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

Specialties Ob/Gyn

Published

:cry:

So here it goes.... I was a doula in a birthing center for 6 yrs, labor and delivery was my passion... my calling. I went to nursing school only because I wanted to be a L&D nurse. (I do not like anything not pertaining to mommy/baby). I graduated from school and worked for the state as an RN until I finally landed a RN position in L&D and began my internship program May 1st. This position that I landed is at the largest L&D in the entire NATION. We deliver average - 80 babies per day, if that gives you any idea. To work in L&D you have to work LDR, LH, OR as a circulator and in recovery. So here we are into July. I have come home crying more than not, I have gone to work crying more than not. I am lost. This was nothing like I thought it was going to be. It is like hearding cattle, get 'em in, get 'em delivered and get 'em upstairs so we can fill this empty bed with another warm body. This is nothing like the experiences of working at a birthing center and I have no hospital experience so I am like a new nurse. I had to start from the bottom up building my skills - learning every thing from IV's and injections all the way up. I am having diffilculty in several areas - time management, prioritizing and accepting all of these interventions that I feel so conflicted about. I am expected to be off orientation in 2 more weeks. I know I will not be ready. I walk in to work every day praying for 2 things - that I will not have a delivery and that I will not have a IUFD. I hate births at this point, everything about this "miracle" has been tainted by my experiences since coming to work at this hospital. It is very fast paced, full of interventions, and you have no time to "bond with or labor" your patients.

So.... I feel like my world is falling apart. This was the only reason I became a nurse at all....

Should I try to transfer to HRP or one of the post partum units? Is it like this at all of the hospitals or just this one????

I can not belive this has happend.... I am lost, fearful, disappointed... in myself and this experience. Please.... any advice????? :cry:

Specializes in L&D-RN; PCT med surg, Oncology.

Hi Katrina,

I know how you feel. I am a new labor and delivery nurse working in a teaching hospital. We also get bomb barded with patientsas well last week we were running out of rooms to place patients and here they also have the get them in; get them out mentality. If you feel uncomfortable with your load. I would advise that you go to your manager or director and let them know of your concerns b/c maybe they are unaware of the extreme stress you feel being new to the area ( maybe also ask for more time on orientation). I would also look at other hospitals in the area to compare the patient load. I would not go to a post partum with a 5 couplet load. that can be very stressing as well that is 10 pts and if you are trying to do your job according to accurate policies and procedures you would be equally stressed out. Like I said, I would talk to the manager and express how you feel unsafe as a nurse handling that kind of assignment so that in the event you do decide to leave it wouldn't come as a surprise. I would also just encourage you to continue doing all that you can to provide competent and prudent nursing care. Im sure it will get better for you. Good luck and be blessed! :nurse:

This was my post about two months ago. I'm also a new nurse, but I externed in L&D for a year so I was a little familiar with it. Unfortunately I didn't take a position at the hospital I externed at and instead took one at a larger hospital that did 450-600 deliveries a month. It too felt like a baby factory and my orientation was horrible. When my manager finally met with me, it was at the end of my orientation and she told me she needed to know I could handle any emergency on my own before she'd let me off of orientation, my preceptor then proceeded to let me sink or swim by giving me the hardest pt load and seeing if I could handle all the pressure. Needless to say I left and found a hospital where I feel a lot more comfortable and where I speak with my manager daily and feel like I'm part of a team. I know you have a monetary commitment to the hospital you're at, but maybe you could look for a place with a sign on bonus to use to pay off your commitment? Good luck with what you decide.

Katrina,

We're at the same place. This hospital has a well-deserved outstanding reputation. Yes, it is extremely high volume, but each and every patient receives an excellent level of care. It's not a birthing center, nor is it a small country hospital - it doesn't pretend to be. It would be almost impossible not to know that from day one.

That high volume is the reason moms come here. Quite simply, we see it all, and we do it all. Besides the routine deliveries, it's a tertiary referral center for high risk OB. We manage extremely high risk pregnancies almost as a matter of routine, treating patients on a daily basis that other smaller hospitals see once or twice a year. Did you know that AFE has a published mortality rate of >90%, yet of the several we see each year, >90% of walk out of the hospital with a live baby. We're doing placenta accretas almost weekly - same story - good preparation, excellent support from all departments, mom goes home happy. Moms know that if we can handle the high risk stuff, we can certainly handle their usually routine delivery.

Regardless of the time of day or night, there's always anesthesia, neonatologist and OB staff in house - always. Most places can't say that. Come throught the door with a prolapsed cord and no pre-natal care? No problem - we'll have your baby out in a matter of minutes. No waiting for the on-call OB, no waiting for anesthesia to drive in from home.

You know the setup - it's a huge place, but it's broken down into smaller pods with 10 different nursing stations covering only six rooms each. Once a patient is in their little pod, it's hard to realize that there's another 60 rooms down the hall and around a few corners. Every LDR is private, every PP room is private. Everyone is very good at what they do, from the nurses to anesthesia to the OB docs.

