Hello everybody! I've responded to a few posts recently, but this is the first I've started.
So, I have been offered my dream job in a local hospital's maternity center. They have a great reputation among patients, and while I don't have a lot of information about employee satisfaction, I get the impression it's fairly high.
All of that said, my residency is structured with 3 weeks of orientation (one to the hospital and two didactic with learning modules and NRP certification). Following that, I have 9 precepted weeks on the postpartum side of things. The expectation is then 6 months-1 year of independent postpartum nursing and then moving into a 10-12 week L&D preceptorship.
My question is, while the overall progression to L&D is clearly very thorough, does 9 weeks of floor work seem sufficient to be able to move into the role of an independent nurse for postpartum? I am a fairly quick learner, but I had only spent 2 (mostly observational) days on a MBU in my clinical rotations and so don't even know what I don't know yet. I see orientations for other specialties that range from days (eeeeekkk!!) to half a year. But rarely do I see information on MBU/LD specifically. Thoughts?
And while I'm here, any words of wisdom/recommendations/stories of experiences? I'm so thrilled for this opportunity and want to make the very best of it!
Seriously best response ever! !! I posted a similar post recently and have been waiting to get reaponses. I found this thread and read your response and I am seriously taking away lots of valuable info!! Well put and we'll written!!!! I too recently accepted a position as a l and d nurse and I am coming from a neuro tele floor. I can't express how excited I am, but, I am terribly nervous and feel as if I am started allllll over. I am up for the challenge but definitely nervous. ...I have a couple questions that if you would like to answer would be great!!!
1. Cervical dilation- how to check mom's and what it feels like and how do I know if I am correct and do they let us practice?
2. Is there a possibility that I could deliver babies with out a dr? What is that like
Thanks !!
Congrats!! I'm not sure if you meant me, but if so, Thanks!
I don't actually do labour, I am primarily a peds nurse and I also do mother baby and special care nursery probably half or less than half the time as we are a smaller hospital so a semi-joined unit :) But I can kind of answer those questions haha
1. Using two fingers of your dominant hand, insert into the lady parts and reach far back. If the mom is just starting labour, or not in labour yet, it can be very hard to reach the cervix. You often hear this described as "closed thick and posterior". On the other hand if the mom has progressed a fair ways, the cervix will have moved further anteriorly and be much easier to reach. If it's hard to reach I've seen the labour nurses and obstetricians get the mom to put both fists in the small of her back and this helps some to reach those posterior cervixes. The cervix when not dilated is described as feeling kind of firm like a nose type of consistency apparently? Haha. When softening it's softer more like an ear. I have just heard that from others I don't know how accurate it is. We have practice lady parts/cervixes, and when someone trains for labour they will have a preceptor with them and both nurses will check the dilation, so yes you should get practice! Maybe some labour nurses can come and answer that question a little better? Lol
2. Yes, in our hospital it is a possibility as we don't have obstetricians there 24/7. I don't know what your hospital is like, but there is always a small chance they may not make it. I have been brought in to help once when a mom came in fully and they had no time for the doctor to make it there. The labour nurse delivered smoothly, removing the nuchal cord, and it went well! I was nervous though hahah. She was quite experienced and it wasn't the first time the doctor couldn't make it so she was pretty composed! I imagine its a little scary even when you have experience, but most hospitals when they are training someone to labour you will have a preceptor for awhile, and even after that they will know you don't have a ton of experience so hopefully there will always be someone more experienced there who can help you :) Ask your preceptor for her experiences and advice on what to do in that situation. (Oh and we call "any doctor stat" usually to try to get someone there. They also don't "break the bed" until they know the doctor is there, the labour nurses all say if they have to deliver they would rather have the bed there then risk the slippery baby sliding into the bucket :P Which would be easier to happen when you aren't used to delivering all the time like the OBs!)
Hope this helped a little, Good luck in your new job! :)
Thanks so much for your input!!! Very very helpful and I will be poking my nose and ears for the next week lol!! I'm looking forward to giving everyone an update after the next few weeks! Thanks again for all the help!
NurseStorm, BSN, RN
153 Posts
Congrats!! I'm not sure if you meant me, but if so, Thanks!
I don't actually do labour, I am primarily a peds nurse and I also do mother baby and special care nursery probably half or less than half the time as we are a smaller hospital so a semi-joined unit :) But I can kind of answer those questions haha
1. Using two fingers of your dominant hand, insert into the lady parts and reach far back. If the mom is just starting labour, or not in labour yet, it can be very hard to reach the cervix. You often hear this described as "closed thick and posterior". On the other hand if the mom has progressed a fair ways, the cervix will have moved further anteriorly and be much easier to reach. If it's hard to reach I've seen the labour nurses and obstetricians get the mom to put both fists in the small of her back and this helps some to reach those posterior cervixes. The cervix when not dilated is described as feeling kind of firm like a nose type of consistency apparently? Haha. When softening it's softer more like an ear. I have just heard that from others I don't know how accurate it is. We have practice lady parts/cervixes, and when someone trains for labour they will have a preceptor with them and both nurses will check the dilation, so yes you should get practice! Maybe some labour nurses can come and answer that question a little better? Lol
2. Yes, in our hospital it is a possibility as we don't have obstetricians there 24/7. I don't know what your hospital is like, but there is always a small chance they may not make it. I have been brought in to help once when a mom came in fully and they had no time for the doctor to make it there. The labour nurse delivered smoothly, removing the nuchal cord, and it went well! I was nervous though hahah. She was quite experienced and it wasn't the first time the doctor couldn't make it so she was pretty composed! I imagine its a little scary even when you have experience, but most hospitals when they are training someone to labour you will have a preceptor for awhile, and even after that they will know you don't have a ton of experience so hopefully there will always be someone more experienced there who can help you :) Ask your preceptor for her experiences and advice on what to do in that situation. (Oh and we call "any doctor stat" usually to try to get someone there. They also don't "break the bed" until they know the doctor is there, the labour nurses all say if they have to deliver they would rather have the bed there then risk the slippery baby sliding into the bucket
:P Which would be easier to happen when you aren't used to delivering all the time like the OBs!)
Hope this helped a little, Good luck in your new job! :)