Feeling sick and stupid

  1. 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!
    Last edit by lannisz on Nov 26, '06
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  2. 21 Comments

  3. by   ERNurse752
    I don't have too much specific advice, since I'm not an OB nurse...but this sounds like a horrible, unsafe situation. It isn't your fault. If it were me, I'd be talking to the manager about it, and if I didn't get any support from her I would quit.
  4. by   SierraN
    I also think you need to speak to your manager. The day you described sounds like some sort of a nightmare. We all have days where we don't get to eat (as a matter, I might get a meal break once a week if i'm lucky...but unless I'm in a room pushing with a patient or in the OR, I just yell out to someone..HEY __________ watch my patients and then I run to the bathroom when I have to go because i'm crazy like that)... but your day sounds a little over-the-top. What were all the other nurses doing while you were running around like a chicken with your head cut off? It could have seemed overwhelming because you're new...or your preceptor has her head up her___. I don't know. Only advice I can give is take good care of yourself and your health, try to have a good attitude, take one day at a time..or sometimes one hour at a time and if it keeps up...find another job...it's not like there's not 1000's of other places you can work as an RN.
  5. by   SmilingBluEyes
    I, too, think a word with your manager is in order. Not having the same preceptor is far less than ideal, although in some units, is the norm. Also, they are tossing you around too many places too soon. Med-surg experience is invaluable, but it's almost like apples-oranges, going from m/s to ob. You can't really count on your m/s experience to carry you in OB too far. Maybe they expect too much of you too soon, given your M/S experiences......not sure.

    Speak to your manager of these concerns you brought here. They are valid and you are too new to bounce about like that. They should know better-----watch things. A poorly-run or disorganized unit runs this way, and it's not a good place to work. If your manager fails to, or refuses to act on your concerns, you have a rough road ahead.

    Good luck!
    Last edit by SmilingBluEyes on Nov 26, '06
  6. by   TrudyRN
    It sounds like you are not viewed as an orientee, who should have a limited assignment. You are being viewed as a full-fledged, flying on your own, staff member. Put a stop to it AT ONCE. YOU put a stop to it. Let me repeat that so you understand that YOU must put a stop to it. If YOU don't, neither will they. Take your boss aside and share with her what you have said here - a different preceptor every day, unlimited new patients, no breaks, even to urinate or, I'd bet, swallow some water. Let her know that you are not ready for the full load yet. 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. Maybe the being treated like a slave, with no rest breaks, bathroom breaks, or, I'd bet, meal breaks, maybe the totally unrealistic, dangerous, and unacceptable workload have all taken their toll. And there's no way you could have encountered everything yet, so the irritability of that one preceptor is absolutely unwarranted and not acceptable. To that person, I'd say privately, "I know you were irritated with me the other day

