCLEX-RN) to become a Registered Nurse (RN). Start accruing clinical experience in a related field like obstetrics. This experience can often be obtained through entry-level nursing positions, internships, or volunteering.Alongside this, aim to acquire certifications related to labor and delivery to improve your career prospects.  Consider pursuing more advanced certifications such as Inpatient Obstetric Nursing (RNC-OB) and Electronic Fetal Monitoring (C-EFM). These certifications can enhance your profile in this specialty. Foster traits like passion, empathy, resilience, and excellent communication skills. Despite the challenges, the rewards of assisting in the miracle of birth make this journey fulfilling for many labor and delivery nurses. How to Advance Your Career As A Labor & Delivery Nurse Advancing your career as a labor and delivery nurse involves a combination of experience, education, and networking. Firstly, accumulating years of experience on the L&D floor can increase your understanding of the specialty and make you a more valuable team member. Beyond direct patient care, look for opportunities to take on leadership roles, such as charge nurse or nurse manager, as this can provide essential administrative and management experience. Secondly, furthering your education is another route for career advancement. Pursuing a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) can open up opportunities to become a Nurse Practitioner (NP) or a Clinical Nurse Specialist (CNS), roles that come with increased autonomy and responsibility. Additionally, obtaining specialized certifications, such as the Inpatient Obstetric Nursing (RNC-OB) or the Electronic Fetal Monitoring (C-EFM) certification, can demonstrate your commitment to the field and enhance your professional credibility. Lastly, networking plays a vital role in career progression. Participating in professional organizations and conferences, such as the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), can provide valuable connections and keep you updated on the latest developments in your field. By combining these strategies, labor and delivery nurses can achieve significant career advancement and potentially influence the future of their specialty. Education Requirements & Helpful Certification To become a labor and delivery nurse, you must first obtain a degree in nursing. This could be an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). After graduation, passing the National Council Licensure Examination (NCLEX-RN) is a prerequisite to becoming a registered nurse (RN). Once you've obtained RN status, gaining experience in a hospital setting, preferably in obstetrics or a related field, is usually required before transitioning to the Labor and Delivery unit.  To enhance their skills and career prospects, labor and delivery nurses often pursue additional certifications. Two notable certifications are the Inpatient Obstetric Nursing (RNC-OB) and Electronic Fetal Monitoring (C-EFM) certifications, offered by the National Certification Corporation (NCC). These certifications validate a nurse's expertise in caring for pregnant women and monitoring the fetus, respectively, making them highly valued in the labor and delivery nursing field. Average Salary For Labor & Delivery Nurses The labor and delivery nursing specialty can be both emotionally rewarding and financially lucrative. As per the most recent data, the average annual salary for a labor and delivery nurse is $79,100. However, this figure can vary significantly depending on factors such as geographic location, level of nursing education, years of experience, and the specific healthcare facility.  Nurses in metropolitan areas or those working in larger hospitals often command higher wages up to $100,000. It's also worth noting that salaries tend to increase with advanced degrees and additional certifications in this field. Despite the challenges, the financial compensation for labor and delivery nurses is generally considered competitive compared to other nursing specialties. Specialty Organizations & Communities Association of Women's Health, Obstetric, and Neonatal Nurses American Nurses Association American College of Nurse-Midwives   National Association of Neonatal Nurses Ideal Personality Traits Empathetic Resilient Excellent Communicator Organized Strong patient advocate Browse Jobs Let's start building the life you want.

nurse with mask on

Education Requirements

To become a labor and delivery nurse, you must first obtain a degree in nursing. This could be an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). After graduation, passing the National Council Licensure Examination (NCLEX-RN) is a prerequisite to becoming a registered nurse (RN).

Once you've obtained RN status, gaining experience in a hospital setting, preferably in obstetrics or a related field, is usually required before transitioning to the Labor and Delivery unit. 

To enhance their skills and career prospects, labor and delivery nurses often pursue additional certifications. Two notable certifications are the Inpatient Obstetric Nursing (RNC-OB) and Electronic Fetal Monitoring (C-EFM) certifications, offered by the National Certification Corporation (NCC). These certifications validate a nurse's expertise in caring for pregnant women and monitoring the fetus, respectively, making them highly valued in the labor and delivery nursing field.

How to advance/career pathway

Advancing your career as a labor and delivery nurse involves a combination of experience, education, and networking. Firstly, accumulating years of experience on the L&D floor can increase your understanding of the specialty and make you a more valuable team member. Beyond direct patient care, look for opportunities to take on leadership roles, such as charge nurse or nurse manager, as this can provide essential administrative and management experience.

Secondly, furthering your education is another route for career advancement. Pursuing a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) can open up opportunities to become a Nurse Practitioner (NP) or a Clinical Nurse Specialist (CNS), roles that come with increased autonomy and responsibility.

Additionally, obtaining specialized certifications, such as the Inpatient Obstetric Nursing (RNC-OB) or the Electronic Fetal Monitoring (C-EFM) certification, can demonstrate your commitment to the field and enhance your professional credibility.

Lastly, networking plays a vital role in career progression. Participating in professional organizations and conferences, such as the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), can provide valuable connections and keep you updated on the latest developments in your field. By combining these strategies, labor and delivery nurses can achieve significant career advancement and potentially influence the future of their specialty.

RESPONSIBILITIES

Most common cases.

  • Normal labor and vaginal deliveries
  • Assist in cesarean sections (C-sections)
  • Care for women with high-risk pregnancies, such as pre-eclampsia, gestational diabetes, and preterm labor
  • Situations demanding neonatal resuscitation 
  • Manage complications like postpartum hemorrhage

How to become a

  • Begin your journey by earning a degree in nursing, either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN).
  • Upon graduation, prepare for and pass the National Council Licensure Examination (NCLEX-RN) to become a Registered Nurse (RN).
  • Start accruing clinical experience in a related field like obstetrics. This experience can often be obtained through entry-level nursing positions, internships, or volunteering.Alongside this, aim to acquire certifications related to labor and delivery to improve your career prospects. 
  • Consider pursuing more advanced certifications such as Inpatient Obstetric Nursing (RNC-OB) and Electronic Fetal Monitoring (C-EFM). These certifications can enhance your profile in this specialty.
  • Foster traits like passion, empathy, resilience, and excellent communication skills. Despite the challenges, the rewards of assisting in the miracle of birth make this journey fulfilling for many labor and delivery nurses.

Specialty Groups and Communities

  • Association of Women's Health, Obstetric, and Neonatal Nurses
  • American Nurses Association
  • American College of Nurse-Midwives  
  • National Association of Neonatal Nurses

In terms of the benefits of being a labor and delivery nurse, the experience offers profound emotional fulfillment. Few nursing specialties provide as many opportunities for joy and satisfaction as labor and delivery. Assisting in the birth of a child and supporting a family during this monumental moment in their lives can provide a profound sense of purpose and fulfillment. 

Every birth is unique, which keeps the work interesting and engaging. 

Nurses in this field are continually learning, growing their medical knowledge, and honing their technical skills. Another advantage is the opportunity for close patient interaction. Labor and delivery nurses often spend hours or even days with the same patient, allowing them to build meaningful relationships. This closeness can be rewarding and enrich the work experience. 

Lastly, labor and delivery nurses often work in a strong team environment. They collaborate closely with a team of healthcare professionals, including physicians, midwives, and other nurses. This collaborative atmosphere can foster a sense of camaraderie and mutual support.

There are challenges associated with being a labor and delivery nurse. The work can be physically demanding and emotionally draining. The long hours on one's feet, night shifts, and the intense emotions that can accompany childbirth can all contribute to significant stress and fatigue. 

