I do not think I can make it in L&D... devastated

Sandwitch883RN · Jul 12, 2008

Katrina... I recently discovered this website and am soooo glad I did. I posted my own story of feeling defeated and having no confidence after being an L&D nurse for two years. I have had three jobs in the two years out of nursing school and haven't been able to find just the right "fit". However I know L&D is my passion. I've considered doing other things but can't imagine not being in an L&D. I've been given very good advice and support from others, telling me to hang in there and keep searching for the right hospital. The biggest thing i've learned from this website is that im not the only one who feels the way I do! What a relief!! I was starting to think maybe I wasn't even cut out to be a nurse and that all other nurses felt secure and happy with their jobs! My experience has been much like yours. I applied to a new facility yesterday and will start at the end of July. It's a very tiny rural LDRP so I will be exposed to Labor, postpartum and nursery. I never thought i'd consider a tiny hospital but I really got "good vibes" while I was there. Maybe it will help you to know that you're not the only one who has gone home crying!! Sorry this is so long! Take care :nuke:

mom2michael, MSN, RN, NP · Jul 12, 2008

No, there are some really awesome places out there to work and like MANY jobs in nursing there are some that are worse and some that are better than others.

That job seems way to intense for me and I'm just floored that as a new nurse you are expected to be a fully functioning L&D nurse after what...12 weeks???? That isn't right. I get 6 MONTHS of just L&D orientation and I have 1.5 years of experience as an ER nurse.

I left the ER because I was really tired of the get 'em in and get 'em out mentality that has plagued me since I started. I never felt like I got anywhere, just ran around like crazy all day trying to get everything done just to free up another bed. I shutter now at what could've happened because I was just too busy to notice.

If it were me, I would quit. A job should never make you feel that bad about yourself and your dreams.

Is there any way you can just leave the facility and find something different? Perhaps a birthing center or an OB unit that delivers 100 a month rather than a day? If you can't leave, is it possible to transfer to PP or baby care?

I 2nd the rural facility. My facility is not considered "rural" but any means but we are a small, very tight knit and VERY close unit. We deliver about 3-4 babies per day and we provide total care for our moms and babies. It brings the best of all the worlds together for me cause I love PP and baby care but I also desire the thrill of L&D.

(((((HUGS))))))

RNKatrinaK · Jul 12, 2008

Thank you so much for your replies. They made me feel better. It is a horrible sinking feeling when you think about all of the time, money and energy that we put into graduating as a nurse.... then to think that I am in the wrong profession. When I was a doula, like I said, I worked at a birthing center and I also did numerous deliveries at St. Mary's Hospital. Their LDR unit was all inclusive. Moms delivered and stayed in the same room until discharge. It was wonderful. They did not feel like they were being transferred all over the place, they bonded with the nurses and received wonderful care. This hospital has a different unit for every thing. And you have to be cross trained in everything but PP. That unit is seperate all together. I asked about the PP unit and was told that you have 5 couplets - basically 10 patients (5 mommies/5 babies). To me that is still a lot, but perhaps it would be better than what I am experiencing now. I just wonder how much education time you have for breast feeding, ect with that many patients. How many pts do you both have?

It is scary to think that I am suppose to be capable of managing care of high risk patients with numerous complications - from preterm labor to vehicle accidents, pt on insulin pumps and pic lines to epidural pain management, patients on cervadil, cytotec, pitocin, laboring patients, doing deliveries, circulate in the O.R., recover surgery patients, and what feels like a gazillion other things that fall under my realm of responsibility, including the care of the baby for atleast 2 hours until our pt goes up to the PP floor, and caring for the IUFD's and doing all of that paperwork - when I have only been on the floor for 12 weeks. We have 2-3 patients at all times. There are days when I may have 3 plus deliveries. I can not do all of this and feel safe this soon. That is all there is to it. This hospital is known as the baby factory for a reason, I suppose.

I have to do something, I just do not feel that staying is an option. I need medication at this point!!!!!!!!!!!

The thing is, I have to make a decision and have another job in 2 weeks. If I leave AFTER my internship is over, then I have to pay back the hospital $5,500.00 for my training. It is in a contract that I had to sign when I accepted the position. Just another wall to get over.

I am so thankful you have written me..... :heartbeat I do not feel so alone... or incompetent.

JaneyW · Jul 12, 2008

DON'T give up yet! It sounds like you are working in a baby factory! Is it also a teaching facility? You are suffering from overload and also from moral distress. I was just at the AWHONN convention and attended a seminar about moral distress in the perinatal environment and trust me, you are not alone. From uneeded internals to uneeded c-sections to iffy or non-existent or RN led informed consent, there are many situations that can defeat the best of us. Especially those of us who are in this as patient advocates and not just for the paycheck.

Get through as much of the orientation as you can and start NOW looking for another place. A smaller place would love to have someone who has been trained as comprehensively as you have been. If you can't move, you are stuck with what is available, but if you are willing to relocate cast a wide net. It doesn't have to be rural or even a birth center. I am working registry right now in a large metropolitan area and have seen wide variations on practice and unit culture within 10 miles of each other. I have also seen wide variations on quality of MD practice--but that is a whole other thread!

I hear the discouragement in your 'voice', but please don't give up on L&D. Find a place that is better suited for you, join AWHONN and learn how to stand up for your patients (that will also come with experience), and try not to be so hard on yourself. It takes a LONG time for your hands to start reaching for things and doing things without having to think so much. It took me around two years.

