Feeling sick and stupid

Specialties Ob/Gyn

Published

Hi, I'm new to my job in OB. I've been orienting for 8 weeks now, been 6 weeks on the floor. I've always wanted to do OB and I thought my 2 years of med/surg would make things easier. But I feel like a new grad...everything is so different! I don't have the same preceptor every shift - it changes from day to day - and depending on who I am working with seems to determine if things go well or not. I am also doing a lot of reading/studying/education as part of my orientation. I want to learn to do this well. But every shift, not only does my preceptor change, but my patient asignments as well. Some days I have so many different "experiences" that nothing makes sense! It would be nice to follow a patient from start to finish to better understand the process. I feel fairly comfortable with postpartum. Yesterday however, I started out with 2 PP couplets. Then I was given a walk in admit (hadn't done before) then within an hour I was told to be the baby nurse for an imminent delivery with meconium. That went OK then I was immediately sent to another delivery. After the two deliveries I was busy charting, doing checks etc. and before I knew it, 2 hours had passed and I hadn't checked in on my PP couplets. The walk- in was to be sent home and one of my PP couplets also wanted to leave. My preceptor (who had not left my side while I was helping with the two deliveries - so she knew I was working non-stop) starts rattling off "did you do the PKU for room 2? what about DC papers for the OP..."etc. I told her I had been in the two deliveries and hadn't had a single moment to check on the other patients. She got upset with me and I'm really not sure how I could do anymore than I was doing....I did not even have a single minute to leave the babies, I hadn't had lunch or even been able to use the bathroom. It was 10 hours into my 12 hr shift. I'd been feeling more and more sick to my stomach and my head was pounding. I thought I was going to vomit! I won't even go into all the details, but I don't understand how they can expect one (NEW) person to do everything at once: 2 couplets, 2 deliveries and an outpatient? What was really bad is that it was a SLOW day - we were overstaffed, but I was given all those patients? I understand they are trying to give me lots of experiences, but I don't feel that I'm doing any of it well - or even able to learn since it's all so scattered! I cried all the way home. I called in sick today with headache and horrible nausea. I don't know if I got so stressed because I was sick, or if I got sick because I was so stressed. Will I ever learn this? I feel so stupid!

Specializes in primary care, pediatrics, OB/GYN, NICU.

I've always wanted to do OB nursing and I was so happy when I finally got this job. But I can't believe the level of anxiety I have about this. I couldn't sleep last night because I was going over and over in my head what I could have done differently to have a smoother orientation? The first DAY I was on the floor it was a madhouse and my preceptor (who, thank God I have not had to work with her since then) gave me 3 PP couplets. I just went with it and did my best. There was no one else to help, and fortunately they were healthy mother/babies. A few days later when I found my mailbox and locker, there was a huge packet from the unit educator and a letter "Sorry I missed you - please spend your first two shifts doing a scavenger hunt and getting to know the unit. You should shadow another nurse, but not do any hands on care." Hah! Right. I'm just now feeling like I know where things are. I came from a small 50 bed hospital and worked primarily with ortho patients. We did get a variety of problems since we were rural, but OB was a separate unit and they shipped out moms/babies that went bad. We didn't have computer charting or scanners. Our drugs were in drawers. Now I'm learning a completely new type of nursing at an enormous medical center, with new equipment, and computerized charting. I have to scan my badge and access a computerized system just to get out a single bag of normal saline or a tegaderm. It's very time consuming. I have talked to the educator about what I'm not learning, but it doesn't seem to help. I really was hoping to get excellent training here - it's supposed to be the best in the region. Maybe I'm the problem, I don't know.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

It's not you....it takes time to learn, particularly if you are doing so "on the fly".

Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.
I couldn't sleep last night because I was going over and over in my head what I could have done differently to have a smoother orientation? ..... Maybe I'm the problem, I don't know.

Well, personally, I don't think so. Maybe you could have been more vocal about what you need, but sometimes people get in the position of "not knowing enough to ask questions!"

Giving you three PP couplets on your first day on the unit, when they know you were coming from a totally unrelated background, makes no sense at all. It sounds as if they just wanted another pair of hands and weren't interested in what you needed!

Maybe some of the experienced OB nurses here could give you an outline of what they think the orientation should be. I don't know if that will help with your current situation but maybe if you move on and go somewhere else.

It's a shame that someone who really wants to work in OB is getting such a bad orientation. It's a shame that anyone would get than in any unit!

Being thrown into the deep end is just no way to learn to swim!

Specializes in L & D and Mother-Baby.

Do NOT feel stupid! You are NOT!!! Trust me! After a six month orientation, I still felt afraid! (As a matter of fact, I still do!) I've been doing this for a year now and everyone I talk to says to feel comfortable in labor nursing it take two years!!

Can you ask to orient to Mother-Baby for a while, then Well baby nurse, then Labor? I personally had to orient to labor first because our manager feels that if you can handle labor, you can handle anything! But Well Baby nurse is a whole different ball game! Good luck and hang in there!

Specializes in primary care, pediatrics, OB/GYN, NICU.

Thank you Mama Madge (love your name!). I've had a couple of the nurses tell me that too.... that it takes about two years to really feel comfortable. Actually, I was hoping and thinking it might be nice to stay in Mother Baby for awhile, but probably not an option. I think I would have really stressed if I started out in L&D! I really think your manager is right though. Thanks for the support - I'm going back tomorrow - time for some lamaze breathing!