Additionally, while childbirth is often a joyful event, it can involve complications and loss. Dealing with these challenging situations requires emotional resilience and can be very difficult. It's important for labor and delivery nurses to have strong support systems and coping mechanisms in place to handle these challenging aspects of the job.

Personality Traits

  • Excellent Communicator
  • Strong patient advocate

Average Salary

The labor and delivery nursing specialty can be both emotionally rewarding and financially lucrative. As per the most recent data, the average annual salary for a labor and delivery nurse is $79,100. However, this figure can vary significantly depending on factors such as geographic location, level of nursing education, years of experience, and the specific healthcare facility. 

Nurses in metropolitan areas or those working in larger hospitals often command higher wages up to $100,000. It's also worth noting that salaries tend to increase with advanced degrees and additional certifications in this field. Despite the challenges, the financial compensation for labor and delivery nurses is generally considered competitive compared to other nursing specialties.

Certifications

National Certification Corporation (NCC)

  • Inpatient Obstetric Nursing (RNC-OB)
  • Electronic Fetal Monitoring (C-EFM)

Work Setting

Labor and delivery nurses work in various settings from bustling urban hospitals to smaller rural ones, each presenting a unique pace and resources. Some may opt for standalone birthing centers prioritizing a holistic childbirth approach, while others work in academia or public health, offering educational support. Experienced labor and delivery nurses may even become travel nurses, undertaking temporary assignments across the nation. 

How to Become a Labor and Delivery Nurse

Gayle Morris, MSN

  • Labor and Delivery Nurse: Career Overview
  • Steps to Become
  • Education Options
  • Licensure and Certification

Are you ready to earn your online nursing degree?

Labor and delivery nurse supporting patient

Labor and delivery nurses play crucial roles in the birthing process, both for the infant and the mother.

Labor and delivery nurses work with a multidisciplinary team at hospitals and birthing centers to ensure the health and safety of pregnant individuals and babies. They work hard to improve patient outcomes and positively impact maternal mortality rates, which jumped from 17% in 2018 to 24% in 2020 .

You need an active registered nurse (RN) license to become a labor and delivery nurse. Although you can become a registered nurse (RN) with an associate degree in nursing (ADN), many employers prefer nurses with a bachelor of science in nursing (BSN) degree.

Find out more about the steps to becoming a labor and delivery nurse, including education, licensure, and certification.

How Long to Become 2-4 years

Degree Required ADN or BSN

Certification Basic Life Support Certification, Advanced Cardiac Life Support Certification, Inpatient Obstetric Nursing Certification

Popular Online RN-to-BSN Programs

Learn about start dates, transferring credits, availability of financial aid, and more by contacting the universities below.

What Is a Labor and Delivery Nurse?

Labor and delivery nurses have specialized responsibilities, including monitoring fetal heart rates, identifying potential risks, and assessing labor progression. They function with compassion, strong communication, and critical thinking skills to provide comprehensive care in an environment that can quickly develop emergencies.

Their daily tasks range from assisting with cesarean sections to providing emotional support to new parents. Because each patient’s needs differ, labor and delivery nurses must provide care that is culturally appropriate and age-specific.

These nurses may work the day, evening, or night shift and are highly sought after for travel nurse positions. Regardless of time or setting, these nurses must maintain constant communication with physicians and families to ensure the best and safest care for mothers and babies.

Steps to Becoming a Labor and Delivery Nurse

To become a labor and delivery nurse, you must have a two- or four-year nursing degree, an active RN license, and clinical experience. Employers may also request basic life support and advanced cardiac life support certifications.

Earn an ADN or BSN

An ADN is a two-year nursing degree that is the quickest way to become a labor and delivery nurse and the minimum degree needed to practice. A BSN program takes 2-4 years, depending on the program and your prior education or work experience.

Pass the NCLEX Exam to Receive RN Licensure

After obtaining your ADN or BSN degree, you must pass the NCLEX-RN exam. It is a computer adaptive test that most graduates take roughly 45 days after graduating from nursing school. The National Council of State Boards of Nursing (NCSBN) developed the test, which is the final step before obtaining a state RN license.

Gain Experience in Obstetric Nursing

Nursing students typically complete clinical experiences in specialty areas such as obstetrics and labor and delivery. These clinical rotations provide a foundation where students can make connections with faculty, nurses, and others in that area.

New graduates interested in gaining clinical experience to work in a labor and delivery unit may need to begin in other hospital departments that provide a broad foundation.

Consider Earning a Specialty Certification

Certifications validate an RN’s expertise in a specialty area, including labor and delivery. Certification can increase your job prospects, earning potential, and ability to serve in leadership positions.

The National Certification Corporation (NCC) offers several core certification examinations for nurses working in labor and delivery, including inpatient obstetric nursing, electronic fetal monitoring, maternal newborn nursing, and low-risk neonatal intensive care nursing. The American Academy of Pediatrics offers a neonatal resuscitation program as an evidence-based approach to newborn care.

Labor and Delivery Nurse Education

Labor and delivery nurses must graduate from an accredited nursing program and pass the NCLEX-RN exam.

The quickest path to becoming a labor and delivery nurse can be completed in 1-2 years; Credits can later be used to earn a BSN

  • Admission Requirements: A high school diploma or its equivalent; math and reading courses and a writing proficiency exam; minimum 2.5 GPA; prerequisite courses
  • Program Curriculum: 60-70 credits in developmental psychology, microbiology, human anatomy and physiology, pharmacology, family health nursing, and nursing clinical hours
  • Time to Complete: 1-2 years
  • Skills Learned: Clinical training to monitor and care for patients; using catheters and tube feeding systems; dispensing medication; clinical experience in a healthcare facility

BSN candidates can enter directly out of high school or after earning an ADN. A BSN degree can be completed in four years, but licensed RNs may complete the programs more quickly through an RN-to-BSN bridge program or an accelerated BSN program .

BSN-prepared nurses have a higher earning potential and more career opportunities than nurses with an ADN degree. Many employers and professional nursing organizations recommend hiring BSN-prepared nurses as there is a documented increase in survival and lower odds of patient mortality. Hospitals that have raised their ratio of BSN-prepared nurses experience a decrease in length of stay and a 32% decrease in surgical mortality, such as cesarean sections.

  • Admission Requirements: Minimum 3.0 or higher GPA, some programs are flexible and accept 2.5; high school diploma, its equivalent, or an ADN degree; resume; letters of reference; a personal essay; clinical or volunteer experience is not required in all programs but highly recommended
  • Program Curriculum: Biomedical statistics and research; evidence-based practice; nursing fundamentals; physical assessment in nursing; pharmacology; leadership and management; community health; medical-surgical nursing; psychiatric and mental health nursing
  • Time to Complete: 2-4 years
  • Skills Learned: Critical thinking; evidence-based practice; clinical assessments and population health skills; information management; patient care technology; leadership and management

Labor and Delivery Nurse Licensure and Certification

Each state has different requirements for nurses to maintain their RN license. Most require licensure renewal every two years and a certain number of continuing education (CE) credits

There are several certifications labor and delivery nurses can earn to improve job security and demonstrate specialized expertise. Continuing education contributes positively to the healthcare organization by improving the quality of care and demonstrating a commitment to professional growth and excellence.

