Out of orientation now . . . (this is long)

[RaeT,RN]

Ok, so they've "cut the cord" from my preceptor (though she is still my resource person over the next several days, until I go to nights Mon after Thanksgiving.) I am scared out of my mind.:uhoh21:

Yesterday, I was "kind of" on my own (busy, so I had my pts and my preceptor had hers) and got an active multip. They scare me (not much doesn't scare me right now). I actually did great! Everything went very smoothly and I felt pretty good, like "check me out! I can do this!"

And then, after my delivery, another nurse asked me to "listen out" for her pt. Now, to me that means listen out if the call bell goes off and see what she needs, you know, help her to the BR if she needs it or something. She gave me no report. I asked another nurse after a little while to keep an ear out for her call bell and I took my multip to the floor. I got back and then the primary nurse for that pt pulled me into an empty pt room and blasted me for not doing hourly strip charting because I had assumed care of the pt and I was remiss in not charting on her and assessing and if the doctor called, it would be up to me to answer questions about her. I apologized, said that I misunderstood her and the time frame she expected me to "listen out" for her. I just felt lousy and so embarrassed because I had not done what I was supposed to do.

So I go back in to chart for the hour that I was "listening out" for her and I see in the nurse's notes that she has documented that she gave me report and I had assumed care of the pt. THIS WAS A FLAT OUT LIE!!!!:angryfire I never got ANY report on her - I knew nothing about her!!!!!!!!!! I am still mad about it and went to my charge nurse in tears over it. Lesson learned: always ask the next time I am "listening out" for a pt if I am actually listening out or assuming care. She can't just give me her pt without the charge nurse involved anyways!!!!!!!!!!!!!!!!!!!!!!!!

So that was yesterday. Today I thought I was going to throw up in getting report. Today I had a VBAC who came in last night with bleeding, both the pt and her husband are physicians, already on one milliunit of Pitocin and oh, by the way, her platelets are 87. Needless to say, (her friend) the OB insisted on a repeat c/s. I have never breathed a bigger sigh of relief than when that decision was made. I am absolutely worn out.

But at the end of the day, I still love my job and am so happy to be where I am:rolleyes: I think I have a rough year or two ahead. . . Thanks for reading.

[Dayray, RN]

Something similar happened to me.

A good friend of mine asked me to "watch" her patient. So I watched the tracing for an hour and then the nurse comes and tells me she had hung an antibiotic and could I still watch her a while longer because she was tied up with another patient. At this point I asked a few questions about the patient because I wanted to make sure everything was being done.

Her response was pretty vague basically just said that the patient didn’t need anything and that she would most likely go home in the Am. So I continued to watch the monitor and then answered the call light to get her up to the BR and just let her stay off the monitor.

If it hadn’t been such a busy night I probably would have offered to take report on the patient because my friend was really busy and I only had 1 patient. I was just busy enough helping others to not think that hard about the situation. So the night passes and then at change of shift (3 hours later) one of the nurses on the next shift asked me for report on the patient. I said, "well I don’t really know much other then she is most likely going home today she's not in labor but wants to be". When I saw my friend I told her that I would have charted for her but I didn’t know enough about the patient to be accurate.

Well the next night I was spoken to by the charge nurse and my friend is angry with me for leaving the charting for her. I explained that if she wanted me to take over the patient I would have been glad too but that I needed report and it needed to be said that I was taking over. She thought that the 2 or 3 sentences she had spoken to me were report and had assumed I was taking over.

We never really resolved it but both just kind of dropped it because we couldn’t agree.

-Lesson learned ask "am I taking over or am I just watching?" and if I’m taking over then "I need a real report".

As to VBAC’s - the PLT count would have bothered me but don't let people scare you over VBAC's the risk of rupture is really over emphasized because of the rule of having an attending in house. Trust me if it weren’t for that rule you would see tons more VBAC's.

[midwife2b]

Some nurses I work with would have a cow if I did anything to their patients in their absence. "Watching" often means different things to different people.

During lunch, for example, I "listen out" for patients but only CHART if I do something (Vag exam, treat decels, increase pit).

This is a good topic for discussion to bring up with your coworkers. What is "watching" your patient, and what is expected?

IMHO, you did exactly what I would do... but if the nurse is gone more than 30 minutes, I probably would chart something...

[SmilingBluEyes]

Watch out for people like that....

And welcome to doing OB nursing on your own......keep on doing what you know is right. You have the makings of an excellent OB nurse.

[kimogieo]

Yesterday was my first day off my orientation, so i was on my own for the first time. I had two weeks of orientation, i thought it was alright but i kept getting pulled aside to do someting thats not even my job. The unit manager thought I was there to help her instead of doing meds and learning how residents take their pills, g tube, etc. I was oriented to 3 units withing 2 weeks. So yesterday was my first time alone, i did 3-11 shift...sadly i had 4 g tube pts, 10 finger sticks and the finger stick pts alone took a bunch of my time. I was not even halfway done giving 5 pm meds and it was already 7 because i wanted to give insulin to my patients since it was so high. I was going crazy and wanted to cry but i had to suck it up, I was giving insulin two hours late. I felt like crap after i got out of that facility. I had 30 patients, i felt like quitting because I mixed some 5 and 9pm meds and gave it but only supplements or colace. and then.....when i got home around 1am, i realized i forgot to do treatment it was horrible. I kept crying to my boyfriend, i kept apologizing to the next nurse after me because i wasnt able to clean the cart and she said she understands that she was like that too in the beginning.

I will work today again and tomorrow in another unit, less hectic i hope and I will try and get things done on time. Its so stressful, and they thought i was doing good during my orientation because i am a new grad and im able to deal with doctors and everything but with my med pass, i guess i need to speed up more but im scared to make mistakes, i mean i didnt even had the time to look at the labs and call the MD. i need help T_T

[AprilAZRN]

I sounds like you are moving along in the right direction, learning some important lessons on the way. Absolutely find out if you are assuming care or helping with call lights and fetal distress. It's a common miscommunication, and that simple clarification is so important (and it's asked often, so no one should look at you like you're off your rocker). I'm sure in another 6 months you'll be feeling a lot more comfortable. There is ALWAYS more to learn and we have all been new at one time. Hang in there and have fun.

Hang in there!