How fast is too fast?

[sweetcheekers]

I began orientation to L & D this week after being a mom/babe nurse for the last 15 months. I was reluctant to learn this new role because I work in a small hospital on night shift which usually has only two nurses in OB, one L&D RN and one mom/babe RN. Occasionally both nurses are L & D trained, but not often. Anyway, I was worried about becoming a L&D nurse and then being "on my own" at night as a newer nurse, and not having any back up to rely on. I feel very anxious that this orientation is going to be rushed due to the fact that now, on my shifts we are going to have no L & D nurse because she took a weekend package shift. So next month, we'll have to fill those hours with PRN staff. I know this will get old and fear that I will pushed into taking those L & D hours so they are covered and meanwhile they will put a new nurse into my mom/babe hours so the nurse working with me will be inexperienced, too. (Much easier to find mom/babe nurses than experienced L & D nurses.) Anyway, I've oriented 3 days this week, and will again 3 days next week (for scheduled inductions/sections). Then, after only 6 days of orientation my manager would like me to take one on my own the next week. A co-worker told me she probably means as the primary caregiver with an experienced nurse following me. I still think that seems awfully fast considering all the different scenarios that can be involved and policies that are to be learned. I'm barely comfortable being involved as the secondary nurse at this point. I'm working on getting comfortable myself, and observing what all is involved and taking place around me. I think that it is really unfair to take a pregnant mom and her signifigant other who are already anxious and give them a nurse who is not confident or comfortable. I don't think that would be much comfort to them. I know I'll be anxious for a long time, maybe forever, but I think it would be better for myself and the patient to allow a little more time and a few more experiences before I am suppose to be running the show with or without a standby nurse. Any thoughts? Please, help!

[KellNY, RN]

Tell her point blank--you do not feel comfortable. if she pushes you, I'd look for another job. It's your license and your ethics and reputation on the line, and if it ever came down to it, one of the 1st things against you would be "If you didn't feel capable of caring for Ms. XYZ, then why did you accept her as a patient?".

You owe it to yourself and your patients to get more orientation. Short staffing isn't your problem, and it's not your patients.

[Selke]

Ohmigosh, this sounds so unsafe and scary. I just feel so strongly about this issue. Can you even read a fetal monitor after that short orientation? Sounds like you won't even have a resource nurse with you when off "orientation." I would look for another job, pronto. Management of that hospital must be nuts. Are they even trying to find an experienced L&D traveler nurse for nocs? If/when something goes bad, an attorney would have a field day looking at staffing patterns and level of experience of the RNs. The other poster gave you good advice. You have to look out for your patients, your license and livelihood, which are in jeapordy in a situation like this. I bet this unit has other unsafe elements and dodgy practices, too. Only 2 RNs for OB per shift? What do they do with more than 1 patient in labor? For a c-section (that would take both RNs) -- who cares for the other pts?

[SmilingBluEyes]

WAY TOO FAST. This won't do. Tell the manager you can't take a patient on your own after only 6 days' orientation. You need more like THREE MONTHS MINIMUM.

I don't like how this place sounds. It sounds very unsafe. I would think twice before continuing there.

[nurse79]

i agree...very unsafe conditions. its not worth risking your license..and your staff should be accomodating. They too were once new L/D nurses. I had orientation for 3.5 months and i still do not feel that was enough!! In this department, it especially helps to have the support of your staff..you never know what type of pt will be walking in your door! If management is reluctant to support you, then go elsewhere. go with your gut feeling. good luck.