WHAT I DO AS A POSTPARTUM NURSE & HOW MUCH I MAKE

Postpartum nurses are registered nurses who specialize in caring for mothers and babies after birth. However, many people don’t know that their job description spans FAR beyond helping new parents change diapers. Postpartum nursing includes aspects of the emergency room, operating room, PACU, med/surg, cardiac, mental health and hospice nursing, all wrapped up in one (baby blanket).

Not only do postpartum nurses wear many different hats, but they also go by many different names.

A postpartum nurse is also called a:

• baby nurse
• maternity nurse
• mother-baby nurse
• mom/baby nurse
• maternal child heath nurse
• neonatal nurse
• newborn nurse
• maternal newborn nurse

It’s all the same thing!

However, what’s not the same about postpartum nurses is how much money they make. Their pay can vary dramatically depending on where they live and how long they’ve been a nurse for. Continue reading to learn more about what I do as a postpartum nurse, and how much I make.

NO SHIFT IS CREATED EQUAL

Just the thought of trying to explain an average shift for a postpartum nurse feels like a daunting task since one shift can be SO different from the next.

So, I’ve decided to first give a pretty basic run down of what postpartum nurses do during a day shift, and during a night shift, when their patients are NOT having any complications.

These kinds of shift where there are no complications are rare, and are best case scenarios.

These shifts are the ones where you walk out of work and think to yourself, “If only every shift was like that!”

It’s much more common to work a shift where there are some complications, so that’s why I’ll also review what some of those issues and complications may be.

While reading this, please keep in mind that long gone are the days of newborn nurseries where all babies went to be assessed, and to help mom get some rest.

All mothers and babies “room-in” now. Meaning they both stay together in their hospital room for their entire stay…no matter what.

According to the Baby-Friendly Hospital Initiative launched by the World Health Organization (WHO) and the United Nation Children’s Fund (UNICEF) in 1991, “rooming in” helps with bonding, increases parents’ confidence regarding caring for their baby, and promotes and supports breastfeeding.

So, instead of sending babies off to a nursery to be cared for, they now stay with their parents, and we refer to the mom and baby who stay together as a “couplet”.

Postpartum nurses usually care for 3-4 couplets at a time. So, if I have 3-4 couplets, that means I will have a total of 6-8 patients.

And no, unfortunately postpartum nurses don’t get to hold babies all day since babies room-in with their parents. The parents are the ones who are holding them most of the time.

A 12 Hour DAY Shift With NO Complications

Ok, ready for a great postpartum shift? Here’s what a 12 hour day shift looks like if there are NO issues or complications.

0700 – The night shift nurse gives me report on my patients and introduces me to them. I return to the nursing station to review my charts, and write a list of what each couplet will need to have done at certain times during my shift. There are so many patients and so many small tasks that have to be done in postpartum that I find making a chronological list is essential so I that don’t miss anything. While I’m doing this, I prioritize which patients I should see first.

Here’s a pdf of what my postpartum report sheet looks like. Please feel free to use it and share it with others! The mother’s information is at the top of the sheet, and baby’s is at the bottom. The blank rectangles on the left are for the patient’s name or sticker label.

0800 until 1000 – I begin to perform head-to-toe physical assessments on all of my mothers and babies, one by one. I begin with the one who needs me most, then I go from there. I try to assess all of my patients by 1000. So, if I have 4 couplets, that will give me 30 minutes with each of them. Often it doesn’t take that long, but sometimes it takes longer depending on the patients’ needs or if I assist with breastfeeding.

I will discuss their plan of care for the day with them. I’ll administer pain meds and stool softeners if the patient wants them. I make sure they know how to order their food, I’ll offer to refill their drinks, and I’ll always make sure that their call light is within their reach.

In between seeing patients I will also touch base with other care providers such as the lactation consultants, obstetricians, pediatricians, hearing screen tech, newborn screen lab tech, birth certificate clerk, and social services.