Moms that come here don't leave here wanting to have their next baby somewhere else. They want to come right back here the next time for their next baby. Trust me, there are several hospitals in Atlanta where moms don't have that feeling.

JWK -

I agree with you that the hospital has a great reputation, nor do I disagree with you about the quality of care that is provided to moms. Yes, many moms come back with subsequent pregnancies, as they do in birth centers. If their expectation were met and they were satisfied with the out come, why wouldn't they? If I were having a high risk pregnancy, that is the place where I would want to deliver. However, with that said, not every patient is high risk and needs to receive the interventions and the technology that our system routinely uses.

I am not from this city or state and as I had mentioned in my posting, I came into this position with minimal hospital experince in L&D. It is nothing that I could have prepared myself for, as I have never been in a setting this large. It is difficult to imagine it unless you are experiencing it. This posting was not about the hospital, it's reputation or qualifications. It is about my ability to handle it or not with my level of experience. I certainly need to be assured that I can before I am left on my own, for the safety of the mom, the baby and my license.

I know how our system works, I know that we have the structure in place for emergency situations and while most nurses have been supportive, there are certainly those that have the sink or swim attitude towards new comers.... I am still simply trying to stay afloat.

Again, this was not about the hospital, but about my personal level of comfort and ability to perform the job as required.

My story is just the opposite. I'm an RN who quit nursing to become a Doula! I love childbirth and newborns! Albeit the pay is not nearly as good, but I am happy doing what I do. I know my limits. I'm 52 years old and decided that the stress and charting was just not worth it. I worked in surgery, not L&D. Too stressful! I admire all of you L&D nurses. The responsibility you carry is daunting. It's just not for me.

Well, I made the change, I transferred up to High Risk Perinatal and can I just say I LOVE IT !!!!!!!!!!!!!!!!! OMG !!!! I should have done that long ago. It is everything I wanted, time with the patients to give patient education, a much more calm pace, Still involved with OB aspect of nursing, ability to make a positive difference in pt experience, all of the nurses on the unit are sooooooo nice!!!!! I actually enjoy going to work again!!!!!!!! Best change I ever made!!!!

Specializes in Community, OB, Nursery.

Good for you! You sound like you know you made the right decision, and that is what counts here. I'm happy for you, as your excitement is palpable. I know your patients are glad to have you as their nurse too. :)

Specializes in L&D, QI, Public Health.
Well, I made the change, I transferred up to High Risk Perinatal and can I just say I LOVE IT !!!!!!!!!!!!!!!!! OMG !!!! I should have done that long ago. It is everything I wanted, time with the patients to give patient education, a much more calm pace, Still involved with OB aspect of nursing, ability to make a positive difference in pt experience, all of the nurses on the unit are sooooooo nice!!!!! I actually enjoy going to work again!!!!!!!! Best change I ever made!!!!

Congrats!!! Tell me more about the unit. Is it an antepartum unit?

Specializes in ob, er.

I myself work in L&D in a community hospital and have been there for 5 years. Your experience is nothing like mine. Maybe you should check into going to a smaller practice where there is not as much chaos. Also, maybe look into a LDRP unit. That way there is not the rush to deliver them and send them on their way so you can fill the bed. You would have the same pts from admission to discharge. I know personally where I work most of our pts are known on first-name basis to most of the staff (not always a good thing haha!). And we also get the same pts back later for future births which is nice to be with them on more than one special occasion.

Specializes in L&D,postpartum nursery.

i feel for you, and agree with some of the other posts, try a smaller hospital, i work in a hospital that del about 300 del a year, i love that i get to bond with my laboring pt most days,(unless we are really busy), i also get to help mom learn to breast feed as well as basic care, just thinking about working in a dept where i couldn't bond with pt, i know i wouldn't be happy. keep your chin up you obviously went to school for a reason.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

How are things going Katrina? Any updates ? I sure hope things are better.....

remember, you are not alone. You received great advice here.

Things are GREAT !!!!!!!! I found my home on the HRP unit and I could not be happier. Long term patients, lots of time to be able to spend with them providing education prior to labor, increasing my skill level, knowing that my care is making a difference and being able to provide the bedside care that I desire. It is a good fit because I can empathize with these mothers as they feel such apprehension, fear, and are on the emotional roller coaster that one endures when you are on bed rest in the unfamiliar surroundings of a hospital away from your loved ones for weeks and months. I personally experienced a high risk pregnancy and spent about 4 months in and out of the hospital on bedrest (complete placenta previa), and delivered a premie myself many years ago. A good place for me to be indeed.

The nurses on the unit are like a family and you always have someone to back you up in times of need. Transferring to High Risk Perinatal was a God send.

Thank you for asking. I am glad I moved on from L&D and yet can still provide great care for mommies and babies.

Katrina

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