    about...but I cannot allow you to talk to me the way you did. As you know, I had had absolutely no break at all, even to urinate, and I guess you probably didn't either, so you know how I feel. I have only been here a few weeks and I don't know everything yet, nor had I encountered this or that yet, so I was slow." YOU must stand up for YOURSELF. P.S. You are stupid only if you allow this to be repeated. Any job that is making you physically sick and gets you calling off while still an orientee - mmm, think twice about staying there if they don't fix this stat.
    Last edit by TrudyRN on Nov 26, '06
  7. by   rnin02
    I totallly understand! I moved from Tele to the nursery, and its like being a new grad again. I remember many days where I was constantly taken to deliveries, so I could get delivery experience, but at the same time, I was missing out on finishing things in the nursery, such as getting my assessments done, blood draws,etc. I think my experience was better than yours because I had only one main preceptor for days and one for nights. It wasn't always the same, but most of the time it was. I would either talk to your manager, or talk to the charge nurse when you come in to start your shift. Let them know what you need to finish your orientation successfully.
  8. by   4bears
    I know exactly what you are going through, I too have had med/surg exp. and I am in 6 weeks into orientation in LDRP, and I am going through the same thing. The nurses act like I am completely stupid and have no experience at all, I have to keep reminding myself, I am a Nurse, a good Nurse and I can do this. I also have new preceptors every day, and then each preceptor does things different and I get "Why are you doing it this way?" Ahhh thats the way I was shown, "No do it this way", then the next day "Why are you doing it this way" So and so told me to, "Well that's wrong and you do it this way" ALL I WANT TO DO IS SCREAM!!!! I have met with my lead preceptor (who never precepts me - just oversees my orientation) several times to discuss concerns, and it gets turned around that I am having trouble or lack confidence - No I just don't know the proper way to do things. Some preceptors even told me "I hate precepting, don't take it personal if I don't talk to you too much!!!!!""""" What? So believe me I FEEL YOUR FRUSTRATION, I always wanted to be in this area of nursing, but right now I miss my med/surg floor where I was treated like a proffessional and was appreciated. I feel sick to my stomach right now because I have to work tomorrow and dreading finding out what else I don't know.
  9. by   lannisz
    Quote from 4bears
    I know exactly what you are going through, I too have had med/surg exp. and I am in 6 weeks into orientation in LDRP, and I am going through the same thing. The nurses act like I am completely stupid and have no experience at all, I have to keep reminding myself, I am a Nurse, a good Nurse and I can do this. I also have new preceptors every day, and then each preceptor does things different and I get "Why are you doing it this way?" Ahhh thats the way I was shown, "No do it this way", then the next day "Why are you doing it this way" So and so told me to, "Well that's wrong and you do it this way" ALL I WANT TO DO IS SCREAM!!!! I have met with my lead preceptor (who never precepts me - just oversees my orientation) several times to discuss concerns, and it gets turned around that I am having trouble or lack confidence - No I just don't know the proper way to do things. Some preceptors even told me "I hate precepting, don't take it personal if I don't talk to you too much!!!!!""""" What? So believe me I FEEL YOUR FRUSTRATION, I always wanted to be in this area of nursing, but right now I miss my med/surg floor where I was treated like a proffessional and was appreciated. I feel sick to my stomach right now because I have to work tomorrow and dreading finding out what else I don't know.
    Ahhh, a kindred spirit! I too went from med/surg into OB. I started back in September and while I feel totally in my element for postpartum, I am now starting L&D and it feels like I am a student once again! (Yuck. I always got sick to my stomach on clinical days!) My preceptors change daily. Everyone has their own way of doing things...No we never do a rectal temp! Yes, of course we always do a rectal temp initially! Why are you doing it that way? Haven't you ever seen a _________ thingamajig? What hospital did you come from anyway?
    And then there is the gossip, the politics, the backstabbing (actually that feels pretty familiar...). Frankly I just want to learn to do this job and do it well for a very long time. I really hope they don't chase me away! Hang in there - I try to remind myself that all of them were new once too, and many of them have never had any other kind of nursing experience other than OB. I think it's time we formed a support group, don't you?
    Last edit by lannisz on Nov 26, '06
  10. by   lannisz
    "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."

    This type of thinking may be part of the problem....yeah, maybe six weeks without being bounced around. Some consistency would help. Six weeks orientation on another med/surg unit, yes, it would be plenty....but not OB/LDRP. If your unit is anything like mine (huge and high risk) it's a whole new ballgame!
  11. by   santhony44
    I'm not an OB nurse either but I don't see how anyone can be expected to learn how to function well if your "orientation" is totally disorganized. Even going from one unit to a similar one can take a little time; going to something so totally different needs systematic, organized, consistent orientation. Having more than one preceptor may not be a bad thing, but having a different one virtually every shift does not make sense.

    There should be some sort of "plan" in place to move you through to functioning independently and your orientation sounds totally haphazard.

    I agree with the poster who said that if you don't get any help from your manager, start looking elsewhere.

    Good luck!
  12. by   SmilingBluEyes
    well in small and "low risk" it gets bad too. If the patients are unstable, we don't ship em!

    6 weeks is NOT enough for anyone to orient to OB from another specialty. Takes more like 3 months.
  13. by   at your cervix
    I just left the hospital I was working for for this very same reason (among others) although I have 9 years of experience, the new nurses were getting a terrible orientation, much like the one you described, and we had a lot of new nurses and a lot just kind of falls through the cracks when you dont' have the same preceptor. Many of the experienced nurses tried to fix the situation by pointing out the problems, volunteering to precept the new nurses etc, but we got no where, we went to our manager, the DON and up to the CEO. We got no where and I finally made it known that I could not work in a facility where they would not listen to the concerns of the experienced nurses and put patients at risk and I left. The manager had less experience than most of the nurses on the unit and would do whatever she could to prove that she was the boss and no one was going to tell her what to do and it often compromised patient safety! I have been gone for six months and two weeks ago it was annouced that the former manager would be stepping down. This is a very good thing for this hospital!!
  14. by   lannisz
    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.

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