1000 until 1100 – I sit down to chart. Some hospitals still use paper charting, but most chart in the computer, also known as the electronic medical records (EMR). Many nurses will chart as they go, but I prefer to assess all of my patients first. As I’m with each patient I’ll write their assessment info on the back of my report sheet, then I’ll transfer that information into their chart at a later time.

1100 until I take my lunch (whenever that may be!) – This is the time that patients are usually discharging to home, so I focus on discharge teaching and whatever else needs to be done to get them home. This is also when patients who are still less than 24 hours after delivery need another set of vital signs done. At my hospital, vital signs on mom are done every 4 hours for the first 12 hours after delivery, then they are only done once in a 12 hours shift. Vital signs on baby are done every 4 hours the first 24 hours, then every 8 hours.

After lunch until 1600 – This is usually when I get new patients since some of my other patients may have discharged to home. Getting a new patient is time consuming due to performing head-to-toe assessments and doing teaching with the parents about their plan of care, newborn safety, and what needs to be done before they can go home.

1600 – Another set of assessments and vital signs is due on mom and baby who are less than 24 hours post delivery.

1800 – Usually catching up on charting!

1900 until 1930 – Night shift arrives and I give them report. I say goodbye to my patients.

A 12 Hour NIGHT Shift With NO Complications

I loved working postpartum night shift!

Night shift allows you to be more autonomous, and you usually have more quality time to spend with your patients because it’s after visiting hours are over.

1900 – I get report from the day nurse and I meet my patients. I check their charts and prioritize who should be assessed first, and then I make a list of what needs to be done on my patients in chronological order. Just as I would working day shift.

2000 until 2200 – I assess my patients one by one, and review the plan of care for the shift with them. In an effort to help them get as much rest as possible, I will discuss with them that I’ll try to only come in to do my assessments when they’re awake or during the certain times we agree upon. I make sure with the mother that it’s ok if I wake her up when a pain med is due to be given.

Then, I administer pain meds and stool softeners if the patient wants them. I make sure they know how to order their food, I’ll offer to refill their drinks, and I’ll always make sure that their call light is within their reach.

2200 until 2300 – I get to charting my assessments!

2300 until I take my breakfast, lunch, or dinner, or whatever it is – I take vital signs on patients who are less than 24 hours after delivery and weigh the babies. Babies are weighed once a day after birth to watch their weight loss, and at my hospital we weigh them around midnight.

After meal break until 0400 – When I worked nights, the hardest, most emotional time for my patients was usually during this time. Babies would be cluster feeding and mothers would really hit that wall of exhaustion. Extra time, empathy, encouragement, and support was necessary. Also, I gave a lot more breastfeeding support at night because we only have lactation consultants during the day. During the night shift I’d put on my lactation consultant hat and sometimes spend up to an hour helping one mom.

0400 – Another set of assessments and vital signs may be due on mom and baby.

0600 – Usually catching up on charting!

0700 – Day shift arrives! And it’s such a beautiful sight because it meant that my bed was not far away! I give them report, and say goodbye to my patients.

ALL OF THE OTHER STUFF POSTPARTUM NURSES DO DURING A NORMAL DAY & NIGHT SHIFT

Interweaved throughout the day and night shift timelines is a plethora of a lot of other things that postpartum nurses do, including:

• listening to and empathizing with an emotional mother
• removing urinary catheters
• giving baby baths
• checking baby and/or mom’s blood sugar levels
• calling doctors for new orders or critical lab results
• removing I.V.s
• starting phototherapy
• getting moms up to the shower
• changing bed linens
• doing a lot of patient teaching about how to care for themselves, and a lot of family-based teaching about how to care for their baby

Additional tests and screenings are done on babies when they turn 24 hours old. Read more about these tests in my other post here.

Also keep in mind that even a great day or night shift on postpartum is usually heavily broken up by patients pressing their call light and needing you for things like:

• the baby is spitting up
• help with changing the diaper
• help with swaddling baby in a blanket
• help getting out of bed to go to the bathroom
• help getting up to the shower
• baby is fussy
• they need drinks refilled
• they want more pain medication
• they need formula heated up
• they need help with breastfeeding
• they feel nauseous
• they feel itchy

And it’s not uncommon to have 2-3 patients needing you at the same time.

