Aspiring CNM in L&D

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So here I am working L&D. I have been there 4 weeks now and guess what? I am not particularly happy there. I am bothered by the fact that every woman who walks through our doors in intervened upon. I am bothered that we "RN's" have to cover our butts, so whatever the fetal monitor says, I have to show that I have intervened, usually with O2 etc..I am bothered that the "patient" gets multiple vag exams before, during, and after rupturing membranes, and then she ends up with a temp, chorio, and then a C-section. I am bothered that a co-worker gave me an attitide when I let my young pt on pit walk around the unit to help her labor progress. I didn't know the pt had to be on a monitor while walking. I said ok and put the pt on an avalon monitor. I felt so dumb!

I don't think I want to work there anymore. Maybe I will be happier working Hospice/days...:o

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I'm sorry that you are not enjoying your new job. As with any new job, it just may take some time for you to adjust. You may want to hang in there awhile longer. After you are off orientation, it may get better because you will have a little more control over the nursing interventions, as long as you aren't violating hospital policy.

On the other hand, I understand your frustrations and that is one of the reasons why I don't have much of a desire to work in L&D, although I've heard that some are better than others. If you do decide to leave, home health can be a great nursing job! Or you could see if they would transfer you to PP and then you would still have the women's health experience. Let us know what you decide.

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Specializes in L&D, QI, Public Health.
I'm sorry that you are not enjoying your new job. As with any new job, it just may take some time for you to adjust. You may want to hang in there awhile longer. After you are off orientation, it may get better because you will have a little more control over the nursing interventions, as long as you aren't violating hospital policy.

On the other hand, I understand your frustrations and that is one of the reasons why I don't have much of a desire to work in L&D, although I've heard that some are better than others. If you do decide to leave, home health can be a great nursing job! Or you could see if they would transfer you to PP and then you would still have the women's health experience. Let us know what you decide.

I agree with HealthyRN. I'm feeling the orientation blues also. I'm hoping it gets better after I get off, and then I'll reassess.

In the meantime, try to get as much value as possible when working at your hospital. Make note of the things you don't like and visualize how different your future midwifery practice will be.

Right now, that's the only thing that gets me going.

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Specializes in Rural Health.

Oh my gosh babe, I feel your pain.

I'm about month #4 into my orientation and I really don't like L&D. I work in a full service OB department, so I always have my PP and Nursery to go back to when my days of L&D have me down in the dumps.

My ideals and desires are NOT shared on my floor and in my unit at all whatsoever. I got a patient up to the rocking chair for goodness sakes, at the bedside, after a AROM (baby's head flat against the cervix so no cord issue). My preceptor came unglued. Why??? Because the baby was down so far we couldn't get an accurate FHT while mom was in a rocking chair. She yelled at me in front of the patient and family and made me look like a total fool. There was no contraindications to a rocking chair and mom did not want an epidural yet (if at all). Hmmm....what about position of comfort for mom??? That goes out the window where I work. The only position of comfort the RN's I work with know about are the 2 positions for an epidural. Side lying or sitting up.

This is one of my story of 1000's I could share.

We pit our babies/moms to the max and almost always end up in a C-section. Moms who are no where NEAR ready for a sucessful labor are tied down to the bed with IV lines, IUPC's, FSE and every other thing we can shove in an orfice because of what???? The "doctor" is ready for the baby to be born, before 5 p.m. too, cause he has a dinner date with one of the nurses (ok, I'm a bit bitter right now so I best stop).

I too thought L&D would be a great pathway to the route of the CNM. It's taught me a lot though, it really has. It's taught me the things I don't want to do when I become a CNM. Its taught me where I want to work when I'm done.

I wish I could tell you it gets better. I'm sure there are other places out there where I would be in heaven (a birth center comes to mind) but I'm in this for the short course and just until I finish with school which right now seems to be a million miles away.

I regret more often than not leaving my ER job and coming to OB, I really do. I've even contemplated multiple times calling my manger back and begging for my job.

But then I go to PP or to the nursery and I fall in love with why I'm there. I remember that when I'm off orientation (hopefully pretty soon) I can start to branch out on my own and start doing things my way (but still following our P&P). I even started taking a Lamaze class so I could better help my moms deal with labor pains before their epidural (or without an epidural). I went to nights because days made me crazy. Nights is a bit better cause there isn't an OB that actually WANTS to induce at night, so most are real honest labors and you have a bit more control over what goes on at night.

I tell no one at work about my desires to be a CNM because they don't understand. Why would I want to work with women and do low intervention births when you have the great advances of modern medicine???

Oh, I could go on and on and on, I really could.

Please, PM need if you need someone to vent with. I feel your pain!!!!

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Specializes in LDRP.

Wow, I feel for all of you guys.

Hang in there. You have more power than you think. Get through orientation. Establish a reputation as a reliable, competent labor nurse. Then, slowly start making changes. You need to have the respect and support of the docs and other nurses, so for the time being you do it their way. Then, slowly start tweaking here and there. She's on pit...on the monitor...on the birthing ball. :>)

What you will start to prove and they will start to notice is that labor goes faster and easier when your patient relaxes and has some control. And there is a way around anything....I had a doc once that wanted a tube in every orifice and refused to let a multip out of bed-even for the bathroom-after she was 5cm. So one day he pops in unexpectedly from the office and I have his gravida 4 in the bed-on the birthing ball. (I had it rigged so it was safe...you would have had to be there.lol ) :eek: He was SOOO mad...his face was red. But one fine day, he had a court appt. he had to be at and I told him I'd get the pt. delivered before he had to leave, but I had to do it my way. No questions. He agreed....I pulled it off. After that, we kind of had an understanding.

