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Labor & Delivery

Wilmington, NC

Labor & Delivery RN – High-Risk

Position Overview

Join a busy women's services labor & delivery unit managing high-risk obstetric cases. You'll work a fast-paced environment with approximately 350 deliveries monthly, providing comprehensive care across antepartum, labor & delivery, and postpartum settings.

Shift & Schedule

  • Day shift: 12-hour (6:45 AM – 7:15 PM)
  • 3 days per week
  • Every third weekend required
  • 13-week contract
  • Up to 7 days RTO (pre-approved; must work 2 of 3 major holidays)
  • Float to mother/baby care as needed

Clinical Scope

Antepartum & Monitoring:

Non-stress tests, oxytocin challenge tests, sterile vaginal exams, external fetal monitoring, IUPC placement and calibration, recognition and treatment of abnormal fetal heart rate patterns.

High-Risk Patient Management:

Preeclampsia/eclampsia, preterm labor, placenta previa/abruption, multiple gestations, malpresentations, premature rupture of membranes, intrauterine fetal demise, uterine rupture, VBAC management.

Labor & Delivery:

Amnioinfusion, assisting high-risk deliveries, circulating and recovering C-sections (required skill), hemorrhage/shock management, neonatal resuscitation, APGAR scoring, and newborn assessment.

Medications & Therapeutics:

Magnesium sulfate, Pitocin, prostaglandins, terbutaline, insulin drips, anticoagulation therapy, antihypertensives, antiseizure medications, epidural anesthesia, IV conscious sedation, and opioid management.

Postpartum & Neonatal:

Baby-friendly protocols, breastfeeding support, fundal/lochia assessment, postpartum hemorrhage management, thermoregulation, infant identification, couplet care.

Requirements

  • Minimum 2 years high-risk L&D experience (required)
  • BLS, NRP, AWHONN Intermediate (required)
  • ACLS (preferred)
  • 24-hour unit orientation

Support Services

In-house 24/7 hospitalist and anesthesia coverage; NP and CRNA support; MFM consults available. Unit secretary, pharmacy, radiology, rapid response, respiratory, social services, and interpretation services on-site.

Additional Expectations

May be required to work Storm/Hurricane Team and report during catastrophic events or mass casualty situations. May be reassigned to other units as needed. Candidates must be comfortable with potential COVID-19 patient care.