another update..

Trauma Columnist · Aug 25, 2002

Hang in there Amanda - it does get easier. Are you finished with orientation? Perhaps you could ask your preceptor or a nurse you admire what they do to stay organized? As to the OB nursing job - I firmly believe things work out in the end, so learn the medical nursing side and be the best you can be and then reapply for the OB nursing job. Good luck...judi

JailRN · Aug 25, 2002

(((((((HUGS AMANDA)))))))

keep plucking away ans soon, you'll get what you want.

spineCNOR · Aug 25, 2002

Bless your heart! I sympathise with your disapointment over not getting the job you wanted, but hang in there. Another opportunity, and maybe even a better opportunity, will come along when the time is right.

And as for the comments from your nurse manager--she should be able to offer you coaching as well as criticism--has she given you any constructive advice on how you can meet her objectives? If not, consider approaching her to ask for guidance.

traumaRUS is right--it would be good to seek help from your preceptor or a nurse on your floor that you admire.

IMHO it takes a good year for most most new grads to feel comfortable (yes, probably even your manager), so be patient with yourself. Even though you may not be where you want to be right now, you are still gaining valuable knowledge and experience. If you work OB in the future you will be better able to take care of patients with medical problems- asthma, diabetes, etc- than nurses who have never worked anything but OB!

Best wishes!

Brownms46 · Aug 25, 2002

I'm very sorry you didn't get the position...but truly believe...you should continue to hold onto your dream...and never let it go.

Now as for the handling the 12 pts! :eek: I totally feel 12 is waaaaaaay too many pts...and I don't care if you have the best LPN out there helping you! I have worked as an LPN with an RN, and we worked our buns off with just 6-7pts! And I was working with long time experienced nurses! That is just waaaaaay too many folks. Six by yourself...maybe...but even an experience nurse needs help...sometimes if you have a very demanding pt...who may have a lot going on with them. But 12 pts..Lord...I would be looking for a better place to get my feet wet. But I hope you will soon....get the position you wish...and leave those 12 pts behind.. :cool:

P_RN, ADN, RN · Aug 25, 2002

Pretty soon you will turn around and realize that YOU are the experienced one. It will just "click" one day.

indynurse · Aug 25, 2002

When I was a new grad it took me a while to find a way to organize myself for the shift. Even when you do have a "system" some days even the best organizational system won't cut it. When I worked med-surg, I had a paper that I had drawn vertical and horizontal lines on to make boxes. At the top of each column I wrote the hours of the shift (0800/0900/1000, etc...) and to the left of each row I would put the pt room number. Then, as soon as I got out of report I would check all of my med sheets and Kardexes for times meds or when treatments were due. As I gave the med or did the tx, I would mark a line thru it on my cheat sheet. The boxes were also big enough for me to make a quick note if I didn't have time to chart something in the moment or if I got a new order. It wasn't a perfect system, but I found if I could take 5 minutes at the beginning of the shift to organize this, I could glance at my clipboard at the top of the hour to see what I needed to get done that hour. I worked with another nurse who has a clipboard that has storage. She keeps extra pens, highlighter, commonly used phone numbers and some quick reference type info in there.

When I work post-partum I use the system I used in med-surg. When I work L&D, I usually only have one or two pts. Then I use index cards and have a separate card for each pt and keep the cards in my pocket. I find this just works better because each pt has a clipboard with their flowsheet on it and having yet another clipboard to keep track of would not be as easy as keeping a couple of cards in my pocket.

I totally agree with spineCNOR. I think the experience you are getting on a medical unit will be a major asset when you do finally get that OB job you desire. While the vast majority of OB patients are healthy and young, you will get pts with chronic medical conditions. And many of your assessment skills on a medical unit can apply to an OB pt. Our pts can get pitting edema, need neuro checks, develop DVT's or PE's. Think of this time on the medical unit as a means to your goal. Also, keep up with OB issues. Know what HELLP syndrome, GIDDM and PIH are and how they are managed. The next time you interview for an OB job, show the interviewer what you have learned and how the skills you have obtained in your current position will apply to your new job on OB.

Good Luck!

Love-A-Nurse · Aug 26, 2002

hi, amanda! keep your spirits high and you will get where you want to be. all the best to you!

Anaclaire · Aug 26, 2002

I'd say you've received some excellent input from the wonderful people on this thread!

I know you are disappointed about not getting the job you wanted. I firmly believe that everything happens when it should... don't force things... if you know what I mean.

I agree that the first 3 months after graduating is full of disorganization and feelings of being overwhelmed. The cheat sheet idea is excellent! I've always developed some sort of one everywhere I worked. Can't survive without it! After about 6 months, you should notice that you don't feel so overwhelmed... you're still running around and confused at times but not as much as before. By the time 9 to 12 months has passed, you'll have a good routine that works for you and you'll feel close to comfortable. EVERY job is like that after just graduating. Moving from one area to another will be difficult for the first 3-6 months too, but not nearly as bad as it is for you now. Just think... you've actually made it through the worst part!

As far as working in the OB/Nursery/L&D areas... that's my specialty... the Mother-Baby Unit and NICU. In order for you to be a "stronger candidate" for the next position you apply for, you can start now to make yourself into the candidate that your next manager wants. You can think to yourself, "What would a manager want to see on my application/resume that would cause her/him to hire me?"