  • Neonatal Resuscitation Program : Designed to improve neonatal health outcomes by providing evidence-based guidelines and hands-on training.
  • Inpatient Obstetric Nursing (RNC-OB): Provides a competency-based validation of nurse knowledge and its application. Nurses are eligible after two years of specialty experience providing hospital-based care during antepartum, intrapartum, postpartum, and newborn periods.
  • Care of the Extremely Low Birth Weight Neonate (C-ELBW): For nurses who provide care to seriously ill and extremely low birth weight babies and their families. Practice experience is recommended but not required.
  • Maternal Newborn Nursing (RNC-MNN): A competency-based exam for nurses with a current RN license and at least 2,000 clinical hours of specialty experience and employment in that specialty within the last 24 months.
  • Inpatient Antepartum Nursing (RNC-IAP): Eligible nurses must have a current and unencumbered license in the U.S. or Canada, 24 months and 2,000 hours of specialty experience, and employment in the specialty in the past 24 months.

Working as a Labor and Delivery Nurse

A career as a labor and delivery room nurse is highly rewarding and challenging. Nurses focus on providing care during childbirth and play a critical role in ensuring the health and well-being of both mother and newborn. They must be adaptable and quick-thinking.

Nurses seeking to advance their careers may pursue advanced practice roles such as women’s health nurse practitioner or certified nurse-midwife . Nurses with advanced degrees and experience may encounter more opportunities for roles in management or education.

Labor and delivery nurses can earn a comfortable living, with the national average annual salary of about $73,000 as of June 2024, according to Payscale data.

Frequently Asked Questions About Becoming a Labor and Delivery Nurse

How long does it take to become a labor and delivery nurse.

Becoming a labor and delivery nurse takes from 2-4 years. The exact timeline depends on the degree earned. Certification requires an additional two years of work experience.

What exactly does a labor and delivery nurse do?

A labor and delivery nurse monitors fetal and maternal health, assists during labor, vaginal birth, and cesarean sections, provides postpartum care, and supports families. They ensure safe delivery and immediate newborn care, working closely with doctors and other healthcare professionals.

Is being a labor and delivery nurse hard?

Yes, being a labor and delivery nurse can be physically and professionally challenging, and emotionally difficult during times of loss. It involves long hours, emotional and physical stress, high responsibility for maternal and neonatal health, and the need to respond quickly to emergencies.

What degree is best for labor and delivery nurses?

Although an ADN degree is the minimal entry-level education necessary, most employers prefer BSN-prepared nurses as their advanced education contributes to better patient outcomes and lower mortality rates.

Related Pages

Advocating for Patients of Color as a Labor and Delivery Nurse

Advocating for Patients of Color as a Labor and Delivery Nurse

Women of color are dying at alarming rates in childbirth and even up to a year after. Find out the challenges facing pregnant patients of color and how labor and delivery nurses can help advocate for them.

How to Become a Nurse-Midwife

How to Become a Nurse-Midwife

This guide covers how to become a nurse-midwife. Explore educational pathways, certification and licensing requirements, and earning potential.

The Best Online RN-to-BSN Programs of 2024

The Best Online RN-to-BSN Programs of 2024

Are you an RN interested in completing your undergraduate nursing education? These top RN-to-BSN programs can be completed in just 12-24 months.

Nurse Practitioner Certification

ANA Nursing Resources Hub

Search Resources Hub

A female nurse leans in closely as she checks on a young patient after surgery. The little girl is wearing a hospital gown and tucked into bed as she talks with her nurse.

Critical Thinking in Nursing: Tips to Develop the Skill

4 min read • February, 09 2024

Critical thinking in nursing helps caregivers make decisions that lead to optimal patient care. In school, educators and clinical instructors introduced you to critical-thinking examples in nursing. These educators encouraged using learning tools for assessment, diagnosis, planning, implementation, and evaluation.

Nurturing these invaluable skills continues once you begin practicing. Critical thinking is essential to providing quality patient care and should continue to grow throughout your nursing career until it becomes second nature. 

What Is Critical Thinking in Nursing?

Critical thinking in nursing involves identifying a problem, determining the best solution, and implementing an effective method to resolve the issue using clinical decision-making skills.

Reflection comes next. Carefully consider whether your actions led to the right solution or if there may have been a better course of action.

Remember, there's no one-size-fits-all treatment method — you must determine what's best for each patient.

How Is Critical Thinking Important for Nurses? 

As a patient's primary contact, a nurse is typically the first to notice changes in their status. One example of critical thinking in nursing is interpreting these changes with an open mind. Make impartial decisions based on evidence rather than opinions. By applying critical-thinking skills to anticipate and understand your patients' needs, you can positively impact their quality of care and outcomes.

Elements of Critical Thinking in Nursing

To assess situations and make informed decisions, nurses must integrate these specific elements into their practice:

  • Clinical judgment. Prioritize a patient's care needs and make adjustments as changes occur. Gather the necessary information and determine what nursing intervention is needed. Keep in mind that there may be multiple options. Use your critical-thinking skills to interpret and understand the importance of test results and the patient’s clinical presentation, including their vital signs. Then prioritize interventions and anticipate potential complications. 
  • Patient safety. Recognize deviations from the norm and take action to prevent harm to the patient. Suppose you don't think a change in a patient's medication is appropriate for their treatment. Before giving the medication, question the physician's rationale for the modification to avoid a potential error. 
  • Communication and collaboration. Ask relevant questions and actively listen to others while avoiding judgment. Promoting a collaborative environment may lead to improved patient outcomes and interdisciplinary communication. 
  • Problem-solving skills. Practicing your problem-solving skills can improve your critical-thinking skills. Analyze the problem, consider alternate solutions, and implement the most appropriate one. Besides assessing patient conditions, you can apply these skills to other challenges, such as staffing issues . 

A diverse group of three (3) nursing students working together on a group project. The female nursing student is seated in the middle and is pointing at the laptop screen while talking with her male classmates.

How to Develop and Apply Critical-Thinking Skills in Nursing

Critical-thinking skills develop as you gain experience and advance in your career. The ability to predict and respond to nursing challenges increases as you expand your knowledge and encounter real-life patient care scenarios outside of what you learned from a textbook. 

Here are five ways to nurture your critical-thinking skills:

  • Be a lifelong learner. Continuous learning through educational courses and professional development lets you stay current with evidence-based practice . That knowledge helps you make informed decisions in stressful moments.  
  • Practice reflection. Allow time each day to reflect on successes and areas for improvement. This self-awareness can help identify your strengths, weaknesses, and personal biases to guide your decision-making.
  • Open your mind. Don't assume you're right. Ask for opinions and consider the viewpoints of other nurses, mentors , and interdisciplinary team members.
  • Use critical-thinking tools. Structure your thinking by incorporating nursing process steps or a SWOT analysis (strengths, weaknesses, opportunities, and threats) to organize information, evaluate options, and identify underlying issues.
  • Be curious. Challenge assumptions by asking questions to ensure current care methods are valid, relevant, and supported by evidence-based practice .

Critical thinking in nursing is invaluable for safe, effective, patient-centered care. You can successfully navigate challenges in the ever-changing health care environment by continually developing and applying these skills.

Images sourced from Getty Images

Related Resources

Smiling female medical practitioner attends to smiling patient in hospital bed

Item(s) added to cart

critical thinking in labor and delivery nursing

What is Critical Thinking in Nursing? (With Examples, Importance, & How to Improve)

critical thinking in labor and delivery nursing

Successful nursing requires learning several skills used to communicate with patients, families, and healthcare teams. One of the most essential skills nurses must develop is the ability to demonstrate critical thinking. If you are a nurse, perhaps you have asked if there is a way to know how to improve critical thinking in nursing? As you read this article, you will learn what critical thinking in nursing is and why it is important. You will also find 18 simple tips to improve critical thinking in nursing and sample scenarios about how to apply critical thinking in your nursing career.

What is Critical Thinking in Nursing?

