New grad in L&D. Are these things normal?

NuGuyNurse2b · Oct 14, 2016

Really? That's ALL you got out of her post?? Frankly, I didn't even NOTICE that part, because I was focusing on the fact that she's a new grad in a highly technical and high-risk specialty thrown ON HER OWN TO RECOVER A NEWBORN (birth, while physiologically normal, is also the riskiest event in terms of death or permanent neurological damage any person will ever encounter - chew on that for a moment), and that the other nurses, who should be in this specialty because they revere the birth process, are mocking women for wanting to have a natural childbirth and are - g-d forbid - vocalizing during their labor.
She asked if this is normal. It is NOT normal. It's DANGEROUS. Focus on that, instead one stupid line that, rereading her post, I STILL couldn't find.

I can only suggest you try again. It's the very last paragraph. And mind you, when she originally posted, it was one big paragraph that was later edited by mods to make it more readable. I saw a post from someone who was upset but yet claimed to be thick skinned, and made an assessment about her co-workers that I found questionable.

And once again, alls I asked was for OP to look at it from the other shoe. She obviously doesn't agree with the culture, but before she makes those assessments about her peers, she should try to see it from their point of view. Clearly you and everybody else missed that part of my post.

queenanneslace, ADN, MSN, APRN, CNM · Oct 14, 2016

When I read the title of your post I was all prepared to say: "Hmpf, yeah, it's that bad." Because L&D can be ... eye-opening ... in the way things are done.

But after reading the content in your post. NOPE. Nuh-uh, get outta there, that is not a good place for patients, for nurses or for living things in general.

A side note - do nurses employ dark humor to cope with work and challenging patient situations? Yes.

Will I defend this behavior? Nope. Never.

I will not normalize this or justify it. I will work hard every day to exemplify professionalism in the workplace. I have colleagues who are nothing short of stellar human beings - both in earshot and out of earshot of patients. It is a pleasure to work with these individuals, and patients are served well by not only their skills as a nurse, but their committment to professionalism.

So yeah, you can get into an environment where this kind of boneheaded behavior is tolerated, and you will even find people who will justifiy and normalize this type of behavior. It is something I will not stand for.

There are excellent nurses, clinicians and providers out there. They employ team work, the provide respectful and patient-centered care, and they prioritize safety of their patients. And they'll even call out their doofus coworkers for making demeaning comments about their patients. I can't say all work environments are perfect - of course they're not - but you can find much better. Don't compromise your standards!

kejRN · Oct 14, 2016

This is definitely not okay and I am sorry that this has been your experience in an area that can be rewarding to work in. I have been working on L&D for a few years now, granted I was not a new grad when I started. L&D is such a specialized area that it takes a long time to learn things. There are still things that I am not completely comfortable doing and I still ask a lot of questions. Nurses who are new to that area should get a lot of support. I would definitely pursue conversations with your unit manager or director and see if some of these things can be resolved. Good luck and I hope things get better for you!

Jolie, BSN · Oct 14, 2016

I'm glad to read a few posts reassuring you that your experience on this unit is not normal or acceptable.

As some posters have indicated, "dark humor" is not unusual in healthcare, or any high-stress occupation. It is a coping mechanism, and as long as it is utilized in private, with trustworthy co-workers, it harms no one and serves to protect our mental health. But I don't think that is really the issue here. I think what you are overhearing represents an extremely poor attitude towards a patient population that is not respected by many of your co-workers, along with abysmal leadership that tolerates all kinds of unprofessional behavior in the name of staffing a unit with a horrible reputation that can't attract or keep quality staff.

I can imagine that you were excited to be hired into L&D as a new grad. It represents a "dream job" that few are able to find without experience or connections. I can only imagine what you were promised in terms of orientation, mentoring and support, especially since most nursing education programs offer limited L&D clinical experience. It appears that promised training won't be forthcoming unless you clearly and firmly demand it, and even then, maybe not.

I've been out of the hospital setting for almost 20 years, but even back in the dark ages of the 1990's, national standards of care (per NAACOG and per NRP) called for 2 fully independent RNs in the delivery room at the time of birth, one dedicated to mom one to baby. Someone will correct me if I am wrong, but I doubt that those standards have loosened with time. So, leaving you to attend a newborn by yourself was wholly inappropriate and in violation (I believe) of accepted standards of care.

