Labor and Delivery (L&D) Nurse

Who these nurses care for

Laboring patients through delivery, including high-risk antepartum and emergency cesarean.

What the shift actually looks like

Continuous fetal monitoring, labour support, and the capacity to move to an emergency caesarean in minutes. One-to-one in active labour, but the unit can go from quiet to fully committed without warning.

Credentials and certifications

Typically required

BLS, ACLS, NRP; fetal monitoring certification; EFM required

Typical ratio

Typically 1:1 in active labor

What to specify when you send the req

Delivery volume, whether the unit does high-risk or VBAC, and circulating expectations for cesareans.

Why this role is hard to fill

Fetal monitoring competency and cesarean circulating are the two skills most often missing when a candidate looks qualified on paper.

What candidates ask before accepting

Answering these in the req itself shortens the process considerably, because they are the questions that otherwise surface at offer stage and cause declines: Delivery volume, whether they circulate for caesareans, high-risk and VBAC policy, and anaesthesia availability.

Contract or permanent?

Contract for census swings, leave coverage and seasonal surge. Per diem to protect ratios without expanding core FTE. Permanent when the seat is structural. The expensive mistake is running contract labour for eighteen months on a role that was always permanent.

Licensure

Registered nursing is covered by the Nurse Licensure Compact in most of the country, so a multistate license lets a nurse work across member states without a new application. Thirteen jurisdictions sit outside it — Alaska, California, DC, Hawaii, Illinois, Michigan, Minnesota, Nevada, New York, Oregon, Puerto Rico, American Samoa and the Northern Mariana Islands — and in those markets every out-of-state nurse needs a single-state license first. Those are the markets where reqs stay open longest.

How we work this req

Every candidate is spoken to before you see them, with licensure for your state, certifications and unit-specific competency confirmed before submittal. We screen to the credential the unit actually needs rather than the title on the posting. Rates sit inside the ranges on our published cost breakdown.