Everything I do is wrong!

Specialties Ob/Gyn

Published

Specializes in labor and delivery.

I continue to have a very hard time in my labor and delivery orientation. It was extended an extra month, which I was happy about-the way the manager explained it, I wasn't being punished, I just needed extra time. Then when I talked to the educator I was told I would be fired at the end of the month if I didn't start to 'get it'. As far as I know this is not true, it's a union hospital and I'd probably be put into the postpartum unit-which is starting to look better every day!

Anyway, my last day at work we had a pt that had thin mec so the NICU team was there for the birth, the baby nurse was also there and my preceptor and I. Since the baby nurse didn't have anything to do she told the doctor she would be his assistant. The birth was quite bloody-shooting across the room with a bad labial tear. After the birth, I gave the doctor sutures, gave the pt an IM injection of pitocin for the bleeding and was getting the baby bands ready, meanwhile the baby nurse was massaging the pt's uterus. I realize that this was my pt but I saw her massaging the uterus-something I hadn't done in that situation before and felt grateful that someone who knew what they were doing was being so helpful. Well, of course, the baby nurse calls me over and says 'what are you doing?! baby bands are your last priority! You should be massaging the uterus!'

I feel like I can't win, would everyone else have known that the baby nurse wasn't there to help at that point? Am I that dense? She immediately told my preceptor and I am sure has also told the educator. How do I handle this? I just don't get the politics or maybe I am just a bad nurse. Any advice for when the educator confronts me?

Thanks for reading this!

Teensmom

Up Vote Up Vote ×

I feel like I am reading my own personal story. I have been working at a hospital for 3 years in the delivery room. Started full time nights, hated nights, no day spots to be had, so I accepted a position at another hospital 2 days a week, day shift and still continue at my other hospital 1 night a week per diem.

Anyway, I have been on orientation at the new hospital for 4 weeks now, was supposed to come off today, and was told by the nurse educator "it's going a lot slower than we have anticipated". I feel like a new nurse all over again, and usually drive home each shift crying because I just feel like I am not doing what is expected. The hospital actually has a LOWER census than my other hospital but the paperwork and nitpicking is ridiculous. I am honestly considering leaving except I can't go back to nights full/part time and really don't want to begin another orientation somewhere else.

The politics are absolutely out of control, and my confidence feels completely shaken. Maybe we can commisserate together!

Up Vote Up Vote ×

I feel bad for you because I'm sure it's very frustating to feel like you are not getting it, but if the pt. was bleeding "across the room" then absolutely you should have been rubbing her uterus not doing baby bands. Especialy if the was a baby nurse there. Where I work, if you need a baby nurse then you need to be focused on mom. Let the baby nurse do the baby stuff like bands. I'm sorry but if the situation is what you said, then I agree with your preceptor.

Up Vote Up Vote ×
Specializes in OB.

It doesnt sound like you are in a very supportive environment to me. They should be teaching you these things, not yelling at you about them. Perhaps a job switch is in order?

Sorry this is happening to you.

P.S. Why was she doing fundal massage? Our docs always do it, unless they ask us to. It wasnt being done for the labial tear of course, so...well I dont know. Maybe I dont have enough info but it sounds like a dumb thing for her to yell about.

Up Vote Up Vote ×
Specializes in labor and delivery.

PCMom, the baby nurse had nothing to do, the NICU team was taking care of the baby and she had offered to be the MD's assistant. I am glad she was doing fundal massage, usually our doc's do this too but the md was busy stitching, if she hadn't been there, I would have been doing it, if I'd known that the md requested it. Also, the baby nurse doesn't do the baby bands, the primary nurse does them. I really feel so unsupported and made to feel wrong about everything but maybe I am wrong.

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Have you tried telling your preceptor how you feel? If you don't feel you can, then you going to have trouble there in that unit, I believe. If I missed this, I am sorry. I read what you said about the nurse educator, but where is the person assigned to precept you with all this??

Up Vote Up Vote ×
Specializes in Rural Health.

I've been there and done that. To be in a situation where it's a no win situation all the time is probably the most frustrating, heartbreaking situation to be in. I cried every single day I was on my L&D orientation. Nothing I ever did was good enough, in the right order or up to the standards of "them". And I understand, you can't win for losing.....I've been there......if you would've done the fundal massage then they would've been yelling at you because the bands weren't done. I know......

I quit my toxic work environment job and went to another facility that is so incredibly supportive it's the complete opposite side of the pendulum - it's so wonderful.

Try talking to your preceptor about it, your nurse manager about, the educator about it. Talk to someone. Tell them how you feel. If they aren't willing to be supportive then you have basically two choices, suck it up and deal with it or quit. Only you can decide what is best for you.

Good luck!!!!

Up Vote Up Vote ×

YOU ARE NOT A BAD NURSE.....