Although I am wondering why not, to be honest with you, if you have already been there for 6 weeks. I personally think it takes a full year to be fully competent in one's job but it does seem that you would be off to a pretty good start after 6 weeks. Maybe the constant changing of preceptors has really hurt you.

I can understand why she's struggling. Different preceptors - being tossed from one part of the process to another - so fragmented! I totally *get* the thing about 'let me see the whole thing from start to finish'. I agree. I would need that, too, to get my bearings.

Talk to your manager and don't let it get turned around on you. Stand your ground that even though you are an experienced nurse, you are new to OB. It IS like apples and oranges. You WILL need some time and training that is consistant and organized.

Hang in there!

Specializes in primary care, pediatrics, OB/GYN, NICU.

It does get better with time. and it makes a difference who you have as preceptor too. Consistancy and step by step really help too. For me, also new to L&D, this last week went SO much better. I had two very patient and understanding preceptors and was honest with them about my fears w/ L&D. Even though things were crazy busy this week, I learned a lot and feel like I'm doing more every day. I will have a least another month of orientation.

Specializes in Foot Care.

This sounds like what they call "baptism by fire".

It also sounds very unsafe for you and your patients.

We don't do LDRP where I work (we are strictly postpartum), but we do aim to ensure that patient assignments are reasonable and within the capacity of the nurse to perform. I do not like seeing the more experienced staff "coasting" all shift while other staff are knocking themselves out with all the new admissions. When I'm in charge, a lot of thought goes into ensuring that nobody gets all the scut work dumped on them - we all get as equal an assignment as possible.

Your preceptor is ultimately responsible for the patients under your care until your orientation is complete. Maybe the assignment is something she is capable of handling on her own, but you shouldn't be expected to start out at the skill and organization level of someone as experienced as she is.

Did you debrief with her after the day from hell? Did you ask her how she would have organized her day to handle the workload? I would definitely ask for some input as to how the day could have flowed more effectively. It is not appropriate for you to go 12 hours without a break to eat or use the washroom. You can't look after your patients to the best of your ability if you aren't looking after yourself too.

This is your chance to start learning a very important skill: delegation. Don't be afraid to ask the preceptor: "Can we get someone to do the PKU for us?", "We just took the last admission, can someone else take this next one so I can get the patient settled?" Practice this skill. You will need it to survive in nursing. There are plenty of people out there who will take advantage of your desire to do it all, and won't offer you any help - be sure to ASK FOR HELP WHEN YOU NEED IT. Nurses aren't and shouldn't be martyrs.

Specializes in primary care, pediatrics, OB/GYN, NICU.
This sounds like what they call "baptism by fire".

It also sounds very unsafe for you and your patients.

....I do not like seeing the more experienced staff "coasting" all shift while other staff are knocking themselves out with all the new admissions. When I'm in charge, a lot of thought goes into ensuring that nobody gets all the scut work dumped on them - we all get as equal an assignment as possible.

....Did you debrief with her after the day from hell? Did you ask her how she would have organized her day to handle the workload? I would definitely ask for some input as to how the day could have flowed more effectively. It is not appropriate for you to go 12 hours without a break to eat or use the washroom. You can't look after your patients to the best of your ability if you aren't looking after yourself too.

This is your chance to start learning a very important skill: delegation. Don't be afraid to ask the preceptor: "Can we get someone to do the PKU for us?", "We just took the last admission, can someone else take this next one so I can get the patient settled?" Practice this skill. You will need it to survive in nursing. There are plenty of people out there who will take advantage of your desire to do it all, and won't offer you any help - be sure to ASK FOR HELP WHEN YOU NEED IT. Nurses aren't and shouldn't be martyrs.

Wow. This is very good advice. I think I don't do very well at asking for help. Sometimes the others seem just as busy, but other times they are definitely "coasting" as you say! Also, there are those who make such a fuss about being asked to do anything that it's just easier to do it myself. Yesterday there were 3 nurses at the desk and I was running my tail off. One of them said (chronic coaster) said "Quit working so hard - you make the rest of us look bad!" But truly, there was lots to be done. However, by the end of shift I was able to finish my charting because I had everything done. That same nurse was spinning and complaining about how she needed help to get everything finished. I just smiled and finished my charting. I did not jump up to help her this time.

Stand up for yourself. Been doing OB for about 20 years. Talk to your manager TODAY! Try to get one preceptor, follow her schedule. Talk to her. IF she's a good teacher (which every preceptor should be) make her explain, explain, explain. Talk to the MDs, if you're attending their deliveries, find out their preferences for things, stools, different vaccuums...

(it's great to have the MD on your side).

Step outside your "comfort" zone. Push yourself farther, make your preceptor let you do the care, the paperwork (ugh!). Obviously, she may need to step in if you're making a mistake, but sometimes you learn better from mistakes.

Keep in touch with your manager on a weekly basis, include your preceptor.

Find out what the expectations of each are, and your own too! Maybe they expect too much, too soon.

But please hang in there. The joy of doing your job well, to see the smiles/tears of new parents faces is all worth it.

+ Add a Comment