I need confidence!!

BSNbeauty, BSN, RN · Apr 16, 2014

I'm sure you will do fine. Just ask lots of questions. When it doubt, grab another nurse or call the doc to look at the strip. I'm also new to OB. One time I had a pt. whose strip looked a like there was min. variability. She was 33 weeks. I called the doc to have her take a look and she said it was perfectly normal. I was embarrassed but I rather be embarrassed then to not have a second opinion and something turns out wrong. I've had a incidences where I had to rush 2 of my patients to the OR just because I had a feeling something wasn't right and notified the doc. So it never hurts to have the second opinion. With time, you will become more confident, just like you did as a medsurg nurse.

NurseNora, BSN, RN · Apr 21, 2014

A baby's heart doesn't just stop without giving you warning. Remember that when the rate drops and you start doing what you need to do to get it back up (change position, fluid bolus, stop Pit, give O2). You can take the Basic Fetal Monitoring class at the AWHONN website (awhonn.org) You can also browse through their bookstore and find lots of helpful information.

Going into L&D can be difficult for an experienced nurse because it's so different from what you've been doing. It takes a little getting used to to have two patients in one package, only one of which you can see. But you already have good organizational and assessment skills as a foundation for you new learning. Ask questions, do as many VEs as possible, ask other nurses to get you if they have something interesting come up, and have confidence in yourself.

TexasCourgette · May 6, 2014

Good for you! Know that preceptors don't generally give out that kind of praise very often. She's not crazy, and you're not crazy--you're good at what you do.

Does it become less scary? Yes. Absolutely. Like, none of us would be able to survive L&D if we all hung on to the anxieties we had at the beginning. Things just become more familiar.

But all the way not-scary? No. "Just another day at the office" is always going to carry some stress with it, because that's someone's sweet baby you're watching, and someone's sweet belly you're inducing.

When I took my fetal monitoring course, it was really helpful--I'm very type-A, and having someone else back up and verify what I knew made me feel more confident when talking about strips (instead of asking if something was a late, I would talk myself through how deep it went, how long it took to get there, and how it fit into the variability of the strip--and that gives you your clinical picture). I became much less afraid of variables, and more able to defend interventions in the face of subtle late decels. Now that I have more experience, I know that it's the subtle changes--less variability, a high baseline, little lates--that are more telling than the big ones (like impressive-looking variables--now I see those and just think "that'll be a cool nuchal" instead of "PANIC").

My other major resource, when I was feeling the way you are now, was my co-workers. It really worked for me to joke about something ("ha ha ha, I know I'm paranoid"), and ask for help ("Do you have a moment? Could you look at XYZ section of the strip with me?"). If you know your preceptor is impressed with you, start with her. I promise, people would rather you be a "strip nazi" than not care. Also of comfort: babies don't live and die at the same time, so a sweet thing with good variability is not going to suddenly stop being oxygenated.

And know that your reactions to recognized problems will get smoother, and calmer, and faster--I remember having a bit of a freak out when I was on my own and a baby of mine was in distress for the first time. Now, it feels just like a "mode" to switch into, where you stay very alert, and turn off the pit, on the O2, increase fluids, and turn the patient. It's like a math equation, and there's some comfort in the predictability.

Welcome to OB! Time is going to be the biggest factor in your confidence level. You'll do awesome (just as you did in medsurg)!