4 reasons why critical thinking is so important in nursing, 1. critical thinking skills will help you anticipate and understand changes in your patient’s condition., 2. with strong critical thinking skills, you can make decisions about patient care that is most favorable for the patient and intended outcomes., 3. strong critical thinking skills in nursing can contribute to innovative improvements and professional development., 4. critical thinking skills in nursing contribute to rational decision-making, which improves patient outcomes., what are the 8 important attributes of excellent critical thinking in nursing, 1. the ability to interpret information:, 2. independent thought:, 3. impartiality:, 4. intuition:, 5. problem solving:, 6. flexibility:, 7. perseverance:, 8. integrity:, examples of poor critical thinking vs excellent critical thinking in nursing, 1. scenario: patient/caregiver interactions, poor critical thinking:, excellent critical thinking:, 2. scenario: improving patient care quality, 3. scenario: interdisciplinary collaboration, 4. scenario: precepting nursing students and other nurses, how to improve critical thinking in nursing, 1. demonstrate open-mindedness., 2. practice self-awareness., 3. avoid judgment., 4. eliminate personal biases., 5. do not be afraid to ask questions., 6. find an experienced mentor., 7. join professional nursing organizations., 8. establish a routine of self-reflection., 9. utilize the chain of command., 10. determine the significance of data and decide if it is sufficient for decision-making., 11. volunteer for leadership positions or opportunities., 12. use previous facts and experiences to help develop stronger critical thinking skills in nursing., 13. establish priorities., 14. trust your knowledge and be confident in your abilities., 15. be curious about everything., 16. practice fair-mindedness., 17. learn the value of intellectual humility., 18. never stop learning., 4 consequences of poor critical thinking in nursing, 1. the most significant risk associated with poor critical thinking in nursing is inadequate patient care., 2. failure to recognize changes in patient status:, 3. lack of effective critical thinking in nursing can impact the cost of healthcare., 4. lack of critical thinking skills in nursing can cause a breakdown in communication within the interdisciplinary team., useful resources to improve critical thinking in nursing, youtube videos, my final thoughts, frequently asked questions answered by our expert, 1. will lack of critical thinking impact my nursing career, 2. usually, how long does it take for a nurse to improve their critical thinking skills, 3. do all types of nurses require excellent critical thinking skills, 4. how can i assess my critical thinking skills in nursing.

• Ask relevant questions • Justify opinions • Address and evaluate multiple points of view • Explain assumptions and reasons related to your choice of patient care options

5. Can I Be a Nurse If I Cannot Think Critically?

critical thinking in labor and delivery nursing

U.S. flag

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

  • Publications
  • Account settings
  • My Bibliography
  • Collections
  • Citation manager

Save citation to file

Email citation, add to collections.

  • Create a new collection
  • Add to an existing collection

Add to My Bibliography

Your saved search, create a file for external citation management software, your rss feed.

  • Search in PubMed
  • Search in NLM Catalog
  • Add to Search

Managing the tension between caring and charting: Labor and delivery nurses' experiences of the electronic health record

Affiliations.

  • 1 Department of Family Health Care Nursing, University of California San Francisco, San Francisco, California, USA.
  • 2 Salinas Valley Memorial Healthcare System, Salinas, California, USA.
  • 3 Brenda and Jeffrey L. Kang Presidential Chair in Healthcare Finance, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA.
  • 4 Rory Myers College of Nursing, New York University, New York, New York, USA.
  • PMID: 34402080
  • DOI: 10.1002/nur.22177

Over a decade following the nationwide push to implement electronic health records (EHRs), the focus has shifted to addressing the cognitive burden associated with their use. Most research and discourse about the EHR's impact on clinicians' cognitive work has focused on physicians rather than on nursing-specific issues. Labor and delivery nurses may encounter unique challenges when using EHRs because they also interact with an electronic fetal monitoring system, continuously managing and synthesizing both maternal and fetal data. This grounded theory study explored labor and delivery nurses' perceptions of the EHR's impact on their cognitive work. Data were individual interviews and participant observations with twenty-one nurses from two labor and delivery units in the western U.S. and were analyzed using dimensional analysis. Nurses managed the tension between caring and charting using various strategies to integrate the EHR into their dynamic, high-acuity, specialty practice environment while using EHRs that were not designed for perinatal patients. Use of the EHR and associated technologies disrupted nurses' ability to locate and synthesize information, maintain an overview of the patient's status, and connect with patients and families. Individual-, group-, and environmental-level factors facilitated or constrained nurses' integration of the EHR. These findings represent critical safety failures requiring comprehensive changes to EHR designs and better processes for responding to end-user experiences. More research is needed to develop EHRs that support the dynamic and relationship-based nature of nurses' work and to align with specialty practice environments.

Keywords: cognitive work; electronic health record; labor and delivery; situation awareness.

© 2021 Wiley Periodicals LLC.

PubMed Disclaimer

Similar articles

  • Seven years after Meaningful Use: Physicians' and nurses' experiences with electronic health records. Rathert C, Porter TH, Mittler JN, Fleig-Palmer M. Rathert C, et al. Health Care Manage Rev. 2019 Jan/Mar;44(1):30-40. doi: 10.1097/HMR.0000000000000168. Health Care Manage Rev. 2019. PMID: 28614166
  • Not another box to check! Using the UTAUT to explore nurses' psychological adaptation to electronic health record usability. Winckler D. Winckler D. Nurs Forum. 2022 May;57(3):412-420. doi: 10.1111/nuf.12686. Epub 2021 Dec 26. Nurs Forum. 2022. PMID: 34957564
  • RN Perceptions of a Newly Adopted Electronic Health Record. Schenk EC, Mayer DM, Ward-Barney E, Estill P, Goss L, Shreffler-Grant J. Schenk EC, et al. J Nurs Adm. 2016 Mar;46(3):139-45. doi: 10.1097/NNA.0000000000000313. J Nurs Adm. 2016. PMID: 26906518
  • The electronic health record's impact on nurses' cognitive work: An integrative review. Wisner K, Lyndon A, Chesla CA. Wisner K, et al. Int J Nurs Stud. 2019 Jun;94:74-84. doi: 10.1016/j.ijnurstu.2019.03.003. Epub 2019 Mar 14. Int J Nurs Stud. 2019. PMID: 30939418 Review.
  • State of the Science of Dimensions of Nurses' User Experience When Using an Electronic Health Record. Tolentino DA, Gephart SM. Tolentino DA, et al. Comput Inform Nurs. 2020 Jul 28;39(2):69-77. doi: 10.1097/CIN.0000000000000644. Comput Inform Nurs. 2020. PMID: 32732645 Review.
  • Understanding the role and impact of electronic health records in labor and delivery nursing practice: A scoping review protocol. Bignell CA, Petrovskaya O. Bignell CA, et al. Digit Health. 2024 Apr 25;10:20552076241249271. doi: 10.1177/20552076241249271. eCollection 2024 Jan-Dec. Digit Health. 2024. PMID: 38665885 Free PMC article.
  • Involving Health Care Professionals in the Development of Electronic Health Records: Scoping Review. Busse TS, Jux C, Laser J, Rasche P, Vollmar HC, Ehlers JP, Kernebeck S. Busse TS, et al. JMIR Hum Factors. 2023 Jul 10;10:e45598. doi: 10.2196/45598. JMIR Hum Factors. 2023. PMID: 37428524 Free PMC article. Review.
  • An integrative review exploring the impact of Electronic Health Records (EHR) on the quality of nurse-patient interactions and communication. Forde-Johnston C, Butcher D, Aveyard H. Forde-Johnston C, et al. J Adv Nurs. 2023 Jan;79(1):48-67. doi: 10.1111/jan.15484. Epub 2022 Nov 7. J Adv Nurs. 2023. PMID: 36345050 Free PMC article. Review.
  • Aspden, P., Corrigan, J. M., Wolcott, J., & Erickson, S. (Eds.). (2004). Patient safety: Achieving a new standard for care. National Academies Press.
  • Association of Women's Health, Obstetric, and Neonatal Nurses. (2010). Guidelines for professional registered nurse staffing for perinatal units. Author.
  • Association of Women's Health, Obstetric and Neonatal Nurses. (2018). Health information technology for the perinatal setting. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 47(3), 418-420. https://doi.org/10.1016/j.jogn.2018.03.001
  • Benner, P., Hooper-Kyriakidis, & Stannard, D. (1999). Clinical wisdom and interventions in critical care: A thinking-in-action app. W.B. Saunders.
  • Benner, P., Tanner, C. A., & Chesla, C. A. (2009). Expertise in nursing practice: Caring, clinical judgment, and ethics. Springer Publishing Company.

