I am in week 4 of my preceptor/new grad orientation on L & D. My experience has been rough. I spent two weeks with a preceptor who disliked precepting and refused to answer questions. She would become frustrated with me and then ignore me in the room and take over. (Admittedly, I had no idea what I was doing or what was expected of me.) She stopped long enough to chide me but never to instruct. An example would be she wanted me to change the BP cuff to auto q 15 minutes. I had never used the machine and couldn't figure it out. She later sent me to an empty room to "figure it out." I asked for a manual for the machine and she said there wasn't one. She refused to go with me and also told me to become familiar with the items in the room. Later, she asked for a patient O2 mask. I could locate it but then she wanted me to connect the water to the wall and then the mask to the water. Again, no one had showed me how to do this simple task. I couldn't do it fast enough. She became angry and then I was an observer in the room; She took over. After two weeks of her complaining about my inabilities (What did you learn in school?), I told the manager that this relationship did not seem healthy for either of us and could I have another preceptor. I was transferred to a second preceptor while my permanent preceptor was being trained in PBDS.
My second preceptor, one week, was great. She taught. Gave me my first tour of the birth room and demonstrated how to use every piece of equipment. She was patient with my questions and never discouraged them. She allowed me to function independently until she saw me ask and she would assist me in finding the answer or take over when it was no longer safe (my first crash csection).
My third preceptor is so nice. I really like her as a person, but I am lost, again. I feel like it must be me. How can I have another preceptor who is a bit frustrated with me unless it is me? Again, I really like her. She is a nice person, but I feel like she is letting me fail with no clear parameters. For example, I had told her I didn't know how to manage 2nd stage and I was unclear about when to page the Dr., Peds, Birth table set up, ect. . . Last night, during 2nd stage, I didn't page the Dr. I was waiting for her to tell me when to do that, because I had already stated that I was unclear about this stage. Instead, she said nothing and baby was born w/o a Dr./CNM on the bed, because I didn't page anyone. Mom was a multip and making minor grunting noises but I was waiting to be told to page or at least asked if I should.
Previously, she has told me that she finds me challenging because of my constant questions. So I am stuck. I can't ask questions but I am supposed to know intuitively answers. Lastly, she never stated that I was the primary nurse for 2nd stage. I guess we were both waiting for each other.
Can someone help me with practical suggestions for 2nd stage or a book or something? I am a previous doula with over 100 births as a doula. This is a hospital that I precepted at and have volunteered as a doula for 5 years now. I graduated with a BSN with a 4.0 and I am so defeated and lost. I knew being a new grad would be difficult but I felt I was reasonably intelligent and it would all work out. Now I don't know and lack any confidence I had when I started.
Just to fill in some more details. Patient at last check was 6 cm and never had a subsequent check. I have not been taught cervical exams and really they seldom do them at this hospital. She never made an all out pushing noise (I know what that sounds like) but two briefs moments I thought she grunted. This is a hi risk L & D. Mom was also GDM and spanish speaking only. I was a little lost because I wanted to ask her if she felt like pushing but was a little tongue tied. I will have some time to talk to my preceptor tonight I hope and at least establish some communication guidelines. Thanks for everyone's help.
SpudID--
Hang in there! I'm only a few months into my orientation too but I had an idea that might help you w/ the Spanish speaking patients. I speak Spanish as does my preceptor so we get most of our Spanish deliveries. Even though I speak Spanish, I never knew this little trick until my preceptor taught it to me at the beginning of training. Hispanic patients have the tendency to hang out in the bed quietly making progress and before you know it you will have a nurse delivery if you're not really observant to what they are saying. If you ever hear the phrase "No aguanto" (which sounds a lot like "I DON'T WANT TO") it means you're going to deliver a baby in about 10 minutes so hop to getting a doctor, help, a table..anything! It never fails and once you remember this key phrase you'll smile a little every time you hear it b/c you've been clued in like it's the kitchen timer saying the cake is done! Happy learning...you'll get the hang of it soon.
