discouraged new ob nurse

Jolie, BSN · Feb 14, 2002

Make an appointment with your nurse manager TODAY, and discuss these issues. You can not be expected to function without an adequate orientation, which you have not received. Negotiate a plan to resume orientation with a single preceptor for a reasonable amount of time. Make it clear that you expect to be assigned only to OB during the completion of orientation. You can't possible learn OB by caring for med/surg patients, for crying out loud! Upon completion of this orientation, request a written evaluation by your supervisor, including a plan to work on any areas in which your skills are lacking. Request a mentor on your shift who will be willing to look over your shoulder and help you out. DO NOT SETTLE FOR ANYTHING LESS. It is time to stand up and courteously, but firmly, advocate for yourself and your patients, who need a well-prepared nurse.

If your manager is not willing to make these accomodations, then she is not serious about your development as a staff nurse, let alone patient safety. If she will not agree to these requests, then start looking elsewhere. Don't worry about what potential employers will think about changing jobs. Just be honest with them that your former employer was not committed to providing you with the orientation and education necessary to deliver safe patient care.

Good luck! Let us know how it goes.

Goodlaura6 · Feb 14, 2002

You must be in a small LDRP setting ..Is that right? When our hospital went to LDRP's,(from LDR's) everyone had to learn everything ..well, we lost a lot of good nursery nurses and PP nurses who just didn't want to (or couldn't) learn L&D. New people hired on were given a whirl-wind orientation ..it's hard to learn 3 area at once! It WAS overwhelming for the new folks and not the best situation!PLUS, if it's not busy, you don't get the repition that you need, it takes a good year solid of nothing but L&D to begin to feel like you know what you are doing there!!! Getting pulled to Med/surg, spending time in PP ... that makes it even harder! Don't feel all alone, it's happening other places too (I'm sorry to say)!!!! YOU ARE FINE ...it's the system you're in that stinks! If it is the only OB in your area I guess you're stuck, if you can find a larger OB unit to work in you'll do better. Once you are well established you can rejoin a smaller unit where you have to be "everything" to everyone at all times!!! You have too many hats to wear right now!

mark_LD_RN · Feb 17, 2002

hang in there, everyone learns at their own pace, just relax and learn what you can. talk with your nurse manager about your concerns. But also remember there is a nursing shortage which is real bad in my area. I have to float to other areas as well, There has been times when i worked nights and was the only labor nurse on the unit. I really love what i do, it is the best job i ever had. if i can be of any help let me know. you can write me at [email protected]

rdhdnrs · Feb 25, 2002

I can only echo the advice to talk to your manager NOW. Do not allow yourself to miss out on what you want to do because of incompetence on others' parts. If this manager can't do her/his job, then find a job where you will get the benefit of a real orientation.

Good luck.

shay · Feb 25, 2002

I agree w/rdhdnurs and the others....you need to talk to your manager. New orientees to specialty units shouldn't be floated for at least 6 mos. to a year, in my opinion. In my experience, new orientees weren't floated at all until they had at least this.

I am an experienced OB nurse, and I just started at a new hospital a few weeks ago. I basically function as a full staff member, but you bet your behind I STILL ask my preceptors to check over my charting to be sure I'm charting to their hospital/unit standards. My point is this...everyone needs a supportive preceptor who 'watches over' them when they're new, regardless of experience. It's just good practice. Your unit is not doing this, and they should be.

Protect yourself. If your manager won't step in and do the right thing (give you a PROPER orientation), and your needs are not being met no matter what, I suggest you go ahead and either transfer to a med-surg unit in the same hospital or try to go to another OB unit at another, more supportive, more organized hospital. Yeah, OB can be hard to learn, but if you have good preceptors, it makes such a huge difference.

Hang in there, my dear. Come here to vent any time.

mother/babyRN, RN · Feb 26, 2002

Hi there,

It is scary, especially now a days when we nurses tend to feel simply bodies to staff. Take your time and tell them you will not be counted as staff when you are orienting. You have to speak up.