Publication types

  • Search in MeSH

Related information

Linkout - more resources, full text sources.

  • Ovid Technologies, Inc.
  • MedlinePlus Health Information
  • Citation Manager

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

Goodwin University Home

A Guide to Becoming a Labor and Delivery Nurse

In a National Vital Statistics Report, the Centers for Disease Control stated that there were 3.66 million births in the United States in 2021.

Labor and delivery nurses help make the birthing experience as comfortable and safe as possible for their patients.

If you’re researching guides on specialty nursing concentrations or curious about how to become a labor and delivery nurse , read on to discover:

  • Daily assignments associated with the labor and delivery nurse profession
  • Designated work settings for labor and delivery nurses
  • Degrees required to become a labor and delivery nurse
  • Descriptions of labor and delivery nursing skills that are helpful-to-have, and
  • Details regarding occupational outlooks for the labor and delivery nursing sector

L&D Nurse Career Definition: What is a Labor and Delivery Nurse?

Labor and delivery nurses (also called delivery nurses or L&D nurses) are trained registered nurses (RNs) who specialize in helping medical professionals and mothers during childbirth. Their primary function is to assist in the labor and delivery process.

Labor and delivery nurses play a critical role in providing comprehensive healthcare by offering emotional, physical, and psychological support to patients and their families throughout childbirth—from early labor and birth to postpartum.

Common Duties for an L&D Nurse: What Do Labor and Delivery Nurses Do?

As the primary contact for mothers and family members, labor and delivery nurses are the go-to providers for comfort, questions, and support.

During labor and delivery, nurses are usually assigned a small number of patients per shift, ranging from one to a few.

Roles and responsibilities for labor and delivery nurses include:

  • Administering IVs, medications, and epidurals
  • Advocating for patients’ emotional, physical, ad psycho-social needs
  • Assisting physicians or midwives with cesarean deliveries, inducing labor, or other procedures and surgeries
  • Coaching and uplifting mothers throughout the birthing process
  • Communicating birthing status to all applicable members of the interdisciplinary team
  • Educating caregivers and their families on newborn care like bathing and feeding, as well as any possible neonatal complications, and birth recovery
  • Monitoring and documenting patient contractions and dilation
  • Recording the mother and baby’s vital signs, including blood pressure and heart rate monitoring
  • Referring patients to additional support staff and specialists, and
  • Staying alert and cognizant of any possible changes or complications

L&D Nurse Career Settings: Where Do Labor and Delivery Nurses Work?

Most labor and delivery nurses work in hospitals , but some may opt to assist with home births or work in birthing centers or clinical settings. Other labor and delivery nurses may also function as independent contractors, serving as consultants or community resources.

The requirements for labor and delivery nurses vary depending on the state and medical institution. Some hospitals allow L&D nurses to apply for employment immediately after completing their degrees, while other employers may require applicants to have prior experience as a registered nurse on a general medical or surgical floor.

L&D Nurse Education: How Do You Become a Labor and Delivery Nurse?

Registered nurses specializing in labor and delivery graduate from an accredited nursing program instructing curriculum topics like lifespan development, nursing leadership, and the wellness continuum for women, newborns, and families.

Generally, prospective labor and delivery RNs enroll in a two-year nursing program , such as an associate degree in Nursing , like the one offered by Goodwin University.

Registered nursing hopefuls can also earn their four-year degree in nursing, otherwise known as a Bachelor of Science in Nursing (BSN).

Moreover, Accelerated BSN programs are available for prospective registered nurses who have already completed their bachelor’s degree in another major.

RN-to-BSN programs are designed to streamline the baccalaureate nursing degree process for existing registered nurses with licensures in good standing.

Likewise, bachelor-level L&D nurses seeking to advance their careers can enroll in an advanced practice registered nurse (APRN) graduate program.

After becoming a nursing graduate , all alums must pass the national nursing licensure exam (the NCLEX-RN ) and their respective state boards before practicing in the field. On-the-job training in the specialty may also be administered to new hires.

Not sure which program is right for you? Explore our ASN, ABSN, RN-to-BSN, and APRN downloadable guides for more information!

L&d nursing skills: necessities for labor and delivery nurse success.

A rewarding career for registered nurses of any level, labor and delivery nurses witness medical marvels daily and assist in guiding new life into the world.

L&D nurses must also have the emotional intelligence to handle complex cases. High-risk patients include those with advanced maternal age and birth complications like premature infants or babies with low birth weight.

To flourish in a labor and delivery career, L&D registered nurses should be capable of connecting with everyone, including colleagues, doctors, patients, and families.

Furthermore, labor and delivery nurses should likely possess some of the following characteristics:

  • A calm demeanor in high pain, tense, or stressful situation
  • Adaptability
  • Assertiveness
  • Critical thinking skills
  • Communication
  • Social perceptiveness, and
  • Time Management

Labor and Delivery Nursing Profession: Career Projections and Salary

As of 2022, the U.S. Bureau of Labor Statistics reported that the annual average wage for registered nurses nationally was $89,010.

The same year, registered nurses working in Connecticut made an annual average wage of $94,260.

According to the U.S. Department of Labor , the field of registered nursing is projected to grow six percent from 2021 to 2031, accounting for 203,200 openings each year over the decade.

Are you ready to push your way into a new profession?

Discover a rewarding career path.

Start your nursing journey at Goodwin!

4 Qualities That Make a Good Labor & Delivery Nurse

labor and delivery nurse

Becoming a labor and delivery nurse can be a rewarding and fulfilling career path as you care for birthing individuals during the delivery process. It requires a unique set of skills, qualities, and a genuine passion for providing exceptional care to expectant parents and their newborns. 

If you’re a new nurse interested in specializing in labor and delivery, this blog post will explore the characteristics you’ll need while working in this role and provide valuable tips to support you in your career growth in the coming years. 

Characteristics of Good Labor and Delivery Nurses 

To excel in the field of labor and delivery nursing, it's essential to possess certain qualities and characteristics which make for a great nurse , from compassion and critical thinking skills to the ability to remain calm in stressful situations. Keep reading to learn more about these qualities. 

1. Compassion and Empathy

Labor and delivery can be an emotionally charged experience for individuals giving birth and those around them. To be a good labor and delivery nurse, you’ll need to demonstrate compassion and empathy and offer emotional support, which includes reassurance throughout the birthing process.

2. Ability to Remain Calm 

Labor and delivery can be an intense experience, and working in this hospital unit can be especially stressful during unexpected challenges in childbirth. Remaining calm is essential, so you can work with other healthcare professionals like obstetricians and midwives to make rational decisions and provide a calming presence for birthing individuals and those around them, particularly while they are stressed, anxious, or in pain—and the likelihood of this can be high during childbirth, as it’s one of the most important and intense life events someone can experience. 

