Poor L&D Orientation

[Lavender619]

I'm looking for some advice. I am an RN with 5 years of experience (3.5 years med/sug, 1.5 years NICU) who recently started training to L&D. The hospital I work at is a smaller community hospital known for taking a lot more unmedicated deliveries which is what I wanted. I worked for a few months here in their special care nursery and post partum (though normally taking very stable patients since I could have to be called the the nursery). My L&D orientation is coming to an end and is measured by hours (256 to be exact) which counting out has been approximately 6 weeks. I had an opportunity to take and L&D job at a large high risk hospital with a much longer orientation and turned it down. I'm feeling incredibly unprepared to work on my own. Since we have such a low volume of births some of my shifts have been very slow with a labor patient sleeping or caring for her postpartum after 1 delivery. Most of my experience on orientation has been very straight forward - natural deliveries, some circulating experience, a few triage patients, epidural deliveries. I'm expected to do all of this off orientation. Everyone keeps telling me I can always ask for help and they expect me to, but I feel like there is so much I haven't experienced I'm going to be so incredibly anxious going to work everyday. On top of that, I'm expected to continue working in the nursery on most scheduled days with two weeks of straight labor after orientation.

I don't know what to do. I know the hospital has spent a lot of money on orientation but I feel like I know nothing. I can ask for more time but I know from other nurses it will be a couple more days. I feel like I made a huge mistake coming here and wondering if I should just start looking for another job. I'm nervous this will look terrible on my resume to quit a job I'm only been at for 5 months. Perhaps all nurses feel like this coming off orientation and maybe L&D isn't for me. I thought this would be the area of nursing I would love the most, but I feel incredibly unprepared.

I'm just looking for advice. I'm worried I'm going to turn out to be a terrible L&D nurse because I'm going to be learning everything on my own after orientation. Should I high tail it out of this place? Will I look terrible to another potential employer in L&D?

[ashleyisawesome, BSN, RN]

You are going to feel like that no matter how much orientation you get. I didn't feel confident until I had about a year of experience on my own, and even now I still run into situations that make me uncomfortable. Do you know how to take care of a stable, normal labor patient? Do you know who to call when you feel in over your head in an emergency? Then you are good. I would give it a chance and see how you do. Labor nursing is a team sport. You are never alone. We are always willing to come help if you need it.

[XXXX5]

I recently came off of a very long orientation process for L&D and I still don't feel like it was not long enough or rather the time didn't prepare me in the needed ways to be on my own...I wish I felt like it was a team sport- but I feel like I am looked down upon for asking for help. I don't know if it is in my head or if the senior nurses are giving me a bit of a hazing...How does a new nurse ask for help from a staff that has 10+ years of experience without seeming like a burden?

[Surfandnurse]

L&D is so specialized and especially depending on what experiences you got during orientation, you should definitely ask for more orientation if you are feeling nervous as all get out to show up to work. Of course everyone feels over whelmed when they start, but you shouldn't have anxiety about coming to work. Request an additional two weeks and go from there.

Some people see all the crazy OB catastrophes during orientation and some people get normal, healthy moms and babes! It's not that anybody wants to experience a prolapsed cord, a placental abruption or a mom seizing, but at least after you've been through it (and hopefully there would be a resource nurse with u if experiencing this for the first time off orientation....) you wont feel so anxious wondering when is IT going to happen on my shift.....but then again some people never experience a catastrophe! Knock on wood......

[Lavender619]

Ashleyisawesome: Thanks for the advice. I've been feeling a little bit better lately as I've had some good stable patient assignments that I've cared for decently independently which I probably what I needed.

XXXXS: That sounds really frustrating. Is there anyone else in the same boat you can talk to or get advice from? I've been in jobs like that before and it helped me to find one person who had survived that to give me some advice on how to make it myself.

SurfandNurse: I did ask for more time and originally they said no as they had "heard I was doing well." My preceptor told me she's not sure who they heard that from as it wasn't her. She ended up convincing them to give me 3 more days of orientation. Sounds like I'm not the first in the dilemma and that we don't have very supportive management.

[hexoptic]

As long as you have someone to lean on you will be fine. I work at a small hospital (50 deliveries a month) and we don't leave anyone totally on their own until they have been there a year. Every new nurse is terrified, just ask for advice or assistance when you feel uncertain. Give it a few months and you will be mentoring someone else.