One suggestion is to receive CEUs in the OB/Nursery areas. You could subscribe to journals of those specialties and do the CEUs and send them in for credit. Then, you can show the prospective manager all your records of the extra education you've done. You can also put on your application that you are a member of some of these specialty organizations if you want to fork out the money. Can be expensive, but well worth it in my opinion.

Most importantly, make yourself a very good med/surg nurse while you have the opportunity. Study well and work hard at learning to organize your care. It's very true that you'll find a gazillion OB patients with med/surg problems. I can't tell you how many Moms I've cared for who also had diabetes, high blood pressure, gallstones, kidney stones, broken hips and legs, strokes, morbid obesity, asthma, mental illness, paraplegia, blindness, deafness, ulcers, needed central lines, have horrendous nausea and vomiting, malnutrition, drug and substance abuse, were released from jail to deliver their baby and going back right after discharge, etc. The list goes on and on. As you can imagine, ALL KINDS OF PEOPLE GET PREGNANT.

Take this time and learn all you can. Take advantage of the med/surg unit... soak it all up... because you will be a MUCH STRONGER nurse as an OB or Nursery or L&D nurse, for sure!!! You'll be able to share your knowledge with the nurses you will eventually work with and they will adore you for it!

Let me suggest some web sites to learn more about the specialties of Maternal-Child nursing. Maternal Child is basically broken down into Labor & Delivery, Post-Partum, Ante-Partum, Well Baby Nursery, Mother-Baby (which often includes post-partum and well babies along with a few stable ante-partums), and Intensive Care Nurseries. Level I Nurseries are basically well baby nurseries. Level II Nurseries are special care nurseries where there are mostly "growers and feeders" and a place to care for stable, older preemies. Level III Nurseries are the Intensive Care Nurseries where there are micropreemies, ventillators, ECMO, surgeries, as well as complicated older babies. They often have their own special care nurseries of growers and feeders too. Many Maternal-Child areas include Gynecological floors which are places for adult women... lots of hysterectomies, breast problems, etc. Lots of med/surg type stuff and loads of emotional care for women. Pediatrics is also included in a Maternal Child Division and that would include the Pediatric Intensive Care Unit.

Here are some websites:

LETS BEGIN WITH AWHONN: It is the favorite of all the L&D nurses I know. It is pronounced "A-waan"...

AWHONN "Association of Women's Health, Obstetric and Neonatal Nurses"

This is their main web site. They produce the journal "JOGNN" which stands for "Journal of Obstetric, Gynecological and Neonatal Nursing".

JOGNN web site

NOW FOR THE ONES NEONATAL NURSES ENJOY:

Neonatal Network is the journal of the Academy of Neonatal Nurses (ANN). It used to be the journal of NANN (National Association of Neonatal Nurses). Now NANN has their own journal (started this year) called "Advances in Neonatal Care". The Academy of Neonatal Nurses is a new association of about one year ago. I'm a member of both and will continue to be.

Neonatal Network Journal page

You'll also find on the Neonatal Network site that they publish a journal just for Mother-Baby nurses titled "Mother-Baby Journal". MOTHER-BABY JOURNAL IS THE FAVORITE OF THE POSTPARTUM, WELL BABY NURSERY, AND MOTHER-BABY NURSES I KNOW. I subscribed to it when I was a Mother-Baby nurse and enjoyed it very much.

Here is the links to NANN. NANN has been the specialty organization of Neonatal Nurses for many years... 20 or so I think...

NANN National Association of Neonatal Nurses

A SUGGESTION FOR EARNING CEUs IN THE AREAS OF NICU, WELL BABY, L&D, AND GYNECOLOGICAL NURSING:

There is a web site for "NCC" which is the National Certification Corporation. They are one of the places a person can obtain certification in a specialty after demonstrating years of practice (2 years of full time work) and passing a test. Whereas passing your NCLEX shows you have minimum competency in nursing... like passing the test with a "C", passing a certification test is like taking a test in a special area and making an "A" on it.

Anyway, you don't have to have your credentials to buy continuing education materials from them. They are EXCELLENT materials for learning about Maternal-Child topics. I have received my certification as a High Risk Neonatal Nurse. There are other certification tests a person can take too. It's an eye-opening site. The following link takes you straight to their online store for continuing education, but you can contact them and order by mail if you want.

NCC "National Certification Corporation" continuing education page http://www.nccnet.org/store

Their main web site is http://www.nccnet.org

I hope this hasn't been too much information for you. In the end, I'm just suggesting you think up ways to make your application look better than anyone else's applying for the job you want. You need to sell yourself to them... For instance, if your prospective employer sees that you have a FULL YEAR OF MED/SURG experience, that you SUBSCRIBE TO MED/SURG JOURNALS AS WELL AS MATERNAL CHILD AREA JOURNALS, and that you HAVE CEU credits that you did BECAUSE you WANTED TO rather than you HAD TO, they will look at you and say, "She is up to date in her own area of med/surg with CEUs and journals in that area along with a year's experience, AND she is interested enough in our L&D/OB/Nursery area that she has subscribed to our type of journals and did CEUs on her own... she is very interested in our area and should be knowledgeable book-wise too... we should hire this one and not let her get away!!! She sounds like the type of person who would stimulate our unit too!"

I know it will come true for you. Have patients and work slowly toward your goal... just like in nursing school... you WILL succeed!!!

Warmly,

Anaclaire

:kiss