Newbie advice- 1st job not going so well.

[NuNurse<3]

So I loved Ob that's where I always wanted to be. Well I got extremely lucky and got a GN job on the Ob floor. I'm now an RN and have been on orientation for 6 months.

Well my orientation wasn't great. I didn't get many labors. Like maybe 5 once I was in the role of the primary nurse but they never seemed to deliver on my shift, so I haven't had much experience in that orbeing baby nurse.

Quite frankly the high acuity part scares the crap outta me. I'd almost rather fade into the background when crap hits the fan. I'm afraid to be on my own but my orientation was over so I took my own labor last week for the first time where they actually delivered and the doc said I'm not ready to be on my own. I'm not organized or anticipating everything the doc wants or may need yet and my times management isn't great yet.

So I've been given some options because I'm not getting it good fast enough. I can try to prove myself in the next 2weeks; go to medsurg for awhile, or go casual and take it slow (which I won't do I need to make ft income). What confidence I had is so shattered right now I kinda want to cut and run for some good reasons like becoming a more confident well rounded nurse and also because I'm just scared I guess and feel like such a failure. So does anyone have any advice for a newbie? Thx so much!!

[NoviceRN10]

I don't think going to med-surge is going to help you in this situation, if you really want to become a proficient OB nurse. I think your preceptorship sucked and they failed you by only getting you involved in 5 deliveries over 6 month's time, that is absurd! Are they willing to extend your orientation or are you supposed to muddle through 2 more weeks to try and learn on your own what they didn't help you with already?

[NO50FRANNY]

Hey there newbie,

Firstly I admit that I have zero experience in the area you are working but it sounds very specialised. You shouldn't be so hard on yourself when confidence is obviously part of the problem and that confidence is something you can only gain with experience. Six months is not a long time.

I moved to a specialty area after 10 years of experience as an RN and my confidence built over time- after six months I was still pretty green and in no way on top of the game but I often think how difficult is must be for newgrads coming straight into any specialty. I started in mine with lots of experience with patient care, knowing my drugs, watching people get really sick, good time management all those things that come with time.

This helped a great deal, and I know a lot of nurses would disagree but I think that working on the floor in a ward whether it be medical / med surg or the plethora of other areas gives you a good grounding to start somewhere more specialised. Importantly, before anyone gets upset, I know that wards are also specialties but it is usually a more controlled environment, where a new nurse has usually got a lot of backup and can really learn how to manage their workload and the art of prioritising and anticipating.

I am not surprised that the high acuity patients scare the crap out of you, if you are not confident with your skills and knowledge they will continue to.

Ultimately it is up to you, but if you do decide to leave don't consider it a failure on your part. Some people learn from books and some people learn by doing. You obviously have good insight as to what is going wrong, just choose the path that will help you be a better practitioner and get you where you want to be. Your colleagues/fellow nurses should be able to give you some good advice too, keep your chin up.

I guess I would vote- get your basic skills down, prove how determined you are, get your confidence back. Good luck.

[bayareastudent0711]

if you don't think your orientation was great. SPEAK UP. stick it out for the next 2 weeks. but speak up and ask for help/ guidance/ questions, ask for more orientation. one of the posters was right. 5 deliveries in 6 months? take advantage of all types of learning opportunities. if your shift ends, and she hasn't delivered, attempt to stay longer if possible to see it through, even though after 8 or 12 hours that doesn't sound fun. it is your career on the line. do everything you can to learn more and more, and prove to the unit that you are REALLLYYY trying your best enough that THEY SEE it. they probably think everything is fine and dandy, because they don't see you struggling or hear your questions, busy with their patients and their lives =/ just speak up more, sometimes you go unheard the first time around.

and if the high acuity part scares you: ask what part scares you? the ability to perform the basic skills needed, not confident in your assessment that their status could turn critical because you missed something? clinical judgement?

ask yourself if you can get the answers you need in OB/textbook/practice or in medsurg/hands-on for your career goal.

maybe go slow would be good too? some income is better than NO income.

goodluck and hang in there with whatever you choose!

[NuNurse<3]

Well, I decided to go to medsurg for a while. Hoping to get into the oncology med surg. I talked with my managers, and they were so good to me, they said it was my decision, I can just stay on my full time rotation until I get a transfer, and they'll give me excellent recommendations, and will invite me back down the road if I want to come back. They praised me up and down what a great person I am, how they're happy to have gotten to know me, because I'm the kind of person they want working with them and not to be too hard on myself, and that it would be good for me to get a good foundation, then I'll be really ready for anything. They're being very supportive, so I'm so relieved. Now that I feel like I forgot everything medsurg related though I better get out the books and study up again! Oh and I can just serve as staff doing Post partum care until then , and they also gave me the option of staying casual too to pick up shifts there once in a while if I wanted to. :)

[NO50FRANNY]

Congratulations! Oncology / medsurg- fantastic area to work in, oncology patients have so much going on and you will be an expert with both your basic nursing skills and dealing with complex, sick, patients. It's great that your management were so encouraging, sounds like you are on the right track. From your post it sounds like you are pretty relieved and feeling better, good luck.