I have a very difficult time with the "move 'em out" philosophy, but it isn't everywhere. I have also learned that it is OK to be that slow nurse who takes a bit more time to recover their patient :-). That is one of the nice parts about L&D--you can have your own practice within the unit guidelines. No one else does skin to skin (despite the research)? You can. No one else follows AWHONN standards for second stage (NO valsalva pushing, NO shoving the patient's legs back, having the pt sit more upright without the stirrups, etc)? You can!

Being new to L&D is overwhelming even at a slower pace. Be kind to yourself and find yourself a better fit!

allthingsbright · Jul 12, 2008

Your story sounds so similiar to mine it is almost ridiculous (I was also a doula and am now in a large teaching hospital). I come off orientation soon and am scared out of my mind. I work high risk OB and it is crazy and overwhelming. I have a good day followed by two bad days and my confidence is extremely low.

I'm planning on hanging in there and if I cant hack it go to mom/baby. But I am not giving up yet.

Have your thought about changing hospitals? That would be an option for me as I think a lot of my stress is the patient population, level of acuity, etc.

And I am with you on the IUFD's. They are really, really hard.

Take care! PM me if you ever need to talk--we doulas need to stick together.

JaneyW · Jul 12, 2008

I think we were posting at the same time! I live in California where we thankfully have ratio laws. At some hospitals when I work PP, I will have 4 couplets (our max) and you're right that it leaves not a lot of time for proper education. Especially if you have a complicated pt or a fresh c-section who is vomiting or having a lot of breakthrough pain.

It sounds like you know what you need to do. When we are discouraged, it is difficult to make change. It takes a lot of energy. Set small goals and work right through them. For example, I will look at all postings today. I will fill out two applications tomorrow. Get your resume polished up and think long and hard how you are going to talk about your present situation.

Good luck to you.

smrfett76 · Jul 12, 2008

I definitely know how you feel. I am new to L&D at a smaller hospital. We have 1-2 patients at a time. We are able to have the opportunity to bond with our patients, which is something we really didn't have in Med/ Surg. I think that the hospital you are at seems unsafe to ask a new nurse to care for that many patients and to only have 3 months orientation. I have been orienting for 2 months and am no where near ready to be on my own, but I know that when I am I will have my girls with me. Where I am at, you are never alone. If there are complications, there is always someone just a few steps away. I would explore your options at a smaller hospital and don't give up on L&D. It really can be a magical place to work.

Keep the Faith,

Kim:nurse:

imenid37 · Jul 12, 2008

Is this mega-hospital part of a system? Maybe there is a sister hospital w/ less deliveries for you to work at and still maintain your monies for education? I think you cannot work at THAT L&D. I have done L&D since 1996 and been a nurse for 21 years. I now I could not make it there. Our small hospital is very far from perfect. We get one active labor pt. usually, at the very most 2 (until we could get help in to resume 1:1). You can get to know your patients and even take a breath and potty break most of the time. Get the **** outta there, girl! Your health and sanity will suffer if not. All of the best to you!

buster4 · Jul 12, 2008

I worked in L&D, PP, and nursery, for 11 years.. That is what I always did from the start.. so I was a brand new nurse, but I joined the Air Force and I received my training in the military, to do that type of nursing, I joined immediately after graduation.

My point is, I always worked in a small facility... It was stressful enough, I cannot imagine what you are going through... I would definetely look to get into a smaller facility, or go to PP.. PP isn't that bad.. the most I evewr did was 3 pit drips, and all 3 delivered on a shift... I don't think it was safe, but I did what I had to do, (in the military)... anyway, smaller facilities would be much better... it would be 3 to 4 days sometimes without a delivery... then have a boom for a few days... comes and goes..

I got out of it in 2000.. I got burned out, I got to where I couldn't stand the site of a pregnant woman!! so I knew it was time to do something else....

good luck!! I hope everything works out!! I always said the prayer, "please dear lord don't give me anything I couldn't handle with his help".. I have always been blessed as a nurse... (can you believe it I have never had a death (except stillbirths).. in my career!! I attribute it to being blessed.... or lucky (i say blessed).. (knock on wood)

again I hope it all works out.. life is too short to be so upset so much of the time... good luck!!

RNmama05 · Jul 13, 2008

Give it at least a year before you decide whether you really hate it or whether you just hate the new experience and being at the very bottom of the learning curve.

Being a hospital L&D RN *is* very different from being a birth center RN or a doula. In a sense you are grieving for what you dreamed L&D would be. But give it time to see if you can judge it on its own merits.

It may be, also, that you need to find your niche. The busy "baby factory" where you work may not be the best fit for you. You may prefer a small rural hospital or a large university hospital or a medium community hospital, or working with antepartums, or working mother-baby.

It's too soon to tell yet.

jenrninmi, MSN, RN · Jul 13, 2008

I am so sorry that after having such a passion for moms and babies that you're first experience as an L&D RN is at a baby factory. 80 births a day??? OMG! June, we had our record of the most births my hospital has ever had in history in one month - 171 births!

If I were you, get out of there! Either go to a smaller birthing unit or just take a year and go to a med/surg unit. I wouldn't even transfer to mother/baby in that hospital right now. It is going to be the same.

I know about the passion for l&d. I love, love love my job! 98% of the the time we have 1:1 ratio for l&d. Last week was the first time I ever had 2 labor patients. It was actually a cervical ripening and a labor.

Good luck to you! Don't give up your dream. There is a perfect job out there for you!