New to L&D and feeling low

[purpdiam]

Hello, so I've been a nurse for nearly two years I started out my nursing career on a medsurg unit at a very busy hospital. The unit I was on isn't a typical medsurg unit, we dealt with plastic surgeries, traumas, bariatric, and colorectal surgeries so I've seen many things that I don't think most people get to in the time I had. Since college I've dreamt about being in the obstetrics side of nursing and I was finally granted the opportunity to work in Labor and Delivery at a different hospital. I've been in L&D since mid may so its been about 5 weeks out of my 6 months orientation. I truly believe I like L&D, however I've emotionally been a mess, I just feel like I'm not progressing well. Being the only one on the unit that has no history with L&D and the youngest, makes me feel so insecure and absolutely stupid. If one thing doesn't go as I anticipated I feel like the worst nurse for example, the IV's at this hospital are different from what I'm used to, so I occasionally will miss a stick, if Im having trouble with reading the strips, or I'll have moments where I think "why didn't I think of that?". I'm on the unit from Monday to Friday for 8 hours (till mid July then 3x12's) and the unit, majority of the time isn't busy so I don't get to see many patients or I'm not there long enough to see much happen so a lot of times I'm piecing things together because I can't experience the entire laboring/birth process. The charge nurse and preceptor I'm usually with say I'm doing well but I don't really believe it. I'm practically teaching myself in the education portion of things which is no help, I try to ask as many questions as I can but I think because a lot of the nurses have been there for a while the answers aren't really detailed or everyone does things differently so I'll get confused. I want to have faith that I can do this but my doubts are getting the best of me. Did anyone have a rough beginning that ended up paying off or got easier ?

[klone, MSN, RN]

L&D is an incredibly difficult specialty to learn. The way you are feeling is entirely normal. It will likely be a full year before you feel like you're not totally incompetent, and even then, you will still have so much to learn. However, the rewards are amazing - it's a very gratifying specialty, and such an amazing privilege to be present for an event that the patient and family will remember for their entire life. Hang in there, trust your preceptors when they say you're doing well. If they didn't believe it, they wouldn't be saying that, I promise. 

[vampiregirl, BSN, RN]

Everyone learns differently. If your charge nurse and preceptor see you taking the initiative to learn things and you are asking great questions to clarify/ increase your understanding, they may assume that this is your preferred learning style.

This is very effective for some people! I'm a nerd and love evidence based practice as well as understanding the "how" and "why" of concepts. 

It's also normal to not get every IV stick. I'm guessing you are referring to fetal strips but cardiac strips can be similar in a different way. Just the other day, several colleagues with many years of experience each had a lively discussion about the particulars of a cardiac strip on a patient. That's the beauty of the team atmosphere, it promotes continued learning. It's not realistic to expect to do everything perfect every time. 

Have you considered directly speaking with your preceptor to express your preference for learning. If you are going to start this conversation though, I'd encourage you to bring some specific ideas to the table.

Good luck! And be kind to yourself!

[Skips, MSN, RN]

I know you have a hard time believing this, but you are on the right track. That sounds exactly right. 

L&D is a beast to learn. It's a specialty you don't really spend time on during nursing school because it's indeed so incredibly specialized. It will come with time. I wouldn't expect you to know everything right away as a preceptor. The more experience you gain, you will begin to link the book knowledge to the clinical experience and it will stick. It's how the brain learns new things and makes new connections. (I promise you will get it!). It takes a solid year to year-and-a-half to get comfortable with L&D. 

Missing an IV isn't a big deal. I used to think it was, but now? Nope. I'll try again and if I still don't get it, I'll ask someone else. No big deal. We all have bad streaks.

You have a healthy anxiety. You have two patients to care for now. One you can't "see" or really put your hands or stethoscope on. You got this, though.

6 months of orientation is lucky! I got 12 weeks in my first L&D job, but they kicked me off orientation 3 weeks early. I was not ready. They thought I was, but I wasn't. I never thought I'd ever "get" it, but here I am...in midwife school with about 6 years of experience. I feel like if I can do it, anyone can with how much anxiety and nerves and shakiness I had in the beginning. I was a wreck.

Anyway, I've rambled on enough. I think you're doing well! ? 

[haunani, BSN, RN]

You're exactly where you need to be after only 5 weeks.  

It takes at least a full year to not feel completely incompetent.  It takes 5 years to feel confident.

Notice that those say 'years'.  Not weeks or months.  Your level of anxiety is normal and healthy when learning a whole new specialty.