An Update........(LONG)

Our facility give new grads 16 weeks of training and experienced nurses from other specialities 12. L&D is a speciality that takes time. Especially cervical checks. And then even experienced nurse can be off once in a while. There is too much at stake to be "winging it". Be assertive and demand that she places you w/another preceptor or mentor. Not noticing a negative fhr pattern could mean a crash situation. Especially on a busy unit where other nurses arn't team nursing. One that could endanger mom, baby and your license!:uhoh21:

Hello everyone,

:uhoh21: Well everyone's last pieces of advice were great so I am hoping for more. I am nearing the end of my orientation to L/D, newborn nursery, and Post Partum. I am a NICU nurse so newborn nursery is not going to be a problem, I have had two post op c-sections, I have labored one mom to 7cm and have pushed one mom that was 8cm when I arrived. The paperwork on a laboring pt is unbelievable! Also I have had a fetal demise. I was on-call for 3 days of those 8 weeks of orientation. I have not yet setup a delivery table or taken a pt to a c-section. My manager the third week of my orientation said to me I hope you are a quick learner. IN NO WAY am I competent to be in this department to function on my own. What am I going to say to the doc when he says have you checked her yet, Yea doc I THINK she is 3-4cm/I can't yet tell effacement/ and station is a guess at this point. I don't know what to do, There have been 3 nurses total who have left since NOV. and my preceptor will be going on maternity leave very soon, so I will be there by myself (its been her and I). I will not sign off on the competency and my preceptor is not willing to sign me off either. Does anyone have any advice for me I really like L/D and want to stay there, but man this place is .......

Thanks in advance

Goldenearring1

I would WRITE a statement to your nurse manager that your competence at the end of your orientation period is limited to mother-baby and newborn care ONLY. Make it clear that you are not willing to accept any assignment for a laboring patient or high-risk ante-partum mother without a preceptor SHARING your assignment, until you have completed an additional orientation period, with an agreement at the conclusion of that training that you have achieved the basic level of competence needed to practice OB nursing safely.

If your manager is truly concerned with your educational needs and the safety of your patients, s/he will agree to that. It is not the ideal situation because it limits staffing options, but it is better than losing you, which would be my next suggestion.

Hello everyone,

:uhoh21: Well everyone's last pieces of advice were great so I am hoping for more. I am nearing the end of my orientation to L/D, newborn nursery, and Post Partum. I am a NICU nurse so newborn nursery is not going to be a problem, I have had two post op c-sections, I have labored one mom to 7cm and have pushed one mom that was 8cm when I arrived. The paperwork on a laboring pt is unbelievable! Also I have had a fetal demise. I was on-call for 3 days of those 8 weeks of orientation. I have not yet setup a delivery table or taken a pt to a c-section. My manager the third week of my orientation said to me I hope you are a quick learner. IN NO WAY am I competent to be in this department to function on my own. What am I going to say to the doc when he says have you checked her yet, Yea doc I THINK she is 3-4cm/I can't yet tell effacement/ and station is a guess at this point. I don't know what to do, There have been 3 nurses total who have left since NOV. and my preceptor will be going on maternity leave very soon, so I will be there by myself (its been her and I). I will not sign off on the competency and my preceptor is not willing to sign me off either. Does anyone have any advice for me I really like L/D and want to stay there, but man this place is .......

Thanks in advance

Goldenearring1

It is no wonder three have left since November. That orientation is not nearly long enough. I think (even if you ultimately want L&D) that maybe going back to the NICU and being safe (while you look for a better hospital). Losing your license (or worse) because you are going into a very litigious area is not worth it. Good luck, but I would shop around.

Being still fairly new to L&D myself, the orientation that you have described disturbs me. I'm guessing that you are working in a very small facility, with primarily low risk patients, but honestly, you never know what may walk through that door. Do you have the help and back-up if someone ruptures and you have a cord prolapse? A complete previa? A uterine rupture? Needs Magnesium Sulfate? ETC.....

I oriented to postpartum for 6 weeks and then I worked on postpartum for 6 months. Then I cross trained to L&D for 6 weeks full-time. After the 6 weeks of orientation, I was on my own, but I was "paired" with another L&D nurse for 3 months. I used her as a resource, she'd follow my exams if I needed it, etc. I've been completely on my own for 6 months now. I just oriented recently to PACU so I can recover sections and PPTL's. In a few months I will orient to the OR for circulating. I really think that the way my facility breaks it down makes all the difference in the world. Learning so much all at once can be a little overwhelming.

Find an OB legal seminar to attend, you may start seeing things in a different light. I do wish you the best.