A 12 Hour DAY or NIGHT Shift WITH Complications

A postpartum shift WITH complications usually means that there’s an issue going on with the mother or the baby, and sometimes both.

Many of these complications and emergencies in postpartum have elements of other areas of nursing.

For example:

• A mother is having a postpartum hemorrhage (uncontrolled bleeding), or an allergic reaction to medication, or a baby is having respiratory distress. That’s where emergency room nursing skills are needed.
• A mother has to return to the operating room to stop her uncontrolled bleeding. That’s where operating room nursing skills are needed.
• After a c-section a mother is extremely nauseous, throwing up, and/or itchy. When you ask her what her pain level is from 0-10, she says 11. That’s where PACU nursing skills are needed.
• A diabetic mother may have critically high blood sugars and may be on an insulin drip, or a pre-eclamptic mother has critically high blood pressures. That’s where medical/surgical nursing skills are needed.
• A baby is born with a heart murmur or a critical congenital heart defect. That’s where cardiac or telemetry nursing skills are needed.
• A mother has a history of drug use, suicide attempt or idealization, or they have a history of anxiety, PTSD, abuse, and/or depression. That’s where mental health nursing skills are needed.
• A baby is stillborn, or is born alive, yet has a very poor prognosis and is not expected to survive. That’s where hospice nursing skills are needed.

It’s understandable that a lot of people think that postpartum nurses have it easy, and that they don’t require a lot of nursing skills.

I mean, I rarely have to start an IV or hang more than two IV bags at once.

But…

to believe that postpartum nurses have it easy is a great misconception.

In addition to having nursing skills that span across multiple specialties, postpartum nurses must also have meticulous assessment skills.

For example, a newborn who is jittery looks very similar to a baby who is having a seizure…

and a mother’s normal uterine cramping after birth can have similar pain as a mother who who has a retained placenta which can cause sepsis and death.

Also, some people think that postpartum is a very happy place to work, and it usually is, but it can also be one of the saddest.

In a department where there’s supposed to be so much joy that comes with a new life entering the world…

sometimes it just doesn’t happen that way.

Some people have a bad day at work when their company didn’t meet their sales goal, but when a postpartum nurse has a bad day at work, it’s when a baby has died.

Before I worked with newborns, I fantasized about how much fun it would be to care for them, but I never thought for one second that I’d also have to care for the ones who have passed away.

But after caring for multiple babies who have passed away, I can assure you that the grief and despair doesn’t leave you just because your shift is over.

Those babies and their families will live within the saddest depths of your heart forever.

Thankfully, a baby passing away doesn’t happen that often, but if you’re thinking about becoming a postpartum nurse, please consider that.

HOW MUCH I MAKE AS A POSTPARTUM NURSE

Ugggg, what a horrible transition…to go from babies dying to how much I make.

But, the reality is that postpartum nurses (and nurses in general) earn their living by being there for their patients during the good times, and the bad.

All hospital registered nurses are paid according to their hospital’s pay scale. This pay scale is always dependent upon how many years a registered nurse has been nursing for, NOT by what department they work in.

For example, take two registered nurses who work at the same hospital. One of them works in the intensive care unit, and the other works in labor and delivery. Both have been registered nurses for five years, so according to the pay scale they will both make the SAME hourly pay.

Those nurses’ pay may vary by a few cents or dollars depending on how much of a raise they get every year during their annual evaluations.

So, the longer you have been a registered nurse for, the higher you’ll be on the pay scale.

An example of this is of two nurses who both work in the same department.

One of them is a new grad and the other is close to their retirement. These nurses do the SAME job, but the nurse who’s close to retirement may make DOUBLE the pay of the new grad.

Every hospital has a different pay scale, but usually hospital pay scales will be similar to each other if they are in the same city.

However, pay scales can vary dramatically from city to city and state to state.

