I continue to have a very hard time in my labor and delivery orientation. It was extended an extra month, which I was happy about-the way the manager explained it, I wasn't being punished, I just needed extra time. Then when I talked to the educator I was told I would be fired at the end of the month if I didn't start to 'get it'. As far as I know this is not true, it's a union hospital and I'd probably be put into the postpartum unit-which is starting to look better every day!
Anyway, my last day at work we had a pt that had thin mec so the NICU team was there for the birth, the baby nurse was also there and my preceptor and I. Since the baby nurse didn't have anything to do she told the doctor she would be his assistant. The birth was quite bloody-shooting across the room with a bad labial tear. After the birth, I gave the doctor sutures, gave the pt an IM injection of pitocin for the bleeding and was getting the baby bands ready, meanwhile the baby nurse was massaging the pt's uterus. I realize that this was my pt but I saw her massaging the uterus-something I hadn't done in that situation before and felt grateful that someone who knew what they were doing was being so helpful. Well, of course, the baby nurse calls me over and says 'what are you doing?! baby bands are your last priority! You should be massaging the uterus!'
I feel like I can't win, would everyone else have known that the baby nurse wasn't there to help at that point? Am I that dense? She immediately told my preceptor and I am sure has also told the educator. How do I handle this? I just don't get the politics or maybe I am just a bad nurse. Any advice for when the educator confronts me?
I was in exactly the same situation 7 months ago. When I had originally started my orientation I thought my preceptor was great, friendly, a really nice person. By the end of it I would cry every morning on my way home. I could do nothing right, I would work my a** off all night long and she would mention the one thing I forgot "you were 15 minutes late on a temp". She got to the point where she was downright hostile towards me and would sit around with little sticky notes making notes about what I was doing wrong. They ended up extending my orientation (my preceptor never mentioned it to me I had to find out from my manager) and when I finally met with my manager about it she was just rude and condescending to me when she had always been friendly. I didn't get it at the time, but I just didn't pass their 'tests' and so there was no way I'd ever make it. I've come to find out that this unit has a horrible reputation as being hugely clicky and rude. They never even fired me, the manager just never scheduled me for another shift and never even called me.
Looking back this was the best thing that could've happened to me. I found a job at another hospital, in L&D. I was a little nervous, my confidence was at an all time low. My first couple of days of orientation my preceptor asked me a bunch of questions about what would you do if... what does this mean... would you do this. I answered everything correct and she told me that even some of the experienced nurses would've answered some of those questions wrong. She looked at me and said "yeah, you'll do just fine here". It was such a relief I started crying. I really thought I would never be able to work in L&D, but now I'm at a hospital where they're supportive of me, they don't mind my questions and in fact, encourage them. I've been able to switch to a 36 hr/wk pool position (which wasn't offered at my last hospital) I"m able to pick up extra shifts if I want to. I've found that at some hospitals L&D nurses are not only competetive, they are just mean and nasty. It may not be you, it may just be the nurses you're working with. If they feel like you won't make it (for their standards or for their personal reasons) they'll cut you from the herd and feed you to the wolves. Find a hospital where you're appreciated and where you don't have to leave crying everyday, life is too short to work in that environment.
I would look at yourself and ask, do YOU think you're "getting it"? Do you feel like you know your stuff but aren't getting a chance to prove it? If so, be assertive and ask for constructive input about your performance. If you can't get it, maybe this unit is just not a good fit for you. Try another one, or another area if you don't feel like L&D is it.
Nursing has too many options to put up with this rubbish. And life is definitely too short to be miserable every time you go to work.
I just finished my L&D rotation (I'm still a student), and it was so different than what you are experiencing. I agree with the other posters that teaching and instructing are what is called for, not yelling and demeaning. Your preceptor's behavior is inappropriate. When I read posts like yours, I am even more grateful for the wonderful clinical instructor I had, and for the kind and helpful nurses I worked with. And believe me, I goofed things up, like not doing vitals at the right times, forgetting a few things in assessments of mom and baby. They would gently remind me, and send me back to finish the job properly. I think the most important aspect of what I experienced in my L&D rotation was the sense of confidence I gained by working with these nurses. They trusted me, and so I made sure to live up to their expectations.
So. My point is this- some people should not be instructors or preceptors. I also think you should look into working with someone else. Best wishes to you, and keep us posted.
After 27 years in OB - mostly L&D or Hospital Birthing Centers where an RN does all areas as she is primary nurse for the "family", I can tell you this with a fair amount of confidence. L&D is extremely competitive. I'm wondering if all ICU areas are like that. After all, we, as L&D nurses are dealing (literally) with life and death every single time we care for a mother and her infant. While at one of my jobs, the House Nursing Supervisor for Night shift gave me an article called 'How to Swim with Sharks". I've never forgotten that. She is my friend to this day.
I am sorry to say that even in clinics, the nasty behavior of some other nurses is embarrassing. I've never really worked with men very much, but after working for the last 45 years in different areas - almost always with mostly women, I am ashamed of the behavior I see.
