[Goldenearring1]

Hoping for some good advice,

I recently resigned my position as a Level III NICU nurse to accept a position at a local community hospital as a L/D nurse. They hired a new director and she wants to implement mother/baby care to this unit which means that she wants to get rid of the LPNs and have an all RN staff, she told me that I would have an orientation and that it would be sufficient. When I went in for my first night this weekend I looked at the schedule and was discouraged to find that I am only having 3 weeks of orientation and then be expected to labor and deliver and resus an infant with only one nurse, me. Is this right? I have not had OB experience, I have been exposed but....please help. I really want this job but there is no way that I will be competent enough and I don't want to risk losing my license in 3 weeks. By the way 3 nurses resigned on Fri.

Thanks

[cannoli]

Is this a HCA hospital?

Why did the 3 nurses resign? That may be very telling right there.

Good luck.

[Goldenearring1]

what do you mean HCA?

[Jolie]

Originally Posted by Goldenearring1

Hoping for some good advice,

I recently resigned my position as a Level III NICU nurse to accept a position at a local community hospital as a L/D nurse. They hired a new director and she wants to implement mother/baby care to this unit which means that she wants to get rid of the LPNs and have an all RN staff, she told me that I would have an orientation and that it would be sufficient. When I went in for my first night this weekend I looked at the schedule and was discouraged to find that I am only having 3 weeks of orientation and then be expected to labor and deliver and resus an infant with only one nurse, me. Is this right? I have not had OB experience, I have been exposed but....please help. I really want this job but there is no way that I will be competent enough and I don't want to risk losing my license in 3 weeks. By the way 3 nurses resigned on Fri.

Thanks

This is NUTS! Anything less than 12 weeks of orientation for L&D is unacceptable and unsafe, longer if you will be expected to scrub and/or circulate for C-sections, or recover patients post-op.

Secondly, it is NEVER acceptable to expect a single RN to handle a delivery and infant stabilization. That is in clear violation of NRP teaching and AWHONN standards of care. Some units staff 2 RNs at the time of delivery, some utilize an RN for mom and an RT for baby. There is more than one acceptable way to staff a delivery, but a single RN is not an option.

It sounds like your new unit is going thru some very troubled times. Change is never easy, and that may be the reason for some of the resignations. But you must also consider that the experienced nurses in the unit see trouble coming and want out for the good of their licenses. I would not be willing to stay in a unit which has less than 50% experienced staff, meaning 2 years or more of L&D experience. You will never be able to learn safe and competent care without adequate support from role models and mentors.

I'm sorry for your situation!

[cannoli]

HCA, Healthcare Corporation of America.

[BETSRN]

That's an unacceptable orientation. At least 3-4 months exclusively in L&D is a minimum. Do NOT do it! Learn mother/baby. That's a great place to start. You're right to be concerned. This new director does NOT have your best interests (or the patients) at heart. RUN, RUN, RUN. L&D is great, but find a good safe place.

[Nursesuzi]

I agree with the others, but I think it's unusual for an experienced nurse transfering to LD from what most hospitals consider a "related area" (which NICU is according to my manager), to get 12 weeks. At my hospital, which is in a big metropolitan area and has a great reputation for retaining employees and happy patients, only new grads get 12 weeks then are considered a "half person for another 4 to 6 wks. Most experienced nurses get a month or two and then have a mentor to help them. I would insist on that at the very least.

Now, as far as being alone in the delivery room during recovery. I think recessing a baby alone and having to watch mom simutaneously is dangerous. However, my hospital, which strictly adhers to AWWON guidelines expects that of us. I need to check that out, as do you. I oriented on days and as a new grad, towards the end, I was expected to do that myself. Scarier than you know what. Now that I'm going to night shift, thank god, you have a slew of RN's in the room with you at the beginning of a recovery.

If you decide to take this position, I would definitely check out why the other RN's left. L&D is very different in pace than NICU from what I heard. In the most supportive unit it can be an adrenaline rush. If you are unsupported it could not only double your stress but endanger your license. Do your homework and stick up for your self. Worst case scenario at least you have your NICU exp. to fall back on.

Good luck

S

[purplemania]

Voice your concerns immediately, or make a stand and say you cannot work under those conditions. Be prepared to back it up. I turned down an otherwise good position for a similar reason years ago. Seemed like a big deal at the time, but now I can look back and see I have not had the stress I would have had in that job.

[Nemhain]

No that's not right. You're orientation should be at least 6 weeks. Also, I've never heard of just one nurse caring for mom immediately after delivery and also have to be caring for the neonate. That's wrong.

[Jolie]

Please read the thread entitled "Nrp" and then ask yourself if it is appropriate for a single RN to staff a delivery for the care of both mom and baby.