I am graduating in December and have accepted a position with a local critical access facility. I will have a short internship in Medsurg and then train to work L & D NOC's. I know that I have a lot of responsibility as a new nurse, so I want to learn as much as possible about what I should focus on to prepare for this new role. I would love to have advice from OB nurses and hope that you can share lessons you learned throughout your careers. I am currently precepting in OB and have a decent grasp on post-partum nursing. I feel confident in caring for mom and baby and education. I think my big questions are L&D centered. What are some of the most common indicators of a need for critical intervention? Though we wish that all deliveries could be ideal happy mom happy baby scenarios, what do you do to manage a situation where mom and/or baby are at risk? How do you cope with fetal demise? Have you found ways to support mom after a loss of baby? Are there ways to comfort a NICU mommy that are more effective than others? What are your favorite resources for researching current practice and future direction of OB nursing? Thank you in advance for any advice/input you can offer!
Oh so many questions. Get to know how to read your fetal heart race tracing and what types of tracings are indicative of fetal distress. That is the biggest indicator of how baby is tolerating its environment. For moms the biggest things I watch for are bleeding and symptoms of preeclampsia and infection. Keep a close watch of vitals. Always make sure to try and keep your lines organized and make sure the room is ready to have the bed roll out in case of an emergent c-section. My own personal pet peeve, keep the room clean. Toss something in the linen or in the trash as soon as you use it or change it. Clutter creates unsafe rooms. Dealing with a demise is always hard. I just try to support the family, allowing them to express whatever emotion they are having at the time. Let them know it is ok and normal to feel what they are feeling. I make sure that they get to spend as much time as they want with their baby. You really just need to take cues from them as how best to support. Make sure, if possible and desired, to get mementos for the family. They may not want it at that moment but in the future a foot print, picture or lock of hair may bring them comfort.
The most important thing you can do to be a great L/D nurse is be willing to learn every day. Ask questions! If you are concerned speak up and talk it out. Learn from more experienced nurses on the unit. When you make a mistake, own up to it and learn. Most importantly, pitocin gets attached at at the hub closest to the insertion of the I.V.
Congratulations on your position.
If you are in a critical access location, it is imperative that you identify what your resources are (what is your core staff, who is on call, how to get the House Sup immediately, how long it takes for providers to arrive, who is in house) and frequently review what to do in emergent situations. If you find yourself in a situation that is higher risk for complications, take the time to look up what would need to be done if needed for the situation if you can before something happens (review NRP steps, medications etc). I second the above comment, ask questions and be willing to learn and good luck on your journey!