All I can do is try very hard NOT to be like the others. Not to judge immediately, to give everyone a chance and to let the ones who just aren't "getting it" that they are being seen that way and ask if I can help in any way.
Sometimes you need to take conrol of your own experience. Don't take it the wrong way but, you should NOT have been doing the baby bands, if you are orienting to L&D you need to find every experience that you can-filling out baby bands is not a learning opportunity. As a preceptor, I find it exhausting when I am constantly having to tell my orientee to redirect their attention to the learning opportunity going on at that time. If you seek the learning experiences and actively seek out new procedures, new things you haven't seen, etc you will do great but there are times when the preceptor will not direct you to what you could learn from.
Specializes in Cardiac, stroke, telemetry,Med-surgical.
I've been there and done that. To be in a situation where it's a no win situation all the time is probably the most frustrating, heartbreaking situation to be in. I cried every single day I was on my L&D orientation. Nothing I ever did was good enough, in the right order or up to the standards of "them". And I understand, you can't win for losing.....I've been there......if you would've done the fundal massage then they would've been yelling at you because the bands weren't done. I know......
I quit my toxic work environment job and went to another facility that is so incredibly supportive it's the complete opposite side of the pendulum - it's so wonderful.
Try talking to your preceptor about it, your nurse manager about, the educator about it. Talk to someone. Tell them how you feel. If they aren't willing to be supportive then you have basically two choices, suck it up and deal with it or quit. Only you can decide what is best for you.
Good luck!!!!
Agree.
You definitely should talk to your manager and preceptor. Explain your side of story.
I have only one question to ask you. Was it your first time with post-hemorrhage and fundal massage? Did someone explain/show you how to perform it and told you that it is your responsibility to do it?
Specializes in Cardiac, stroke, telemetry,Med-surgical.
I remember my preceptorship on L&D floor and how I was overwhelmed by all information, different procedures and actions performed by different nurses that suddenly filled the room at the very last moment of delivery. I was trying to see, hear, and learn everything stimultaniously, and understand who is responsible for what and what is my responsibilities and priorities. No one explained anything to me. I was told to stay and watch. Of course, I understood that it was not a good time for teaching and therefore I tried not to intrude or interrupt their work but to watch as much as I could and memorize and analyze.
Anyway, I think that the very last minutes of delivery (and any emergency situation as well) when it seems that everything happens simultaneosly is a very tense and chaotic time and one should know one's role and place realy well so to not interrupt someone else actions. And I do understand you. Talk to them. Or I would say they are not very good teachers.
It sounds like your unit is very unsupportive. If the nurse said she was going to be his assistant it was fitting that she was helping him by massaging the uterus. Although, it would have been good for you to be involved in that sort of situation instead of standing back filling out bands. That ways you could prepare yourself for situations like that in the future. It is important to show initiative in situations like that to show you are able to jump in during emergencies and do what needs to be done. I dont understand why should would have to tell your preceptor, whey was your preceptor not in the room during the delivery and after to help teach you how to respond. There is a lot to learn during orientation to L&D and it is important that your preceptor is there to teach you. It is also just as important for you to seek out those learning opporutnities and make the most of the ones you are given. Because if you make it off orientation there will likely come a day when you are in the room without someone to help you and will need to know how to respond. Do not get discouraged by their negative comments but use them as incentive to show them that you really can do it and become a successful L&D nurse. I seemed to have the opposite problem on my orientation. I had completed my practicum at a hospital that had very complicated pts and high risk deliveries so I felt well prepared after graduation. I moved and the hospital I work for now treats pts with complicated conditions, but we do not have ICU level pts laboring. My preceptor told my nurse manager that I was difficult to teach because I seemed to know everything already. It made it somewhat difficult for me as well because I knew a lot of the basics, but I needed to learn how to be a nurse not a student nurse and to make decisions for myself. The nurses tried to release me too quickly because I caught on and I felt somewhat robbed from my orientation. I feel comfortable taking care patients now, but I was somewhat overwhelmed right after I got off orientation.
You have to really love what you do to be a good L&D nurse. You have to jump in and act quickly in situations. Dont be afraid to ask questions, because that is the only way you will learn. But do not stand back during your orientation. Take full advantage of that time and try to get as many experiences in as possible while you have someone there to 'hold your hand' through it all. If you have not already transferred into postpartum, go back to your unit and tell your preceptor you are willing to do anything and work your booty off to prove it.
