L&D Nurse Off Orientation.. Help!

[NewLDRN11]

Hi AllNurses,

As the title says, I am a brand new RN who will be starting shifts on my own this week.... And I am TERRIFIED!

I had orientation for 3 months where 2 months were with a preceptor. I loved loved LOVED my preceptor! He was so supportive. By the end of my orientation, I was mostly independent. Where I was lacking was practicing more communication with charge nurse and OB. So naturally, those are areas where I don't feel confident (when should I call for delivery, at what point do I call for fetal HR decels...). Also sometimes I have a hard time tracing the FHR with the ultrasound (especially while pushing..)

Anyways, just looking for any words of wisdom! I feel the anxiety creeping up already....

[adventure_rn, MSN, NP]

Congrats on completing your orientation! You'll likely get more OB-specific responses (i.e. when to call in those specific situations) on the OB forums rather than the new-grad forums.

That said, you can never go wrong asking for a second set of eyes. In my humble opinion, you're always better off asking for help when it's a false alarm than missing a patient who is decompensating because you were too nervous to ask for help. You can ask the charge nurse, or any another nurse you trust who has some downtime (i.e. anybody who is just sitting at the nurse's station, your hallmates if they aren't right in the middle of doing something, etc.) Part of the charge nurse role is to be a resource in these types of situations. I've worked in units where we'd always touch base with the charge nurse before contacting a provider; the charge nurse could help triage whether or not it was worth notifying a provider, and if it was important enough to notify the provider, then the charge nurse needed to know about it, anyway. People understand that you're new (because we were all new once), and hopefully they'll be more than happy to help you out.

As for communicating with the OB, I know it sounds cliched, but go back to SBAR. Before you make the call, think through what you want to say. Have any pertinent lab values pulled up or written down, and know what you'd like to ask for (orders, meds, having them come to evaluate). You'll feel more confident as you begin to build a rapport with the providers. Going back to my last advice: if you check in with the charge nurse and s/he feels that it's worth notifying the provider, have confidence and stick to your guns. The provider may just say, 'great, thanks for letting me know, just continue to monitor,' and that's ok.