3. Critical Thinking Skills

Labor and delivery nurses must have fast thinking skills and the ability to make informed decisions under stressful conditions. Childbirth is an incredible and miraculous experience, but it can also be devastating when it doesn’t go according to plan. Nurses can experience trauma and grief as they cope with losing a patient to maternal mortality or infant mortality. In the hours and moments during these challenging incidences, nurses need to be able to think critically to provide the best care possible to patients, anticipate potential complications, and respond appropriately in difficult situations. 

4. Strong Communication Skills

Effective communication is crucial as a labor and delivery nurse—particularly because you’ll be working with a team of other health professionals during the delivery process and will also need to communicate with the birthing individual and their family members or anyone else who is present during the birth. Labor and delivery nurses should be able to communicate compassionately to ensure that the birthing individual is knowledgeable about the process and feels supported throughout. 

Effective Tips for New Nurses in Labor and Delivery

As a new labor and delivery nurse, it’s important to take the initiative to pursue personal and professional development opportunities so you can strengthen your skills, develop the essential characteristics of a good labor and delivery nurse, and continue to grow in this role. Follow the below tips to build up your confidence as a new labor and delivery nurse. 

  • Seek mentorship: As a new nurse, seeking mentorship can help expand your knowledge and fast-track your learning as a labor and delivery nurse. According to research from a pilot mentorship program in Northern Karnataka, India, nurses reported an increased ability to provide care according to stipulated guidelines and an overall increase in the nurses’ knowledge and skills. 
  • Network with other labor and delivery nurses: By joining in-person or online communities for nursing professionals, such as Nursa’s online community, you can meet other like-minded healthcare professionals, including labor and delivery nurses, so you can learn from their experiences, potentially pursue mentorship, and explore other career opportunities. 
  • Pursue continuing education : Labor and delivery nurses need specialized knowledge in obstetrics, neonatal care, and maternal health. Connect with and follow along with the work of organizations, including the Association of Women’s Health, Obstetric and Neonatal Nurses , so you can be up-to-date on the best practices to provide evidence-based care to patients. You can also attend conferences and workshops on obstetrics and neonatal care. 
  • Practice self-care: Being a labor and delivery nurse can be incredibly rewarding but also stressful. As with any nursing position, it’s important to practice self-care and put yourself first during your off-hours, as so much of your time and working hours are spent caring for others. According to research on self-care for nurses and midwives , an intentional practice of self-care builds resilience and lessens burnout and secondary trauma. Self-care practices such as mindfulness, compassion, and resilience were critical in promoting the overall well-being of the nurses within the workplace. Check out our top tips for how to take care of yourself as a nurse and commit to taking at least one action. 

‍ Looking to pick up high-paying per diem shifts in various nursing specialties, including labor and delivery nursing? Download the Nursa app today to browse nearby opportunities that fit your ideal work schedule.

critical thinking in labor and delivery nursing

Meet Jacky, a contributing copywriter at Nursa who specializes in writing about nursing specialties, FAQs, and career advice.

Sign Up with Nursa and Request PRN Jobs near You

Interested in healthcare shifts, related blog posts.

Clinical Levels: Understanding RN I, RN II, RN III, & More

Choose Multiple PRN Shifts on Your Schedule

Nursa isn't just about finding a job ; it's about crafting your ideal work schedule by selecting shifts. Once you create a Nursa profile, you will experience the convenience of scheduling shifts in real-time.

See More Shifts and Apply Now

Explore and find where you would like to work

Pick Up a Job Today

Find per diem PRN job opportunities in your area . High paying CNA, LPN and RN and many more are now available now.

Post Your Jobs Today

Facilities who use Nursa fill 3 times as many open per diem shifts , on average, compared to trying to fill the shifts themselves.

Nursa is no 1 mobile app for clinicians

Download the App Now

Health eCareers logo

opens in a new window

  • Nurse Career

Labor and delivery nurse talking to a pregnant woman

A Comprehensive Guide to Becoming a Labor and Delivery Nurse

Labor and delivery is one of the most sought-after jobs in nursing. It requires a specific skill set plus compassion, dedication, and knowledge. If you are a nurse who is just starting out or is curious about transitioning into the world of labor and delivery nursing, there are a few essential things to consider before starting your career. From how to start your career as a labor and delivery nurse, the demands and rewards of the job, to the profit you can expect to make, we will discuss vital information to help you make an educated decision for your nursing career.

What Qualifications Do I Need to Become a Labor and Delivery Nurse?

To become a labor and delivery nurse, you must first meet some qualifications. Nurses must graduate from an accredited nursing school, earn an Associate’s Degree in Nursing (ADN) or a Bachelor in Science of Nursing (BSN), and pass the NCLEX licensing exam. Many nurses recommend that new graduate nurses start their careers in a medical-surgical unit to gain confidence and nursing skills. However, that shouldn’t deter nurses from applying to a labor and delivery unit if they are new graduates. If the nurse is the right candidate for the job, many hospitals will hire them and have them complete a training course or program of their choice.

Certification in Obstetric Nursing is another option for labor and delivery nurses to advance their careers. The National Certification Corporation (NCC) offers the Inpatient Obstetric Nursing (RNC-OB) certification. The RNC-OB works well for registered nurses (RNs) with two years of professional experience and a specialization in obstetric, gynecologic, or neonatal nursing. Nurses who earn this certification can move up the ladder to a management position and increase their salaries.

What Type of Training and Experience Do Labor and Delivery Nurses Typically Have?

Labor and delivery nurses typically have a more extensive orientation to their unit than, for example, a medical-surgical nurse. During these orientations, nurses undergo intense training and education specialized in the labor and delivery unit. Many hospitals even offer their new nurses a fellowship or nurse residency program. The fellowship or residency programs often last a few months to a year. Nurse residency programs allow nurses to gain confidence and use their critical thinking in real-life, hands-on nursing situations under the supervision of an experienced preceptor. According to the American Association of Colleges of Nurses (AACN), there are multiple benefits associated with new nurse residency programs , which include the following:  

  • Strengthens critical thinking skills and use of evidence-based practices to improve clinical judgment 
  • Builds competence and confidence in clinical decision-making  
  • Enables stronger clinical nursing leadership, communication, and practice safety 
  • Provides individual development plans for new nursing roles 
  • Improves professional commitment, nurse satisfaction, and team interactions 

Job Outlook for Labor and Delivery Nurses

With almost a million nurses coming into retirement by the year 2030, the nursing shortage is here to stay. The American Association of Colleges of Nursing states that according to the Bureau of Labor Statistics Employment Projections 2021-2031 , the RN workforce will likely grow by 6% over the next decade. Statistics suggest the RN workforce will increase from 3.1 million in 2021 to 3.3 million in 2031, a growth of 195,400 nurses. Accordingly, nurses who want to specialize in labor and delivery have an excellent opportunity to land the career of their dreams. 

In addition to the aging workforce and nursing shortage , the number of births in the country will continue to grow, providing labor and delivery nurses with job security. In 2022, the number of babies born in the United States was over 3.7 million, according to UNICEF. With the birth rate steadily increasing each year, the need for nurses working in maternal/newborn units will also continue to rise. 

Nurses who want to specialize in labor and delivery have a few options regarding their place of work. Some of the areas where a labor and delivery nurse can work include the following settings:

  • Labor and delivery unit at a hospital
  • Postpartum floor
  • Birthing centers
  • Obstetric clinics

Salary Guide for Labor and Delivery Nurses

Labor and delivery nurses often earn a higher income than the average registered nurse working in another area of a hospital or clinic. Health eCareers states the average salary for a registered nurse is around $73,000. In contrast, the average salary for a labor and delivery nurse is nearly $80,000. National hourly wages vary by state, but on average, a new graduate nurse with less than a year of experience can expect to earn around $29. Nurses with five years of experience average $32, and nurses with over ten years of experience can earn upwards of $40 an hour, making labor and delivery a very lucrative area of nursing.

