New Grad in Labor and Delivery

  1. 0
    Hi everyone I have been reading some of thses posts and decided to write my own. I graduated in August and came off orientation in L&D on November 20, 2008. I trained on day shift but was hired for nights. So it has been about 3 weeks now and I have had my ups and downs. I have come home crying, anxious and feeling very incompetent. I have been trouble sleeping and have resorted to sleeping pills when needed. All through nursing school and my nurse extrenship I was told that I would make a good nurse. Now, I am not so sure. I feel that I should know more than I do and walk into work every shift praying that I will have a good night. I have made stupid mistakes that I am trying to learn from and hope that in time this feeling goes away.

    Anyone who works in L&D or any field for that matter, can you tell me if this is normal? I hope that I am cut out for this specialty becuase I love it so much. I look in awe at senior niurses who seem to handle two laboring patients, one having decels, and the other getting an epridural, without freaking out. I am super sensitive, anxious and paranoid that I am going to screw something up-is this normal? My co-workers are very supportive but I feel that I might be annoying with all my questions. The night shift has hired many new nurses and I am the last to be hired. The docs make comments because there are so many new nurses (not all new grads). Some older nurses are more helpful than others and I tend to attach myself to the nicer ones. I am getting better with vaginal exams but still have other nurses check for me when I know the doc is not the nicest so that i dont tell them the wrong dilation. I hope one day this all just "clicks" but until then I hope to keep my sanity. I was so excited to be done with nursing school but now I wish I could go back.
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  3. 26 Comments so far...

  4. 4
    I did not work in LD but I can tell you this feeling is entirley normal for new grads. I believe every nurse goes thru it to some degree. You are working in a specialty area and no matter how good a nursing school is, they cannot prepare you for every eventuality. I think you need to talk to your manager and ask for help, such as working with a particular nurse, having the Educator spend time with you ---. What you are lacking is confidence and that only comes after doing something multiple times. And please don't think you will ever get to the point where you do not make mistakes. Your biggest mistake would be to not ask for help. Use the nursing process on yourself. Assess your strengths and weaknesses. Consider what could be done differently and get someone to show you how to make it happen. That includes time management and prioritization. Good luck!!
    jconway45, catlady5, MMARN, and 1 other like this.
  5. 7
    ((((Hugs!))))

    I too went straight into L&D after graduation. It is a high stress area, and there is a lot to learn. I was told by various nurses that it took about a year from them to quit throwing up on the way to work and crying on the way home, and that it took FIVE years before they felt comfortable.

    You are probably doing fine, even quite well. Believe me, they wouldn't leave you working if they thought you were a danger.

    Yes, the feeling is normal.

    Here's where I might differ from some advice you'll receive. Labor and Delivery isn't for everyone. May good L&D nurses admit that they are adrenaline junkies. Not everyone is an adrenaline junkie. Sometimes people go into L&D because they think it will be 'fun' or even 'easy'. LOL...nope. Fun maybe, easy??? I don't think so.

    Admittedly, I was in a HIGH risk facility. It was scary every single day.

    So how am I differing from other advice? Yes, you could stick it out for a year, or two, or three... and you might even have the feelings fade. But what do you really want? Do you want to feel horrible for another year or two about yourself and your job? Take a good long look at yourself. Are you more comfortable with security and stability? Are you more comfortable with risk taking? Do you like to cocoon with a book on your day off, or do you like to skydive?

    I decided no, I'm more into stability and calm. (I had some family stuff going on too, which certainly didn't help) I went into an entirely different branch of nursing and I am insanely happy I did. My first week...my FIRST week I realized I wasn't sick to my stomach when I headed for work. I didn't cry on the way home. I had energy. I liked life again. I felt useful, and fairly competent. (Well...yes, I still had stuff to learn...still do, I'm thinking that's a lifelong process) Long story short, leaving L&D was one of the best decisions I ever made. I worried that I was a quitter, a wuss, a whiner. But sometimes it is wise to realize you're in the wrong place and move on.

