chiapet... if I were you I'd at least wait out your preceptorship, you may learn more in the next 6 weeks than you think! Although of course, you will still have a lot to learn.
I've been off orientation about a month. I've definitely had my highs and lows (we've had a couple of really horrible days to initiate me... see the thread about c/s's without anesthesia... making myself walk back on the unit the next workday was one of the hardest things I've ever done). Some days are great, some I'm still just trying not to drown. For the most part I love it although those couple of bad days have really been a trial.
I made up a bunch of checklists for myself to use - I have ones for:
-my "brain" cheatsheet; it has the same information on two columns so I have 2 pts vital info at my fingertips (and you could make two sided copies for 4 if you wanted). It has: Date, admission time, name, Drs., G T P A L Para, EDC, intact/ruptured - color/odor, show, last meal, ctx/time began/strength/frequency, FHT, T BP HR R, SVE, Allergies, Breast/Bottle, Ped, Marital status S M W D, education, religion, occupation, medications, illness/pertinent hx, exposure/smoke/alcohol/drugs, reflexes, edema, urine dipstick, epidural, rubella, blood, hep b, HIV, VDRL, GBS, age, ht, wt, tubal ligation, chief complaint, d/c treatment, prenatal class .... that sounds like a lot but it fits nicely on the sheet and it is really nice to have it at my fingertips for calling the doctor, for report, for whatever - plus it answers a lot of questions that I have to fill in on our OB admission data anyway & that way I already have them in my head.
-Labor/ Labor checks (starts out with stuff you do for everyone, then things to do if they are leaving vs. being admitted)
(those first three I use by far the most)
-c-section checklist & proper scrub on the back since I was never taught it (!)
-baby 'catcher'/ Postpartum
-Delivery table setup
-Common orders (I'm still getting the hang of both writing orders and documenting)
-a misc. sheet - the code for calling long distance on the phone, etc.
Everyone has their way of doing things that works for them, this helps me. I have it all in a clear sheet protector and keep whatever list I need at the moment showing on one side and my cheat sheet on the other. It is usually on a clipboard (some people wouldn't want to carry it around but it doesn't bother me, plus I always have a writing surface and something for pts to use for signing consents and stuff).
I also have a notebook with our unit policies that is easier to get to than finding and printing it off the computer when I need it, and a notebook with helpful stuff from orientation, breastfeeding handouts, and other helpful stuff I come across (all this stuff is also in sheet protectors). The notebooks stay in my bag in the break room where I can grab them easily if I want something.
Something that my preceptor told me that I try to remember, is to get the 'physical' tasks done first - assess (using the cheat sheet of course!), get on the monitor, get a line in, etc.; for the most part, documenting and stuff like that can be done later if need dictates (um, even though it sucks to get behind on it).
As far as vag exams, I started to "get it" right before I went off orientation and not a day before!! LOL! And I still bug other nurses fairly often to check behind me if something feels weird or I'm not sure. I think someone on this forum said "don't come out 'til you find it!" and they are pretty much right... it's there somewhere. And it does help a lot sometimes to get mom to lie on her hands/get her butt up in the air.
In the last week I feel like I've regressed with my IV's!!! I've had to ask people to help me all week!! Ugh!
I'm also trying to learn to bunch tasks together - for example, if I have to get more monitor paper I try to carry back anything else I may need later all in one trip down to the supply room. But I am still learning like crazy! Do you have any tips to share with me? What is working for you?
After reading your post I'm also wondering, do you take care of mom AND baby at delivery? You don't have a 'baby catcher' nurse come in? Our catcher does initial baby stuff, admits baby, and does the newborn assessment then turns baby back over to me.