It's baby steps like that and countless others that gradually helped me make my way. Hang in there! And remember there are countless opportunities for learning-even when the situation is less than ideal.

Good luck! Shannon

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Gosh, you really are feeling the pain that aspiring midwives feel when working in the many frustrating birth settings available to women in the United States today. THat is why you need to go to School and become midwives. THe women need you, they need more options and we need more of you in the profession of midwifery. You are aspiring midwives who are being asked to practice obstetrics. THe lessons you learn in the settings will be valuable to your future. Hang in there as you move forward towards your goal.

Midwyf

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Specializes in L&D.

Ahhh Shannon...you and I think alike!!

To the original poster - you learn to do work within the system, just like what Shannon gave fine examples of. Learn as much as you can, find co-workers who think the way you do (even if it's on here!), and keep your passion for childbirth! Don't let the medicalized system get you down!

Believe it when I say this --- we CAN enact change from within the system!

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Specializes in Rural Health.
Gosh, you really are feeling the pain that aspiring midwives feel when working in the many frustrating birth settings available to women in the United States today. THat is why you need to go to School and become midwives. THe women need you, they need more options and we need more of you in the profession of midwifery. You are aspiring midwives who are being asked to practice obstetrics. THe lessons you learn in the settings will be valuable to your future. Hang in there as you move forward towards your goal.

Midwyf

Thanks, that was a wonderful pick me up tonight before I head off to work!!!!

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hey Mom2Micheal,

I actually called my old manager from the tele unit today and asked if I could have my job back. She said I could but wants me to think about it for a week.

I don't know what to do again.

I do love birth but not like this....I'm bored doing more charting than anything else.

Maybe I would be better off getting the critical care type of experience I was getting on tele and have that knowledge as a backup instead of pit, epi's and c-sections.

I'm still going to be a CNM when I grow up.

The birthing center that my preceptor works at is going to call me to be a birth assistant PRN.

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Specializes in Rural Health.
hey Mom2Micheal,

I actually called my old manager from the tele unit today and asked if I could have my job back. She said I could but wants me to think about it for a week.

I don't know what to do again.

I do love birth but not like this....I'm bored doing more charting than anything else.

Maybe I would be better off getting the critical care type of experience I was getting on tele and have that knowledge as a backup instead of pit, epi's and c-sections.

I'm still going to be a CNM when I grow up.

The birthing center that my preceptor works at is going to call me to be a birth assistant PRN.

What a tough decision to make.

You are gonna make an awesome CNM when you finish school!!! It's just getting to that point and not making yourself crazy, believe me, I know.

It's really OK to have Tele experience and Critical Care experience as a CNM. I actually think it will make you a very well rounded CNM.

And I think it's awesome you are going to be a birth assistant. Perhaps that is the balance you need.

I'm gonna try and stick it out a year. I don't know that I'll make it, but I'm going to give it a shot. I'm about to come off orientation which I think is going to help and when I come off orientation I'll be mainly PP/Nursery and the 2nd L&D nurse which is fine by me. I've also gone to nights, which has helped out TONS. It's a bit more relaxed on nights. No more endless line of Pit inductions, C-sections, etc...... I don't know that I'll make it the full year but I'm gonna at least try.

It's been tough though because my ER job is actually still open (she never found anyone to fill it) and they now have another ER job open and there is going to be some shifting around of staff so it might be even better hours/days than my previous job. It's been REALLY tempting to come back lately. I miss my coworkers, I miss the doctors and I miss the ER sometimes.

Good luck and keep me updated on what you decide to do!!!!!

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The more I think about going back to tele the better it sounds.

I was working straight nights over there and it wore me down emotionally and mentally. I have three kids at home so I rarely got enough sleep unless I hired someone to watch the kids.

My old boss said I could work straight weekend days if I want and I can work 75%. I think that would simplifiy my life as far as scheduling my study time goes.

The acuity has been really high there for the past few months and they have just changed their service line from med-surg to critical care.

Personally, I like the adrenaline rush of being busy, and that unit is definately busy!

In L&D I have to work 50-50 which makes it hard to fit in study time because for me, working nights takes a whole other day just to recover. I am useless when tired!

I feel guilty having wasted L&D's time, but I really am not happy there.

CPM's do just fine without hospital experience.

If I work weekend days @ 75% I can plan to study 8 hrs p/d X4 with one day off every other week.

I still need to get my NRP and I don't know if this hospital will let me do that if I'm not an L&D RN. The L&D unit required all RN's to get NRP certified at 6 months of hire. The birthing center requires it for all RN's. THAT is my real dillemma.

Any thoughts?

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Specializes in Rural Health.

It seems your mind is already made up about returning to Tele. Don't let the NRP class get in your way. Can you talk to education about maybe just paying for the NRP class yourself? Perhaps call the birth center and your preceptor/friend there and see if they have some suggestions on NRP. If money is an issue, put aside a bit each pay period until you have enough to take the class. Maybe pick up an extra shift before school starts to help pay for it. Surely there has to be a way to get the NRP class w/o being an L&D nurse.

My NRP class had maybe 2 L&D nurses, the rest of us were ER, Nursery, NICU, L&D PACU and RT. Very diverse group of people.........

The work schedule also seems to be a bit more conducive to your school/life schedule. Nothing wrong with that either. Nights work for some, others need days. If your manager is willing to let you do 75%, weekend days, then I would say go for it. It will be a pretty darn perfect schedule during school.

You start school in Jan. and you are in a for a very long, very wonderful journey. You need to be able to focus on that journey without the constant stress of work getting in the way.

Oh and don't feel guilty about anything. You are a month into it. You've tried it, it wasn't for you. No shame in that. L&D isn't for everyone thats for sure!!!

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