I suspect that this was not simply a matter of a single bad day of staffing, but rather a long-standing pattern of slipshod training, care and standards that is not likely improve, nor is it a setting that will ever be conducive to your learning. Please have a pointed conversation with your manager and decide for yourself if this is an environment in which you can grow.

quazar · Oct 15, 2016

And once again, alls I asked was for OP to look at it from the other shoe. She obviously doesn't agree with the culture, but before she makes those assessments about her peers, she should try to see it from their point of view.

Here's where you steered wrong on this one: "the culture" of OB is not to demean and make fun of patients when you don't like/understand/agree with their birth choices, it is to support women in labor and birth, regardless of how they choose to accomplish that task, without passing judgment and by supporting them. Supporting your patients means you don't mock them when they choose medication free birth in a facility that has a high rate of medicated births. Nurses who have a negative view of natural birth and express that negative view will NOT give good care to those patients. I have seen it over and over again at the bedside in almost 2 decades an 5 different hospitals in L&D. If a nurse thinks natural birth and loud vocalizing during labor is stupid/pointless/laughable, it will come through in her care, and her patient will pick up on it. That will affect the patient, the labor, and the whole tone of the birth.

Please do not call what these nurses are doing "the culture" of OB. It is not. Not by a long shot. During labor, women scream, vomit, poop, pee, and do all manner of things that to cope with what is happening to them. If you can't deal with that, or you don't support that, you need to get the heck out of L&D. Not everyone wants an epidural. Not everyone wants to be hooked up to a fetal monitor or IV. Not everyone wants to "feel nothing" during labor. And that's okay. Making fun of them for it is not.

FolksBtrippin, BSN, RN · Oct 15, 2016

I am a new grad (RN) with no hospital experience aside from nursing school. This is my experience on the L&D floor I am in. I've come to you all because I don't know what is normal in the healthcare setting. So I am often left alone. On half of my first day orienting as Baby Nurse, I was left alone. My preceptor would leave and I could not find her. On my second day as baby nurse, she called out and I was ALONE.I told them that I did not feel safe doing this and they told me They would not leave me alone and assist me. The charge nurse stayed with me for the first few seconds of life and then would leave. We are always swamped. Our director does not allow the staff to call safe harbor. Which I heard was illegal. Instead she gets on the floor to "Help" although she doesn't have much experience and needs a lot of help,which takes away time from other nurses.
I have tried to seek help and additional resources from my nurse educator but she has been working on the floor swamped with patients and doesn't have time to help me. During my first few weeks we were so swamped that my preceptor would often just take over and I couldn't really do much. MY first few weeks consisted of hemmorhages, stat sections and mothers who were rushed in transitioning. Tensions are high, everyone is always yelling at each other in front of patients. etc. What baffles me is the conversations that go on. One nurse thought it was hilarious that she didn't help a triage patient in time and she almost gave birth on the floor. They constantly make fun of patients especially the ones that go natural they say things like ughhh "Why are they screaming they need to shut the ***** up"! They were disgusted that an incontinent patient was pregnant. They said some of the meanest things about her and how disgusting she was for wearing diapers and having sex. When I ask for help they just stare at me and sit on their behinds and ignore me.
I don't understand it, never have I worked in a place with such insensitive, grumpy, depressed people. Is this the way nursing is everywhere? I have thick skin, but I will never find pleasure in another person's pain. They gossip about patients in front of other patients and families. Once they ware talking about how they would abandon their patients especially the epidural patients in the time of a disaster, active shooter or fire. This conversation was going on at the nurses station with families walking in the halls. They were not joking either.
I am just so disgusted, I have thick skin and I may not know much about the healthcare field but I have lived a very hard life and I have lived through things probably most of these nurses haven't. I am professional and compassionate. SO tell me, is this the norm.

So sorry you are going through this. I can't tell you if it is normal or not because I am still in school, but I can tell you that I was on a unit like that for one of my clinicals. When I think about the way patients were treated ....... :no:

Sometimes workplaces become toxic.

It's very hard to change this and probably impossible for a new grad to change it. I hope you find a better place.

jenrninmi, MSN, RN · Oct 17, 2016

OMG! No! Not normal! You aren't safe there (at least your license isn't) and neither are your patients. Protect yourself, find another position in another hospital.