Don't know where my heart wants to go

[gikg]

Lately I have been having mixed feelings about where do I want to go as a nurse. Before going to nursing school I have always said that I wanted to be a labor and delivery nurse. Then my maternity rotation came and that changed. The nurse that I was pared with was not nice and just made that experience unpleasant. Then when I graduated I thought that I should not specialized myself in the beginning of my career so that I can be a nurse that knows more than just labor and delivery. So after working in a subacute facility I decided that I should try telemetry, since I always had a passion for the heart :)

I have been working on telemetry floor for the past 3 months. I don't feel completely happy there. I am not sure if is the hospital, the low pay, or just the fact that it is not labor and delivery.

I love pregnancies and labors. I want to learn everything about it. But I am not sure if this love is just because I have a dream to soon have a baby of my own or because i would really love to work in this environment.

Although I love to care for my patients and know that I made a difference in their day, I have noticed that I enjoyed the most when I am doing more of a administrative work.

When I was working in the subacute facility, I was the charge nurse. when we get admission, I had to enter all the orders in the system and assess the patient. Something, we had circulator nurses who could help either entering the orders or assessing the patient. I never wanted to assess the patients, I always wanted to be on the computer working on the orders and contact physicians.

How can I be sure of what I want? Should I try to make the move and completely change my career from telemetry to labor and delivery nurse? How can I make myself decreed to the L&D manager since I do not have any experience in that area?

[cayenne06, MSN, CNM]

I am sorry you had a negative experience in your MB rotation:( would your hospital let you shadow in L&D for a shift? It's really hard to know if you would like it without getting more experience. I adore obgyn, and it's all I've ever done. But I definitely hear lots of nurses who *think* they would love it, because omg cute squishy noobs and happy families. But the reality of L&D can be pretty rough. Acuity can change on a dime, and because of the nature of the field you're often left to manage an e emergent event until the provider can get there, which requires confidence, quick thinking, and very good assessment skills.

[HouTx, BSN, MSN, EdD]

There are good and not-so-good aspects to any clinical area. Unless we have actually experienced an area from the inside, our understanding is very superficial. It's natural to associate OB with 'happy baby' outcomes, unicorns & sparkly rainbows.... until you have had to cope with a terrible outcome. Based on my own experience, OB & ED are the two areas in which physicians are pushing more and more responsibility onto nurses and the resulting scope of practice issues & liability exposure for nurses has become very scary.

You're still very early into launching your career. It's probably more comfortable to work with predictable and controllable tasks like paperwork. Patient care is not predictable at all. They make unreasonable demands. You have to cope with a continuous avalanche of new information and 'stuff' to do. But, as time goes on you will become much more skilled and confident. Eventually, you'll probably be the one helping and encouraging new nurses. Give it some time. There are no perfect jobs.

[cayenne06, MSN, CNM]

Based on my own experience, OB & ED are the two areas in which physicians are pushing more and more responsibility onto nurses and the resulting scope of practice issues & liability exposure for nurses has become very scary.

Very true. Nothing like a cord prolapse at 3am in a tiny rural community hospital, counting the minutes until the OR team arrives. Or the massive postpartum hemorrhage that happens 45 minutes after the midwife/OB has packed up and left. Or the previously stable newborn who starts circling the drain, with only a scared ED doc to give orders while we wait the 30 minutes for the pediatrician to get on site.