For instance, if you work in San Francisco and are making $50 per hour and you want to move to Grand Junction, Colorado, the hospital in Grand Junction (or anywhere else for that matter) will care less about how much you were making in San Francisco.

You’ll be paid by what their pay scale dictates according to how long you’ve been a nurse for.

And let me tell you…

your pay in Grand Junction is gonna be a lot less than what it was in San Francisco,

even if you’ve been a nurse for 20 years.

Unfortunately, the pay scales are not negotiable.

When I worked in Grand Junction, Colorado as a new grad in 2006, my starting pay was $22 per hour.

Two years later when I moved to Santa Rosa, California, my starting wage there was $42 per hour.

That’s a HUGE difference for doing the SAME job.

And why is that?

Why such a big difference in pay between different cities?

It all has to do with the cost of living. The cost of living in Santa Rosa is much higher than in Grand Junction.

My advice to someone who really wants to know how much they’d make as a postpartum nurse would be to call the hospitals that they’re interested in working at and ask the operator to transfer you to their human resource department or their nurse recruiter.

Once transferred to human resources or the nurse recruiter ask them how much new grads start per hour or how much a registered nurse of “x” many years makes per hour according to their pay scale.

So, how much do I make in San Diego after being a registered nurse for 13 years?

I make almost $60 per hour as a postpartum nurse.

That equates to making well over $100,000 per year if I work full time hours (full time hours are three 12 hours shifts per week).

Name another job where you can make over $100,000 per year and only work THREE days per week.

Not many.

And for that reason, I’m extremely grateful.

And I, or you, could even make more than that if you wanted.

If you worked night shift, you would be paid an extra $4-6 hours per hour.

If you’re a charge nurse, add another $2 per hour on top of that.

Some hospitals even pay an extra $2 per hour if you work on the weekend.

If I did all of those things, my $60 per hour would go up to almost $70 per hour.

Additionally, if you make yourself available to work extra hours, you’ll be paid “time and a half”. When I’m needed for extra shifts and I make time and a half I make almost $90 per hour.

But here’s a surprising fact…

I was much more financially comfortable making $22 per hour in Grand Junction than I am making $60 per hour in San Diego because of the cost of living.

My mortgage in Grand Junction was $130,000.

My mortgage in San Diego (the house is the same sized as the one in Grand Junction was) is $525,000.

Not only does housing cost more in Southern California, groceries cost more, gas costs more, taxes are higher…..

So, definitely take that into account!

If you’re offered a postpartum position, consider yourself LUCKY.

It’s hard to get your foot in the door. I got mine in because I had worked in the NICU.

My best advice for nursing students who want to get a job in postpartum?

Definitely get a job in postpartum or labor and delivery or the NICU as a secretary or as a certified nursing assistant (CNA) while you’re in school.

My hospital has hired every single one of our secretaries and CNAs after they graduated nursing school.

And to the experienced nurses who want to change to postpartum?

Look for transition programs in your hospital, or really play up your skills and how they relate to postpartum.

Hopefully some of my examples above helped!

My hospital has hired ER, OR, med/surg, hospice, NICU, and ICU nurses into postpartum so don’t think it’s not possible!

If you want it bad enough, I encourage you to call the postpartum unit’s manager (the hospital operator will connect you) and ask them what you can do to better your chances.

Even better, ask if you can make an appointment to meet with them face to face.

Just do it!

And if the first try doesn’t work,

try it again…

then, again!

Be politely persistent!

Really show them how badly you want it!

If you do that, it’s really only a matter of time.

TO SUM THINGS UP…

I love being a postpartum nurse, and I love it no matter how much I make.

I get so much joy from helping new parents navigate those first few days.

I’m honored to be in their lives during such a special (and hard) time.

I used to hear that nurses who work in postpartum rarely ever leave to go to a different specialty.

And I believe it, because I’ve worked with most of the same co-workers for over a decade now.

I’ve even heard that the postpartum department is “where nurses go to die”.

And all I have to say about that is….

just bury me in my spit-up stained scrubs.

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Disclaimer:
The content that I share on Purely Postpartum is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. I encourage you to always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.