Physical Demands and Rewards of Becoming a Labor and Delivery Nurse

Labor and delivery nursing can be a physically demanding job. You must be able to help patients reposition, assist them to the bathroom, and be quick on your feet. Nurses who work in a labor and delivery setting often work 12-hour shifts. 

Although the job is physically and mentally challenging, working in a labor and delivery unit has many rewards. Many nurses love that they share such an exciting and personal experience with their patients. Helping patients during childbirth is one of the most thrilling and joyful experiences that labor and delivery nurses get to be a part of. Some other tasks that labor and delivery nurses encounter during a shift include monitoring the fetal heart rate and contractions, administering medications, and reporting to obstetricians. Another rewarding aspect of labor and delivery nursing is education. Many nurses love teaching patients and their families about different options for childbirth, newborn care, and breastfeeding. These reasons help draw nurses to the labor and delivery field.

Attributes of a Great Labor and Delivery Nurse

To become a great labor and delivery nurse, you must have specific characteristics and attributes. Nurses must be empathetic and genuinely show that they care about the patients they serve. They must also think on their feet and communicate efficiently with patients and providers, especially when there are complications. Labor and delivery nurses should be excellent at critical thinking to make the best decisions regarding patient care. Another attribute that labor and delivery nurses should strive to have is cultural sensitivity. Labor and delivery nurses care for patients of all races and ethnicities. Each ethnic group has its own cultural views and rules on birth, and nurses must be sensitive to those views.

Being a labor and delivery nurse can be a wonderful career with opportunities for advancement, a higher salary, and rewarding work. Nurses will work with many different specialties and departments within the hospital. From Anesthesia to Radiology, ER to Reception, admissions, and countless other healthcare team members, labor and delivery nurses will need to communicate and collaborate to ensure they are delivering the best care possible to the mothers and families they serve. With the current trend of the nursing shortage, now is a great time to enter the labor and delivery nursing field.

Shelby Allan, RN, BSN is a nurse, a mother to four young kids, and a wife to a busy farmer/cattle rancher. She and her husband live on a farm in Central Nebraska. Shelby is passionate about educating women and mothers with evidence-based research so they may make the best decision for themselves and their families.

Female nurse taking blood pressure of older female patient

Related Articles

Female nurse taking blood pressure of older female patient

How to Change Careers to Nursing

Medical-surgical nurse in an operating room looking at chart

5 Things You Need to Know About Medical-Surgical Nurses

Doctors and nursing smiling and talking with coffee

The Essential Role of Mentoring in Nursing Professional Development

Labor and Delivery Nurse

Labor & Delivery Nurse’s Job Description

Labor and delivery nurses are nurses that assist women during the process of childbirth. Labor and delivery nurses are very similar to perinatal nurses, only they just assist during labor verses seeing the woman during the entire pregnancy like perinatal nurses do. During a woman’s labor, the labor and delivery nurse monitors the fetal heart rate in order to determine if the baby is handling labor well. The nurse also monitors the woman’s blood pressure, temperature, strength and timing of contractions, and cervical dilation. The nurse can assist the woman in finding ways to help labor progress more quickly and comfortably. During the actual delivery, the labor and delivery nurse can help coach the woman with breathing exercises and pushing.

What does an L&D Nurse Do? If complications arise during labor, the nurse alerts the attending physicians so that further interventions can occur, such as a caesarian delivery. The nurse also assists the physicians when epidurals or pain medications are administered, episiotomies are performed, or when the woman requires preparation for a caesarian delivery. The labor and delivery nurse must also be comfortable with starting IVs in order to administer fluids and the labor-stimulating drug Pitocin.

A labor and delivery nurse must possess excellent critical thinking skills and an ability to make decisions quickly using good professional judgment. Each woman who is admitted to the labor and delivery unit has at least one baby who also becomes the patient of the nurse. The nurse must be able to recognize complications and act quickly in order to stabilize the situation and communicate with the patient, the patient’s family, and the appropriate physicians and specialists in order to ensure a safe and healthy delivery.

Skills & Education In order to become a labor and delivery nurse, one must have earned an Associate of Science in Nursing or a Bachelor of Science in Nursing degree through an accredited college or university. Students can take elective courses in labor and delivery in order to better be prepared for a future career as a labor and delivery nurse. Following graduation, the student must successfully pass the National Council Licensure Examination, or NCLEX. Board certification can be obtained following clinical experience as a staff nurse and working in the labor and delivery unit.

Job Outlook While the job outlook for nurses in many areas of practice is positive, it is estimated that positions as a labor and delivery nurse may be harder to obtain over the next decade. This is in part due to the fact that labor and delivery is a popular area of nursing with many registered nurses choosing to specialize in that area. It is also an area of nursing with a lower turnover rate than is found in other nursing specialties.

Salary The average yearly salary for a nurse specializing in labor and delivery is approximately $55,000 a year. A labor and delivery nurse who has several years of experience can expect to make closer to $70,000 or more. Those nurses with a master’s degree or higher can also make a significantly higher annual salary. The annual pay level for a labor and delivery nurse is often higher in metropolitan areas verses rural areas. The average salary is also dependent on the area of the country one practices in.

NURSING SCHOOL OPTIONS FOR EACH STATE LISTED BELOW

[qs_listing areaofinterest=”LPN-LVN-LICENSED-PRACTICAL-NURSING-LICENSED-VOCATIONAL-NURSING” zip=”” degreeofinterest=”CERTIFICATE, DIPLOMA-NON-HIGH-SCHOOL,ASSOCIATE” campustype=”CAMPUS” multidealer=”true”] [sc:QStrack]

  • Visit Nurse.com on Facebook
  • Visit Nurse.com on YouTube
  • Visit Nurse.com on Instagram
  • Visit Nurse.com on LinkedIn

Nurse.com by Relias . © Relias LLC 2024. All Rights Reserved.

IMAGES

  1. The Nursing Process And Critical Thinking (Step by Step)

    critical thinking in labor and delivery nursing

  2. PPT

    critical thinking in labor and delivery nursing

  3. The Importance of Critical Thinking Skills in Nursing

    critical thinking in labor and delivery nursing

  4. Critical Thinking in Nursing

    critical thinking in labor and delivery nursing

  5. Critical Thinking in Nursing Practice

    critical thinking in labor and delivery nursing

  6. Labor and Delivery Maternal Newborn OB Nursing Notes

    critical thinking in labor and delivery nursing

COMMENTS

  1. Standards for Professional Nursing Practice in the Care of Women

    Nursing process: A critical thinking model used by nurses in providing care to health care consumers that ... and dignity of the recipient; is free from harm or mistreatment; and supports informed choices during labor and birth (Bohren et al., 2020. ... The registered nurse coordinates care delivery within their scope of practice. ...

  2. Three Missed Critical Nursing Care Processes on Labor and Delivery

    We focused on three critical labor and delivery nursing activities: timely recognition of and response to indeterminate or abnormal fetal heart rate changes, excessive uterine activity, and new maternal complications. ... In a survey of 757 labor and delivery nurses conducted in the summer of 2020, ...

  3. Decision Making on the Labor and Delivery Unit: An Investigation of

    Within a sample of labor and delivery nurses, physicians, and allied personnel, we used self-report measures to examine the impact of trait factors, including NA, decision-making style, and perceived time stress, on decision quality in a situational judgment test (Study 1). ... Understanding and enhancing critical thinking in recognition-based ...