    Ask yourself...do you like what you see? If you can put aside your fears about your abilities, would it be a fun job? Can you see yourself doing this five years from now? Do you enjoy the feeling of never knowing what kind of a day it will be? If you really love it, persevere. You'll be amazed someday to look back and see how much you've learned. But if you're in the wrong spot...don't be afraid to admit it and move.
    jadu1106, ky_grl82, allthemadmen, and 4 others like this.
  6. 1
    Totally normal feeling! I also went into L&D right after nursing school and pretty much had the same feeling. It is something that is going to take time as you build experience and confidence. I have changed nursing areas three times, the last time just 6 months ago, and everytime I have had that feeling. In nursing school they taught us that it takes 5 years to become totally proficient in any one area. Especially if you are a new nurse. Don't be so hard on yourself. However, if you feel the area you are in is to stressful or risky you should consider changing. Nursing can be stressful and challenging but it should also be a job that you love. I feel very fortunate to have a job that I love to go to everday!
    cooliegirl likes this.
  7. 5
    I graduated from school and went straight to our Labor and Delivery unit in a level 3 hospital!! The way our manager trained new grads was fantastic. If you were a new GN, you had to work in the high risk antepartum unit for at least one year (med surg for prego's) taking care of the abnormal FIRST, your basic PPROM, POL, Pyelo, PIH, insulin drips, mag sulfate....you get the picture. Then when all that became second nature (reading fhr/ctx strips and getting a "gut" feeling when a pt. is going to need a higher level of care...ie Labor and Delivery...) you got your shot to make it in L&D. 12 weeks of orientation, my friend....12 weeks where you did 2 in triage, 2 in the OR and the rest of the time you did one on one labor for 4 weeks and then 2 pt's at a time the next 2 weeks until you were done. Your preceptor and senior staff were assigned to "have your back" for another 4-6 weeks. After doing my year in Antepartum, I was READY for labor and delivery. It seemed like second nature. I already knew the abnormal so it didn't scare me, so I only needed a few more puzzle pieces to fit together like bumping the pit when the pt. is coupling her ctx and knowing they are complete because the ctx have slowed down and the baby's baseline has dropped....all that comes with time!! Be patient with yourself. Do your OWN vaginal exams AND everyone else's and have them check behind you to make sure you are correct. Ask the docs a lot of questions they can teach you too. ?????? Always ask a seasoned nurse if you have a question, this is the only way you will learn and most of all gain confidence. Hope this helps!! BE STRONG, educate, advocate for and deliver your patients!! Good luck.
    misha8210, jadu1106, cooliegirl, and 2 others like this.
  8. 0
    Thank you for your advice, I agree 100% with you. I really enjoy working in L&D I am just scared of it. I know that I have high expectations for myself that cant be reached in 3 weeks time. I just feel that I drag the team down because I am so SLOW!!! My plan is to give it 6months and if I am not feeling more competent then i will look at other options. I talked to my clinical lead today and she said I was doing a good job...(maybe she was being nice) Anyways thanks for your help, I will take one dat at a time. I am glad that you are more happy in your new field.
  9. 1
    I have to say that your experience is not new to Maternity!
    I was also a new grad of 8 weeks and hired in the maternity ward, but let me tell you , it was just as overwhelming 18 yrs ago as it is now! We had 11 in labor at the same time, we only had 8 nurses on & i was one of them! danger danger!! I was so inexperienced , i felt like i got hit by a mac truck!
    Your feelings are genuine & with time & experience you will get over these feelings!
    We are all behind you!! Hang in there kiddo!!
    cooliegirl likes this.
  10. 0
    I am also a new grad starting in L&D next week. I am interested in knowing how you are doing if you are still there.
  11. 0
    I have not started in a new grad RN position...I just passed my test last week. I am still looking for jobs. I am terrified, and am scared I will freak out and forget important things. I was fine in clinical, but I always had my instructor or nurse preceptor as my crutch if things went wrong, so I was more willing to venture off and be more independent while working under them. However, I'll be the primary nurse, and it scares the mess out of me! I find myself getting very upset and I beat myself up when my friends/family ask me questions, and I can't tell them what is wrong with them (not to mention they name the most vague symptoms ever that can be caused by 100 different diseases!). I simply tell them that I don't know everything, that nurses do not diagnose, but I can give them some ideas for what I think may be wrong and they should see a doctor. I get dirty looks or get teased for not being worth anything. Joking or not, it hurts, especially since my confidence in myself is not up 100%.
  12. 2
    I began working in L&D in February '09 as a new grad. The hospital I work at sees A LOT of high risk cases. We rarely have a "normal" delivery. When I first started working alone (after I was off orientation) I was scared to death to go to work every day, in fear of what I would have to deal with, or what emergency would happen. Honestly, the ONLY thing that helped me get over the fear of these emergency situations is to experience them. When something happens like a cord prolapse, hemorrhage, abruption, etc it is SCARY. But afterwards, you just have to reassess and think of how you did. You aren't going to be "perfect" every time, but you will be SHOCKED at how well you do in situations like that. And once you experience it, even once, you'll be so much more comfortable the next time. You have the knowledge, you just have to trust yourself. And yes, it does take several years to be completely comfortable, but even the most seasoned nurses have situations that shake them up. That's why it's so important for nurses to support each other and be there to help. You will make small mistakes, but I guarentee you'll never make that same mistake again. I've made a few mistakes (nothing serious) but I've never made the mistake again, because I've definitely learned. It's so true about the other post, that people think (even other nurses think) that L&D is a "fun, nonstressful unit". I love when I tell people what I do, and they say "Oh that's so fun!! I would love to be able to play with babies all day". SOO far from the truth. I have a friend who is an ICU nurse, and she says that she could NEVER be an L&D nurse. She said she knows that her patients are sick, but our patients go from completely fine and healthy (generally) to close to death in 10 seconds. AND we have at least two patients for every mom we take care of. It's not easy. You just have to be on guard. It's stressful, scary, and hard work, but it is also INCREDIBLY rewarding. You get to be a major part of the happiest day of some people's lives. Thats a huge responsibility and honor. You'll be just fine, just believe in yourself, use the knowledge you have, and give the most you possibly can every day. There's a reason you went into nursing, and you'll be just fine!
    whitescrubs2012 and camibu like this.


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