Interested in L&D but scared of it

profjanmc · Aug 23, 2004

Can anyone give me any insight as to how long it takes to become competant, and do hospitals usually provide enough orientation so that one feels reasonably comfortable before being on their own?

Thanks so much.

Catherine

Wow! This is my dissertation subject, so far I have found that it takes almost two years for labor nurses to feel fully competent, but by about a year, mostg feel competent in low-risk, normal labor and delivery. Hospitals in Northern California generally give 6-8 weeks of orientation, usually with some classroom and the rest clinical with one-two different preceptors. That was generally considered too short and most of the nurses wanted more orientation. Some were able to get additional training, but had to ask for specific reason. Hope that helps. It is the best job in the world! Nothing is like labor..... go for it, you WILL be scared and uncomfortable, but it will pass...Good luck, Jan

see2mee · Aug 23, 2004

Thanks so much for your response, Jan. One to two years seems like such a long time to be so nervous. Being a new RN at my age, 41, it is so tempting to find something less nerve-wracking and just not put myself through all that, but I just can't quite let go of the idea.

I appreciate your input.

Catherine

babynursewannab · Aug 23, 2004

Thanks so much for your response, Jan. One to two years seems like such a long time to be so nervous. Being a new RN at my age, 41, it is so tempting to find something less nerve-wracking and just not put myself through all that, but I just can't quite let go of the idea.
I appreciate your input.
Catherine

Catherine,

Let yourself be nervous! Never let your age dictate how you follow your desires or passions. If you were a straight A student along with caring for your daughter, you thrive under pressure. Please follow your heart. Your brain and soul will thank you for any challenges you throw their way. You had a calling...answer it!

Good luck!

starry nights · Aug 23, 2004

Hi - your age and life-experiences will help you out tremendously in the area as well, in ways that reading books would not - and as in any fast-paced area, feeling uncomfortable and slightly "on-edge" will help you to be more observant and ready to act; take advantage of the knowledge of the more experienced nurses, and ask, ask, ask - I have learned so much, there is still tons to learn but it is getting better!

SmilingBluEyes · Aug 23, 2004

A measure of discomfort or heightened alertness is a good thing in OB. Complacency has no place there, or any place in nursing. As for me, it took a good 2 years to feel fully competent, but even after 7, I still run into new situations I have not seen before.......that's ok. That is where learning comes in that you don't get from books.

Best wishes, whatever you decide to do. ANY area of nursing is a challenge and it takes time to learn. Be patient with yourself, NEVER pretend to know what you don't, and ask questions at every turn. Good luck to you.

see2mee · Aug 23, 2004

Thank you all for you advice and encouragement. Just to clarify, enough nervousness to keep me on my toes I consider a good thing. And, yes, I ALWAYS ask questions when I'm not sure about something. I guess I'm just especially nervous with L&D because it is so specialized, and I had so little experience with it in school. It just seems like SO much to learn about something that is SO important to people. I would hope for a situation where the other nurses are supportive and willing to help when I need it, which is really true no matter where I work. I think it's also true that almost anything seems a lot scarier from a distance. I probably need to just jump in with both feet and start learning. :) I won't be in a position to start something new for a few months, until my daughter is settled, but you have all helped me start to think through this decision.

Thanks again.

Catherine

SmilingBluEyes · Aug 23, 2004

if you ask me, all areas of nursing are specialized. don't let that stop you from pursuing OB!

see2mee · Aug 24, 2004

Thanks, Deb. I SO wish I could pursue this now as I am so unhappy at my current job. I really enjoy my patients (mostly elderly), but they staff the unit on numbers, not acuity, and our manager routinely takes patients who are too sick for a subacute unit, however, the staffing doesn't change. I'm so frustrated at having so many patients (up to 9, although I was once left as the only RN on the unit with 10) and only time to do the bare essentials most of the time. Apparently, our hospital service doctors are rewarded for getting patients off the regular units and onto our subacute unit as fast as possible. It's no wonder the acuity of the patients just keeps getting higher. We also get a lot of confused patients who are serious fall risks, but we don't get extra staff to monitor them.

Could someone tell me, how are the nurse/patient ratios in OB? I assume it depends on whether you are doing L&D or postpartum/newborn care on a given shift. How does that work?

Thanks.

Catherine

SmilingBluEyes · Aug 24, 2004

In labor and delivery, we usually have no more than 2 labor patients per one nurse. Yes, that sounds easy, but labor patients keep you busy and can go "bad" any moment....and I consider each laboring mom "two" patients, cause you do have a baby to consider and treat, sometimes with separate issues from the mom.

In Post-partum, usually no more than 4 couplets per RN-----this is 8 patients, moms/babies. That again does not sound like much, but they keep us busy with teaching, breastfeeding, and pain control needs. Again, each baby IS a patient. The acuity is not usually very high with couplets, however, but I have seen serious complications develop in what seemed to be stable moms and babies.

Since we do LDRP, moms and babies do NOT move rooms, so usually we keep our assignments throughout the shift. There are times when I have a laboring mom and a couplet as well. They try to keep the ratios down where I work, and usually do. Of course, when the "labor bus" pulls up, things do change drastically, rofl. Also, we do our own csections in our OR, so that can make it hairy for an hour so, staffing wise. But we are a pretty good team and pitch in for each other when this happens.

Hope this helps!

see2mee · Aug 24, 2004

That helps a lot, Deb. Thank you very much. That sounds pretty similar to what I remember them telling me at the interview for the job I had to turn down back in December.

Catherine

BETSRN · Aug 28, 2004

Around here it's usually about 16 weeks of heavy duty orientation in a speciality. I agree that it takes at least a year to begin to feel comfortable in L&D.