curious about length of orientation to labor and delivery

  1. I was just looking for some information. How long do most nurses have to orient to labor and delivery? Our unit orients birth center nurses for 6 months with a preceptor, then they are considered as staff always working with a more experienced labor nurse. This is mostly nurses that have been previously working not new grads. Our chief of staff( MD) thinks that it should be longer... which financially is crazy.. he doesnt feel as though these nurses should be counted as staff for at least a year! Most of the nurses that have oriented recentlly have been in nursing for at leat 10 years..they are certainly not new nurses... I'm just curious how long do other centers do???
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    About tntblonde

    Joined: Mar '07; Posts: 11
    STAFF NURSE
    Specialty: OB

    13 Comments

  3. by   BeccaznRN
    I am about 4 weeks into my 15-week orientation on a L&D floor. However, I have been told not to expect to feel completely adequate until around the 1-year mark. I also won't be taking more than a 1:1 assignment alone, won't be able to sign off an outpatient assessment without another RN co-signing, among many other things until I hit that 1-year mark.

    I think it's great that even after my orientation I'm not going to be thrown to the wolves, because I really feel like the 15 weeks are going to fly by! There's just so much to learn in this specialty.
  4. by   SmilingBluEyes
    Look for a place that offers no less than 6 months, if possible. Anyone new to nursing should get no less. If you are an experienced nurse from another specialty, 3 months is good.
  5. by   SmilingBluEyes
    Your Chief of Staff is darn right-----longer is much better. Sadly, new nurses are being done grave disservice getting less. And they have no idea if they are new---and no means to protest. It cheats patients and nurses alike to spend too little time orienting new nurses. Too many places have very short orientations.

    OB is not med-surg or ED. If you can get the longer orientation, it's been shown, you will do much better. And after orientation, expect it to take about 2 years to feel fully "competent" in OB. Prior nurses often do well after 1 year......everyone is different. But it takes a LOT of time to learn any specialty; OB is certainly no exception.
  6. by   nurse79
    I am 2 months off my 3month orientation, and yes it does go by fast! i think i even asked for another week. I was not a new nurse though. L/D is very specialized so it does take a while before you are "comfortable" ..eveyone is different i supposed. Initially off orientation, they should be allowing you to incease your skill level by gettin the pts that are more likely to deliver, pit inductions, and c-sections. In our institution, we cannot triage for a year, and after our advanced fetal monitoring then we are trained in placing IUPCs, and FSEs. I think cervidil placement is also a year later. We cannot triage pts., do discharges, or take antepartum pts for about a year as well. Good luck!!
  7. by   tntblonde
    I am not orienting to the birth center...lol... I'm the preceptor! I have worked in l&d for 15 plus years and postpartum for the 5 years before that, being in nursing for 25 years total..I agree orientation the longer the better. We currently orient nurses for 16 weeks on a full time basis... now here is the part I don't agree with. .. we then take these trained nurses (almost all of whom have nursed postpartum at least 2 -5 years.) then give them 1, 12 hour shift in L&D every 2 weeks. We only have around 500 deliveries a year so they could go weeks without a delivery..I say train them when a position becomes available ... let them work in that position and gain the experience thats what takes time...were looking at our orientation program and the Drs arent too happy with the fact that they are sometimes working with inexperienced nurses, I say the length of time we orient isnt maybe the main issue... what do you all think?
  8. by   JoniL&DRN
    Quote from SmilingBluEyes
    Look for a place that offers no less than 6 months, if possible. Anyone new to nursing should get no less. If you are an experienced nurse from another specialty, 3 months is good.
    As far as orientation is concerned, what do you think about someone who has been on the floor as an intern for ~ 1 1/2 years (with experience on the unit as a doula for ~ 6 mo. prior to NS)? I work on L&D now and am in my 3rd semester. I have been an intern since last May (end of 2nd semester) and will have been doing pt. care incl. VE's and labor for about 6-7 mo. at the time I graduate (orientation is about 4 mo. on my unit). I ask because I greatly respect your opinion.
  9. by   SmilingBluEyes
    You bring excellent knowledge and experience to the table and will make an amazing addition to the L/D unit. I still say, though, as a new nurse, no less than 3-6 months' fulltime orientation is needed. There is still so much to learn that just takes time and practice---and lots of it. Don't let them shortchange you just because of your experience. Functioning independently as an RN versus a doula or intern, still is a big change for anyone.

    GOOD LUCK!
  10. by   JoniL&DRN
    Quote from SmilingBluEyes
    You bring excellent knowledge and experience to the table and will make an amazing addition to the L/D unit. I still say, though, as a new nurse, no less than 3-6 months' fulltime orientation is needed. There is still so much to learn that just takes time and practice---and lots of it. Don't let them shortchange you just because of your experience. Functioning independently as an RN versus a doula or intern, still is a big change for anyone.

    GOOD LUCK!
    Thanks SmilingBluEyes.

    I haven't done much in the way of direct pt. care at this point (more setting up delivery carts and aide type duties) but oddly enough I think that has enhanced my experience and learning. Rather than having to be concerned about caring for my own pt. I've been able to be a mindful observer of various styles of RN (and MD) practice while slowly working into my own. WOW my NM does know something after all!

    I'm sure though that she is hopeful that I'll be on the shorter end of your suggested # ;o)
  11. by   SmilingBluEyes
    The bottom line is this: If you are extremely uncomfortable--- (everyone is a bit nervous no matter what)----at the end of orientation make NO secret of it and ask for more time. IF they say no, then at least ask for low-acuity patients and backup from seasoned OB nurses on each and every shift you work.

    Hope this helps.
  12. by   mimmy
    I have been a RN for twelve years and just began orientation on the LDRP unit about 4 weeks ago. The first two were in triage and the last two were in L&D. My manager said orientation would be 10-12 weeks, and I plan on taking all the time I can possibly get! I cannot believe how incompetant and nervous I still am. I did not expect to feel like a new grad all over again. Do my years of experience mean anything? Each day seems to get a little better, but I think I expected to be comfortable by now. Any advice would be greatful!
  13. by   redpenny
    Hi,
    I am an experienced L & D nurse with labor, post partum and normal newborn experience from a small facility. I recently took a job at a larger busier ob dept. How long would be the norm to expect my orientation to last. I have only had less than 2 weeks of orientation and I feel like they are expecting me to go solo... Is this normal? I have about 8 years of experience in OB, yet routines, docs, schedules, policies, procedures are all different! Please help!!!
  14. by   L&Dnurse13
    Wow. 6 months sounds wonderful. I work in a high risk l&d and only got 12 weeks as a new grad. 2 of those were hospital orientation. 10 weeks after beginning on l&d I was on my own. I did have a resource person assigned to me for the next year. Our resource RN's answer ?'s but do not go into deliveries with you unless something is going on. I felt so lost. I have been in L&D for 4 years now and am comfortable, but that took about 2 years to accomplish. 6 months would be great, but we do an average of 400 deliveries a month, so it is sometimes hard to keep an orientee that long. I know as a preceptor now it is hard to have a new grad ready after 10 weeks. There have been times we have had to let someone go early due to census on the floor.

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