Hispanic patients have the tendency to hang out in the bed quietly making progress and before you know it you will have a nurse delivery if you're not really observant to what they are saying.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Being a new graduate is so hard. (what an understatement). I remember my first job out of school, nearly 9 years ago, and I can honestly say, a couple of people actually tried to sabotage my efforts and put me in some very awkward positions ----and I nearly quit.
Be patient w/yourself. Also, if people are not training you, ask them why. Like one poster before me said, remind them you are going to be on their team and you will be no good to them, unable to do your job or lacking the ability to jump in during extremely busy or crisis times. They will ONLY have as good a coworker/team member as THEY HELP YOU TO BE. And they are actually sabotaging THEMSELVES when they don't help you learn and grow. I had to tell these people that back when I was in my new job. I remember getting stomach aches and diarrhea before my shifts---that was how bad it was. A few really did their best to make me miserable and feel unwanted there.
I did decide at some point, I was NOT going to quit---that I was meant to be an OB nurse, and by hook or crook, that was what I would do. Once these people saw my determination, and once I told them the above, they slowly began to change their attitudes and work with me. Heck, a couple became friends, if you can believe that.
Be patient with yourself. The learning curve in ANY nursing position is very steep. NO reasonable person, doctor or nurse, expects you to be an expert at your job at this point. Know who the mentors are around you and go to them when you have doubts or questions.
DO NOT be afraid to ask when you are unsure of anything. I can tell you, after 9 years' experience, I still very frequently, "bounce things off" my coworkers to see if I am on the right track or correct in what I am doing. I never have pretended to know what I don't----I always ask. Heck the other day, I had a coworker check a cervix behind me; I was simply unsure what I was feeling there. I am never too experienced or to knowledgeable to seek a second opinion, simple as that.
That all said, my friend, EXPERIENCE is your best teacher in staff nursing, as a new graduate. You just have to experience things to know them-----you don't know what you don't know (cliche but true). Don't be afraid to get in there and "do". It will take time, but you will get it after a while.
As I see it, this is about a lot more than "second stage of labor management", but the learning curve you are on and the frustrations you are experiencing along the way. If NO ONE is willing to mentor or help you on your way, you might ask yourself if this is the place you want to work, truly. You deserve better, if things are that bad.
HANG IN THERE. If I were working with you, I would be more than happy to take you "under my wing" and help you along your way. Try to find one who feels as I do and learn all you can from him/her. (((Hugs)))
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
You can't be serious.
She is serious. And she is right, in many cases. (although I hear "no puedo" more often than anything----meaning "I can't". They can mean "I can't stop" when they say this as often as they mean "I can't stand it". Watch out!
NO, we can't generalize about any population, but in 9 years of working with so many different cultural groups, this is true. Many different groups tend to stoicism so amazing, that you may miss cues that a baby is about to deliver NOW---if you don't know these things about them. I have seen many hispanic and asian women just "go along" only to grunt a bit and BAM that is it---baby is here. It helps to watch their faces and body language for cues that things are progressing quickly. You can't always rely on what they say or any emotional display----cause everyone is very different.
I have to say that I have seen many hispanic pt's be very stoic, but I have also seen many that are borderline out of control. Ya just never know; I really hate not being able to speak fluent spanish. It kills me to not be able to communicate with those pt's effectively.
But, I had a spanish-speaking pt last night for Cervidil and you better believe I kept close tabs on her! I sure didn't want to walk in and find a baby in the bed. She didn't deliver on my shift.
I can't believe after reading your post that anyone can treat another nurse like this. Like one of the posts mentioned, do they not realize that you are going to be part of their team and need to help rather than hinder you? Sounds to me like you have second stage down. You had a gut feeling someone needed to be called when you heard the grunting, you were just waiting for some direction since you weren't the primary nurse. I'm sorry to hear this has been your experience, but one good thing is going to come from this. You will more than likely be a very good preceptor in the future. You will probably be very understanding to new nurses trying to learn because of what you have had to endure.
ERNurse752, RN
1,323 Posts
Glad you're feeling a little better...keep us posted on how things go, and I hope things get better soon!