YOU HAVE A BAD PRECEPTOR!!!!!

Come to SC I'll train you

Stick with it don't let them eat you.

Up Vote Up Vote ×
Specializes in OB - Gen. Surg.

OK - here's where I will probably upset everyone. The first time I was told to do a lady partsl exam I told the head nurse (also my preceptor at a high risk very busy L&D unit) that I had never done one before. She said, just look at the dilitation chart on the wall above the patient's head and try to visualize what you feel. I got it right and haven't made an incorrect eval since. I feel like L&D nursing is in my soul. I'm not trying to boast. There are better nurses out there, I am sure. But I seem to have a sixth sense for trouble and have made it my business to know what to do in such cases. It takes time and lots of reading and practice. I ate up every minute of my orientation. It was to be 6 weeks, but at 4 weeks I was mostly on my own. I asked one of the nurses how long it would take before I felt "comfortable". She said a year. By six months I think I had seen about everything I could ever imagine and made it through all of it. Yes, there were times I was frustrated or unsure of myself. But I ASKED QUESTIONS whenever. I never felt like any question was too stupid. Once an MD found my crying after a particularly difficult crisis (mom and babe were fine). He asked me what was wrong and I told him I felt awful that I hadn't anticipated his needs. He reminded me that none of us are mind readers. We do the best we can and if we need help we ASK.

If you don't feel like you are "getting it" perhaps L&D isn't where you will shine. If you don't feel you are getting a good orientation - ask for a different preceptor - talk to the head nurse. Do whatever you can to be the best nurse you can be. I hope you make it. I love OB.

Noor

Up Vote Up Vote ×
Specializes in OB - Gen. Surg.

One More Thing - I have found L&D to be the most competitive area I have ever worked. I love it, but the nurses are extremely competitive. Sometimes that means you don't get a good orientation. Control is their issue. If you are meant to be a L&D nurse, you will "get it". Hang in there.

Noor

Up Vote Up Vote ×
Specializes in Mostly L&D/OB, some ED, Some psych.

I think it depends on the environment you are in. I have been an L&D nurse for almost 20 years and an L&D traveler for over a year. I have always "shined" in every environment I've been in until now. Most of the nurses I work with are half my age and only a fraction of my experience, but every day I am made to feel like I am stupid and don't know what I am doing.

I just keep telling myself, 5 weeks down, 8 to go, and I will move on to somewhere else. Maybe it is not you, it is where you work. If you really want to L&D, you might try at another hospital.

Up Vote Up Vote ×
Specializes in L&D, QI, Public Health.
OK - here's where I will probably upset everyone. The first time I was told to do a lady partsl exam I told the head nurse (also my preceptor at a high risk very busy L&D unit) that I had never done one before. She said, just look at the dilitation chart on the wall above the patient's head and try to visualize what you feel. I got it right and haven't made an incorrect eval since. I feel like L&D nursing is in my soul. I'm not trying to boast. There are better nurses out there, I am sure. But I seem to have a sixth sense for trouble and have made it my business to know what to do in such cases. It takes time and lots of reading and practice. I ate up every minute of my orientation. It was to be 6 weeks, but at 4 weeks I was mostly on my own. I asked one of the nurses how long it would take before I felt "comfortable". She said a year. By six months I think I had seen about everything I could ever imagine and made it through all of it. Yes, there were times I was frustrated or unsure of myself. But I ASKED QUESTIONS whenever. I never felt like any question was too stupid. Once an MD found my crying after a particularly difficult crisis (mom and babe were fine). He asked me what was wrong and I told him I felt awful that I hadn't anticipated his needs. He reminded me that none of us are mind readers. We do the best we can and if we need help we ASK.

If you don't feel like you are "getting it" perhaps L&D isn't where you will shine. If you don't feel you are getting a good orientation - ask for a different preceptor - talk to the head nurse. Do whatever you can to be the best nurse you can be. I hope you make it. I love OB.

Noor

Noor,

I think it's great that you had a positive experience, however everyone's experience is different.

There's too many variables involved to make a blanket statement regarding comfort level and timing. There's the doctors, nurses, patients, hospital policies, orientation structure, skill of preceptors, acuity, location, culture, etc.

As for seeing everything imaginabe in 6 months, all I can say is 'wow'. I work in a high risk L and D unit as well, and the nurses who have been working here for 10 years + have not seen everything and are always learning new techniques, new ways of thinking and new ways disease manifest in pregancy and postpartum.

I do agree that us newbies need to read as much as possible and ask questions. To the OP, find that person you can ask questions to, allow that person to be your unofficial preceptor. There are nurses that like that role, but are interested in the paperwork or the politics involved in doing it. Seek out that person.

Good luck!

Up Vote Up Vote ×
+ Add a Comment