leaving step down icu to go to ob

kdkout, BSN, RN · Apr 29, 2015

What kind of a unit are you going to? What is the highest level of care they give?

I did the same, years ago. THey only hired me because I had ICU experience, so I went into a High risk OB 'see-it-all' type of floor. Because I saw prolapsed cords, amniotic fluid emboli, micropremie births, patients on antepartum for months, etc.....it made me really "skewed" as my first OB job. It was a lot of high risk, so I couldnt "see" what was low risk. When we'd get the occasional "normal" low risk patient in I would still see them as high-risk, and my coworkers (with experience at lower acuity hospitals) would have to remind me that birth is "normal" but we just happen to work in a very unusual place, and not to assume everybody is sicker than they are.

So, my advice is to learn to differentiate "normal" from "high risk" and treat accordingly. Luckily, we had some midwife births which were SO different, and so wonderful, so that really helped me see birth as "normal." I hope this makes sense. It didnt help that this first job was also at a teaching hospital and I got off of orientation at about the same time as the new 1st year residents. So, if it's a teaching hospital, good luck. :-) In that case, find the experienced nurses who know what they're doing and go to them frequently. Find mentors, even after orientation. Dont assume that first year resident knows what they are doing; they are learning too. Yesterday they were a med student and today they are a Dr, but they have been learning from only books. Learn to work together, carefully, and learn from eachother. It'll be fascinating and humbling, like most new jobs!

I ended up leaving that job for other reasons, and going to a lower level of care which I found "fit" me better. Also, a lot of things about labor and delivery are an "art," whereas ICU is more "technical," so that may be a challenge for you to make the transition initially. Watch the experienced nurses, especially the ones who are good with the patients going natural - you can really learn a lot from them.

JoyfulRN14, BSN, RN · May 10, 2015

I left a MSICU job recently and just finished my 5th week on a busy L+D floor. My orientation is 12 weeks total, working one on one with a preceptor. Then a couple weeks working the same shifts as her but we'll each take our own assignments and she'll be my resource person.

I felt like such a fish out of water my first week. It's hard to go from being competent at your job to being mostly lost. :)

Each week gets better. There is still a TON that I need to learn and become more comfortable with. But I feel comfortable admitting a laboring patient, admitting and starting an induction, managing a normal labor, and being the primary nurse during a normal normal delivery and recovery.

My advice would be to do some studying beforehand, unless you're doing a program that has classes up front before being on the floor. Knowing some stuff beforehand will help you feel less lost, and sometimes when it's busy things are just happening around you and there's no time for detailed explanation, so it helps to have some clue.

The VERY basics you should know going into your first day - the stages of labor, basic FHR monitoring and how to read contractions on a strip, very frequently used medications (Cervidil and Cytotec for cervical ripening, Pitocin, and meds for bleeding after delivery - Methergine, Cytotec, Hemabate).

A lot of your learning will come from working alongside your preceptor and seeing how she interacts with patients and learning how to explain things to them.

Here's a great site for self study of FHM:

http://utilis.net/fhm/2406.htm

Have fun!