  4. Quality Patient Care in Labor and Delivery: A Call to Action

    Patient‐centered care recognizes that each woman brings unique knowledge regarding herself and her body to pregnancy, labor, birth, and mothering. Shared decision making, a process by which a woman and her care team interact as partners to make decisions that are fully informed, based on the best available evidence, consistent with personal ...

  5. Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and

    Critical thinking in nursing is an essential component of professional accountability and quality nursing care. ... ' outcomes. 81-83 Research-based guidelines are intended to provide guidance for specific areas of health care delivery. 84 The clinician—both the novice and expert—is expected to use the best available evidence for the ...

  6. 6 Labor and Delivery Nurse Skills: Definition and Examples

    Labor and delivery nurse skills are the knowledge, traits and abilities these health care professionals use to work in a labor and delivery unit. Labor and delivery nurses use their medical knowledge and clinical training to provide care to mothers and their newborn babies. ... This requires critical thinking and emergency responsiveness, along ...

  7. Effects of S-PBL in Maternity Nursing Clinical Practicum on Learning

    When nursing subjects deal with labor pains and childbirth, it is difficult to predict the nature of delivery, and emergency situations frequently arise. ... critical thinking in nursing students was closely correlated with nursing competency ... In maternity nursing, where the delivery process and outcome are difficult to predict and emergency ...

  8. Labor & Delivery Nurse: Career Guide, Salary, Certifications & More

    Critical thinking and problem-solving: Given the unpredictability of childbirth, labor and delivery nurses need to think on their feet and make swift decisions. They need to quickly assess situations, analyze patient data, and identify any potential complications. ... Labor and delivery nurses work in various settings from bustling urban ...

  9. How To Become A Labor And Delivery Nurse

    Labor and delivery nurses have specialized responsibilities, including monitoring fetal heart rates, identifying potential risks, and assessing labor progression. They function with compassion, strong communication, and critical thinking skills to provide comprehensive care in an environment that can quickly develop emergencies.

  10. PDF The Nursing Role in Caring for the Family During Labor and Birth

    related to safe labor and birth that nurses can help the nation achieve. 9. Identify areas related to labor and birth that could benefit from additional nursing research or application of evidence-based practice. 10. Use critical thinking to analyze the effectiveness of nursing care measures to meet the needs of women and their families so ...

  11. PDF Improving Maternal Child Health through Improved Prediction of Critical

    Critical Thinking Task in Maternity Nursing(CT2MN): A maternity nursing case study and 8 follow-up questions that align with the study definition of critical thinking. A.W., an 18 y. o. G2P0010, came to labor and delivery with her boyfriend with a complaint of spontaneous onset of contractions beginning at 1 am. It is now 6 am. She goes to the

  12. Enhancing Labor and Delivery Learning Experiences Through Simulation

    for clinical experiences that enhance critical thinking and problem-solving skills for competent care (IOM, 2011). The purpose of this study was to formatively evaluate stu-dent nurses' transfer of labor and delivery knowledge and clinical judgment to a simulated clinical environment. The specific aims of this pilot study were to:

  13. Critical Thinking in Nursing: Developing Effective Skills

    Critical thinking in nursing is invaluable for safe, effective, patient-centered care. You can successfully navigate challenges in the ever-changing health care environment by continually developing and applying these skills. Images sourced from Getty Images. Critical thinking in nursing is essential to providing high-quality patient care.

  14. What is Critical Thinking in Nursing? (With Examples, Importance, & How

    The following are examples of attributes of excellent critical thinking skills in nursing. 1. The ability to interpret information: In nursing, the interpretation of patient data is an essential part of critical thinking. Nurses must determine the significance of vital signs, lab values, and data associated with physical assessment.

  15. Enhancing Labor and Delivery Learning Experiences Through Simulation

    Simpson-Cosimano, A. (2010). The experience of new nursing graduates on labor and delivery units: A phenomenological approach. College of Saint Mary). ProQuest Dissertations and Theses, 106. ... and critical thinking. It is important for nurse educators to continue to integrate instructional design strategies that facilitate immersive presence ...

  16. Nursing simulation practicum for delivery care: A scoping review

    To examine the effects of high-fidelity simulation of labor and delivery on nursing students' knowledge, critical thinking, and clinical performance: Randomized controlled study: 72 third-year nursing students (E group 36, C group 36) 2 times: S: Nursing knowledge (Delivery care) Critical thinking Clinical performance: Raman et al. (2011) /Oman

  17. Managing the tension between caring and charting: Labor and delivery

    Labor and delivery nurses may encounter unique challenges when using EHRs because they also interact with an electronic fetal monitoring system, continuously managing and synthesizing both maternal and fetal data. This grounded theory study explored labor and delivery nurses' perceptions of the EHR's impact on their cognitive work.

  18. How to Become a Labor and Delivery Nurse?

    Generally, prospective labor and delivery RNs enroll in a two-year nursing program, such as an associate degree in Nursing, like the one offered by Goodwin University. Registered nursing hopefuls can also earn their four-year degree in nursing, otherwise known as a Bachelor of Science in Nursing (BSN). Moreover, Accelerated BSN programs are ...

  19. Nurses Champion New Patient-Centric Model of Labor and Delivery Care

    The labor and delivery unit's Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores for nurse communication point to the model's effectiveness: The score for "nurses listen carefully to you" rose 10.56% in the first quarter of 2023 to 90.48%. Plan-of-care huddles

  20. 4 Qualities That Make a Great Labor & Delivery Nurse

    3. Critical Thinking Skills. Labor and delivery nurses must have fast thinking skills and the ability to make informed decisions under stressful conditions. Childbirth is an incredible and miraculous experience, but it can also be devastating when it doesn't go according to plan.

  21. A Comprehensive Guide to Becoming a Labor and Delivery Nurse

    Nurse residency programs allow nurses to gain confidence and use their critical thinking in real-life, hands-on nursing situations under the supervision of an experienced preceptor. ... Labor and delivery nurses often earn a higher income than the average registered nurse working in another area of a hospital or clinic.

  22. Labor and Delivery Nurse

    A labor and delivery nurse must possess excellent critical thinking skills and an ability to make decisions quickly using good professional judgment. Each woman who is admitted to the labor and delivery unit has at least one baby who also becomes the patient of the nurse. The nurse must be able to recognize complications and act quickly in ...

  23. How to Become a Labor and Delivery Nurse

    Cultivate critical thinking and problem-solving skills. Labor and delivery scenarios can change rapidly, so critical thinking and problem-solving helps ensure safe and effective care. Stay up to date with continuing education. Healthcare is constantly evolving, especially in labor and delivery, so stay current with the latest practices with ...

  24. Decision Making on the Labor and Delivery Unit: An Investigation of

    Method: Within a sample of labor and delivery nurses, physicians, and allied personnel, we used self-report mea-sures to examine the impact of trait factors, including NA, decision-making style, and perceived time stress, on decision quality in a situational judgment test (Study 1). In Study 2, we observed the influence of state NA, state

  25. Enhancing Labor and Delivery Learning Experiences ...

    In today's health care environment, simulation is a viable teaching strategy used to provide the nursing profession with opportunities for clinical experiences that enhance critical thinking and problem-solving skills for competent care (IOM, 2011). The purpose of this study was to formatively evaluate student nurses' transfer of labor and ...

  26. How to Become a Labor and Delivery Nurse

    Labor and delivery nurses with an ADN may receive lower pay and may not have their first choice of positions compared to a labor and delivery nurse with a BSN. ... the BSN curriculum covers the basics of nursing care and how the body works, but also teaches more specialized critical thinking skills. Time to Complete. 4 years. Minimum GPA. 3.0 ...