orientation

RMH · Mar 16, 2003

In our small hospital it is very hard to have a set time/# of deliveries for orientation because of staff schedules, and most importantly, the un predictablility of timing of deliveries. but a few years ago we wrote a protocol(sometimes we follow it). Minimum of 10 deliveries, to include uncomplicated, epidural, mity vac use, and prep for c/s. Also they must take a fetal monitoring class and NRP. If 10 deliveries is not enough, we will continue orienting until the nurse feels comfortable..this is an improvement, since when I started here 11 years ago it was watch 1, help with 1, do 1 then you were on your own!!!. As far as the part about experienced nurses..Ha!Ha! Ha!. We have never had 1 of those walk through the door. Most experienced OB nurses do not want to do med/surg on down time. the problem with rural hospital nursing. Anyone out there want to move to far No. Calif.?

layna · Mar 16, 2003

This is a great question. What I would like to learn more about is the challenge of orienting someone- new grad/RN with experience- in a small rural hospital where I am a manager. We do about 20-30 deliveries a month and I find that there are often times where there is just not enough experience for the new hire on orientation. Our last few new hires have been great about staying home on call if the unit is quiet, but this delays the orientation process overall which is frustrating to the staff who want them ready to fly. I am trying to get more creative with this problem by establishing a relationship with another manager at a tertiary center who agreed to help us train our new RN,s. In May, I will be sending one of our new RN's for a one week experience in a busy L&D unit. I hope that this would be enough to get her going, but I am not sure. She will be 3 hours away from home and I do not know how she would feel about more than one week.

I would love to say that I had the luxury of experienced L&D RN's in this area, but with the nursing shortage and where we are located (northern michigan), those resources are not here.

Any ideas are appreciated- especially from those of you who are working in small rural hospitals.

Thank-you!

layna · Mar 16, 2003

RMH,

I just read your post. Ahhh..the challenges of staffing an OB unit in a rural hospital!

RMH · Mar 16, 2003

Layna,

We must have been posting at the same time..You think you are rural, we do about 10/month!! Weve tried to send nurses to larger facilities and the basics are there, but in big hospitals, the care seems to be broken up, ie. labor, delivery, pp, and there are more staff at ll deliveries, so the overall orientation isn't shortened.

ShandyLynnRN, BSN, RN · Mar 16, 2003

I had 2 1/2 years of skilled nursing units, Nursing homes, and a little med/surg when I started OB.

I also was orienting in a small hospital that did 15-30 deliveries a month. I got 6 weeks on the day shift, and then (I think) 3-4 weeks on nights, and then until I had been there 6 months and could take my FM class I was always with an experienced nurse. They had me learn nursery and neonatal care first, then post partum, and then L&D. OFcourse, I was learning all three at the same time, with emphasis on the other at the time.

Then my boss simply asked me what I felt comfortable doing. Since we were a small unit, there were many nights where I was the only nurse staffed. They were always very good in orienting me, answering questions, asking me questions to test my knowledge, and calling me in when there were deliveries or other things like epidurals or stuff that I hadn't dealt with much!

I had a very good orientation. I have been at OB now for 2 years (one year in my current facility), and I am still learning. It is great to work with people who like to teach. There are still things that I don't know well... for instance how to zero the stupid IUPC!!!! The doc's like to teach too, and are great about answering questions.

I hope you get as good of an orientation as I did!

layna · Mar 16, 2003

I went to a national OB, Ped, Neonatal Nurse Manager conference in Miami, Fla and the majority of the OB managers tell me to expect at least 6 mos to a year for new grads or RN's with no OB experience.

L&D.RN · Mar 16, 2003

We have 5 month orientations, whether you're a new nurse or new to OB. That can be extended if the orientee or the preceptor needs more time. We do have a checklist of things that you have to participate in, different types of births, using certain equipment, etc. Then there is another 2 weeks orientation on nights before you're set out on your own to fly! Our hospital also has a contract with some of the smaller rural hospitals and we train their nurses that want to go into OB. One of those hospitals is so small that they are "on call" for OB. I thought that was a hoot!