It takes a long time and, as someone who has been in delivery for 13 years, I can tell you if you EVER feel comfortable you don't belong there. A wonderful, since retired nurse, once told me that.

Here are some of the things she told me that I then considered nutty, but have since learned, are so...

Trust your instincts. If something doesn't feel right, it probably isn't.

Long legged women tend to deliver quickly. (No, I have no idea why.)

Red headed women tend to have pp hemorrhages (don't ask)

Gossamer cervixes (thin thread like cervix) is a relatively quick delivery for sure, even if the patient is barely dialated.

Those teenagers go quickly.

EVEN if you just checked someone and they are two cms, turn around, walk to the desk and she says she has to push PREPARE TO CATCH!

If someone cannot give or refuses to give a urine sample, she may be positive for cocaine or some other substance

Treat EVERY patient with respect, even if you disagree with their livestyle. You will be rewarded for it.

Someone who won't open their legs for an exam is someone you should suspect a history of sexual abuse.

I know it isn't easy, especially these days with the staffing situation. Nurses can be theri own worst enemies. If someone is impatient with you, gently remind them they were once new to it all too.

Need some encouragement, please feel free to email me at [email protected]

Take care and hang in there. We were all new and nervous . I am STILL nervous when I walk through those doors. I hope I always am. Keeps me on my toes...:)

Angel Baby · Apr 1, 2002

My heart aches for you--you have had many obstacles and your concerns about wondering why you ever thought you could do this is a direct reflection on the hospital.

You have not had an adequate orientation--you haven't had consistency in your training, floating out to another area, etc. As an experienced nurse entering this same environment I would question my ability to handle it.

Please--talk to your manager. If she can't support you--run. Unlike any other area of nursing, each delivery gives you 23 years of liability (that is, when the baby survives). It is not fair to throw you to the wolves like this and your frustration is justified.

Good luck

HADDAMMOM · Apr 4, 2002

Welcome to L&D. It's a wonderful field but it takes a lot of time. It's going to take you a good year to even begin to feel comfortable. When we have a new wperson (depending on their experience) we start them with post-partum, work to nursery and then when they can feel comfortable functioning independently, THEN we start with labor and delivery.

I'd say if you're in a small place, stay there. Ask your manager to help you with finding a good, caring preceptor. That's what you need.

Don't let anyone make you feel bad or push you too fast. It does no one any good (even your unit) to push you when you're not ready.

Get every possible experience you can.

I was a late in life nurse, too (I was a teacher before) and I found that as an older person, I had a much easier time (than the young kids) standing up to nurses who were unsympathetic. Fight for what you need. It will pay off in the end.

mother/babyRN, RN · Apr 5, 2002

Fighting for what you need and want is all and good, but I have to say in many hospitals, this is how it is going to be, period..It is that way in my facility too.. As for the feeling as though you will never learn what you need to know, just remember we are always learning....I have been in OB for 13 years and I STILL learn something new every day...(or night)...Med surg is still a good idea, but in many places, OB is used to float between units because we have an understanding of all areas in the scope of our practice and because there are often more of us than there are of them ( didn't mean that statement to appear so divisive, by the way)... Take that deep breath and go where your heart takes you. If it doesn't feel right, it probably isn't, for now at least...You WILL figure it out, and remember, it is incidents precisely as you describe that is leading people away from nursing...You would think the powers that be would have figured that out by now....Good luck! You will do fine and yes, welcome to the wonderful world of labor and delivery AND all its little realities...(still, it IS a neat place to be)

rnoflabor2000 · Apr 9, 2002

Jolie is right. It's all about your RN license. Don't allow anyone to compromise it...even in this nursing shortage. You don't want to lose your license because you weren't trained adequately. The hospital won't save your license. Only you can. Also, don't become complacent. Treat each patient in labor as an accident waiting to happen.