Oh my gosh, I'm right there with you. I've been on orientation for 6 shifts now (7a-7p) and yesterday my preceptor, gave me all of her patients except 1. I had 3 and a new admit. She is charging so she only had 5. She also wrote all of the room numbers of my patients next to her name on the assignment board like she was covering them. The nerve! :) She's foreign and has an accent nobody can understand. She's very rude to me and I've heard a patient complaining about how short she is with her. She's rude to the other nurses as well. They have the option to ignore/avoid her though. I have to try to learn as much as I can from her and make her happy so that at the end of my orientation I don't get a bad report. Not to mention the fact that I will have to continue to work with her in the future and I have to consider that kind of future tension as well. Only problem is, she isn't a caring nurturer. It seems like to me, she waits till I really mess something up and then she lets me have it, followed by a loud exasperated sigh and occasionally an eyeroll too. Sometimes she just shakes her head and walks away. Or she gets irritated with me because I'm not doing something right or not doing it at all because I don't know I'm supposed to be doing it and she'll take the chart/procedure/etc away from me and do it herself. I've started keeping a box of kleenex in the car for the ride home because it's when I do all my bawling. I'm wondering how to handle this. Ask for a different preceptor? Will that make me seem like I'm gonna be a problem child before I've even started? (not to mention the wrath I'll incur from her) I'm thinking next time I'll put my foot down and say I'm only taking 1 or 2 patients because I need to develop a routine and I can't if I'm on overload. There is another LPN who is just starting there as well and everybody talks about how slow she is and how she's driving them crazy. Poor thing had a rapid response with one of her patients the other day and then she started having crushing chest pain and she had to be admitted (but not until she finished her shift, she refused to leave and put the other nurses in a lurch - isn't that sad?). Now they are moving her over to the SNF because it will be 'easier' for her since she can't handle med surg. I don't want to be that nurse but I'm the new one and I figure I should just resign myself to the fact that they will say the same things about me I guess. Perhaps I can just stick it out till the next new nurse comes along...pretty bleak for a new job, I'm glad most of you say it gets better. I'm looking forward to that.
Why was Miss fundal massage even there? Too be a star??? Or, was she low on 'drama'? Where on earth was your preceptor? She should have been with you and mom in a situation like that. And like others suggested, fundal massage does not go with a labial tear. Don't let them get to you, but prepare for other options. A more supportive atmosphere.
PS Post partum is high stress too nowadays. And your 'star' baby nurse works there.
I'm right there with you too. I became a nurse just so I could do L&D. I have been absolutely dismayed at how competitive and judgmental nurses in this area can be. I have spent some time in med-surg as well. While I really dislike med-surg nursing, the work environment was MUCH better. I am still holding out hope that I'll find an OB job where nurses actually treat each other well.
All I can tell you is to make sure you work very hard to show how committed you are, and communicate (if you can) what you perceive is happening. Hang in there!
I'm a little late to this thread party so hopefully by now you have your situation all fixed but I agree with some of the previous posters - why was the baby nurse doing that instead of nicely telling you that you should do it?
I mean.. in my mind the baby nurse's job should be focused on the baby .. so she could conceivably be doing the baby bands and since it seems like she knew you were new, she could have just gone up to you and been like "here i'll do these, but maybe you can help dr. so and so with the massage." that way you learn without feeling stupid. uughh i hate nurses like your baby nurse!
Also, I know how you feel. I'm a new grad new l&d nurse too and im only on my 7th month and sometimes when things go super crazy and scary my mind literally shuts down and i'm like okay.. i'll do what I know how to do. In your case it was baby bands .. but in a few months when you have more training and more experience it will be fundal massage.. and then in a few more months it will be something else. It's not your fault that you defaulted to baby bands .. it was the safe thing at the time... It's like that whole Patricia Benners novice to experet learning model.. we're still novices so we are focused on tasks rather than the big picture. . . it happens. We'll get the bigger picture someday. :)
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Calzonan RN
515 Posts
I was in exactly the same situation 7 months ago. When I had originally started my orientation I thought my preceptor was great, friendly, a really nice person. By the end of it I would cry every morning on my way home. I could do nothing right, I would work my a** off all night long and she would mention the one thing I forgot "you were 15 minutes late on a temp". She got to the point where she was downright hostile towards me and would sit around with little sticky notes making notes about what I was doing wrong. They ended up extending my orientation (my preceptor never mentioned it to me I had to find out from my manager) and when I finally met with my manager about it she was just rude and condescending to me when she had always been friendly. I didn't get it at the time, but I just didn't pass their 'tests' and so there was no way I'd ever make it. I've come to find out that this unit has a horrible reputation as being hugely clicky and rude. They never even fired me, the manager just never scheduled me for another shift and never even called me.
Looking back this was the best thing that could've happened to me. I found a job at another hospital, in L&D. I was a little nervous, my confidence was at an all time low. My first couple of days of orientation my preceptor asked me a bunch of questions about what would you do if... what does this mean... would you do this. I answered everything correct and she told me that even some of the experienced nurses would've answered some of those questions wrong. She looked at me and said "yeah, you'll do just fine here". It was such a relief I started crying. I really thought I would never be able to work in L&D, but now I'm at a hospital where they're supportive of me, they don't mind my questions and in fact, encourage them. I've been able to switch to a 36 hr/wk pool position (which wasn't offered at my last hospital) I"m able to pick up extra shifts if I want to. I've found that at some hospitals L&D nurses are not only competetive, they are just mean and nasty. It may not be you, it may just be the nurses you're working with. If they feel like you won't make it (for their standards or for their personal reasons) they'll cut you from the herd and feed you to the wolves. Find a hospital where you're appreciated and where you don't have to leave crying everyday, life is too short to work in that environment.
Take care and keep us updated,