NurseGuru

Anyone able to share insight to these programs? Thinking about applying?

Getting into a new grad program is ideal but doesn't happen for everyone. I would suggest looking into volunteer positions where you can work on clinical skills but if you can't get in anywhere because of COVID, then start looking online for case studies or simulation packages! There are so many other things you can do as a nurse. Look into teaching BLS or look into being a telehealth/call center while you're waiting for better opportunities. You can still have an impact. Nurses aren't considered less than if they do something outside of the bedside like public health or community outreach. Lots of nurses start a Youtube channel to teach or share knowledge. Look into research nursing opportunities. Look into COVID testing sites. Look into aesthetics nursing or medical spa nursing. You may find your place in the wide world of nursing by picking a specialty- find something you like and take a certification class!

I'm so sorry to hear that you're experiencing that- it sounds like alot of the other nurses are not being patient or understanding with you and that is completely unfair. As a new nurse, everyone struggles. It wasn't until I was a year or two in that I finally found my flow with time management and felt a little more comfortable. It is really important to seek out a mentor- there has to be someone who is more experienced that would be willing to help you if you approach them. I would make it a priority to keep talking to your nursing leadership because they need to hear how you're doing that way if anything comes up (especially if others are going behind your back to report you) then they hear your side first. There is nothing wrong with enrolling yourself into a continuing education program to work on your skills. We aren't supposed to know everything and no one is perfect. The fact that you took this to heart means you care alot about your job, about your patients and it is so good that you care! That is a really good sign! Be proud of yourself! Lots of people walk away from the profession altogether or start looking into jobs away from the bedside or away from people. Don't forget how hard you worked in nursing school. You EARNED your right to be there, working as a NURSE like everyone else. And it sounds like you are trying your best. You are exactly where you need to be in terms of your learning & development- you're a novice.

Yes, and you can easily find one here or on social media platforms!

Be careful with SDSU. Look into other schools just in case. I transferred out of SDSU after my first semester. I got into their nursing program thinking it was going to go well but then everyone got the email about "we cannot guarantee clinical placements". This was way before covid by the way. This was like in 2013. I do not trust institutions that can't secure clinicals- alot of people suffer and end up not graduating.

Go get ACLS, NRP, but also get intermediate or advanced fetal monitoring, STABLE, and ALSO! Start looking for an L&D mentor ASAP- there is still going to be a learning curve. This is so exciting though, good luck!!

No, no, and no. I would report the census to someone. I don't know what state you're in surely they have a patient to nurse ratio. That is a recipe for burnout. I am most worried about the quality of care the patients are getting.

When I was new to L&D, I thought my preceptors were so mean-borderline nasty because they nitpicked at every little thing I did, I felt awful when I couldn't finish tasks within a certain timeframe or did it a certain way but the reality is that they are so hard on us because this is a highly specialized area with high rates of litigation. It is for the best. Keep your head up! L&D is similar to any other critical care /trauma or urgent care environment in that your own body is physiologically under duress. So, naturally if you are experiencing anxiety and stress that is interfering with life (sleep/ emotional health) then L&D might not be a good fit for you and there is nothing wrong with that - postpartum or antepartum may be better (maybe temporary) thats OK! You literally have hormones, adrenaline, cortisol running through your body and spiking really high at random times in L&D which is not normal or sustainable. Actually, the best way to do OB if you love this specialty is to rotate as often as you can. It helps keep your skills fresh, make you well rounded, and also help prevent serious personal health issues later on. You should be proud of what you have done so far! It is like learning a new language. Unlike physicians, who get a nice residency and fellowship to hone in their skills -nurses have to perform within a shorter period of time. Even the most experienced nurses can make mistakes or forget something- but the best thing you can do is to find a mentor. If you can't find someone at work who is willing to be a resource, then seek someone outside someone who can talk you through the care as a debrief or go over case studies or review strips. Look up the AWHONN and ACOG practice bulletins, read your SOPs, make yourself a nice timeline or spreadsheet with notes on when you do each task. The NCC has an EFM tracing game that you can practice reading strips. Good luck to you! Feel free to PM if you have any other q's.

My strongest recommendation is the first option. You don't want to burn yourself out before getting to L&D. There will always be plenty of time to work on your bedside skills during the birthing process. Being a doula can be super taxing on you physically, and emotionally. If you are OK with coming home tired then go for it. The most important thing- as a doula you have to be focused on the mom. Nothing else. You can't stop to go talk to the nurse or look through charts and try to learn as often as you may think. If they're working through pain, all your energy is on helping them breathe or feel comfortable- but these are things you can easily learn later on because this takes time/experience every person is different. The nurses will also appreciate if you did not interfere with their duties - they may be too busy to teach you anything. I experienced this at one point I thought they were dismissive but that wasn't the case at all they were super nice outside of the clinical area. Not saying this is a 24/7 thing, but alot of times they are pretty focused on the safety aspects of different stages in labor can become dangerous so they may not be as social. The nice thing is that you do have foundational experience, but the tempo for L&D is very different. Working in the prenatal clinic will give you the benefit of learning about pregnancy itself- breastfeeding/ ultrasounds/ understanding labs and charts. It is always nice to learn what is normal before you get into critical/ abnormal. If L&D is something you want to do later on, then clinic is nice to start with. I think getting exposure for L&D -just do a few shifts shadowing or observing if you can and that is plenty you don't have to spend 2 years being a doula before going into L&D.

The biggest difference between OR and OB is a huge curve in patient interaction. The similarities is that you get to work autonomously - lots of standing orders, you drive the birthing process in most cases depending on how much time you spend at the bedside. You also will still do alot of standing plus more additional physical activity especially if the patient does not have a support person or doula. L&D is stressful. There is 'good' stress like the baby coming out and everything going well, but there is alot of other stress because you are constantly on edge, paranoid, anxious because you will spend time monitoring the patient for a while before that happens. And, once the baby is out, there is still ALOT that can go wrong. L&D lifestyle requires hardcore self-care. You have to really know yourself and love your self constantly. Lots of adrenaline rushes, cortisol increase, and hormones. It is hard to explain in words, but the Labor part is real- it means hard work. You have to eat smart, sleep right, exercise on your time off to keep up your stamina, you have to be emotionally available, etc. OB surgeons and MFM (complicated maternal fetal medicine docs)are divas. I will tell you, honestly from my opinion, its like if you cross a trauma surgeon with a neuro surgeon. But- if you really know your stuff, you won't be fazed. Your ratios are generally 1:1 if you patient is in active labor without an epidural, Cat 2 tracing, actively pushing, and after the first hour of delivery. Otherwise it is 2:1. Triage depends on the facility you're working but look up the guidelines. Unless there is a designated baby nurse, you also have to take care of both patients (who will have very frequent v/s and assessments.) Typical day is 12h shift, you will either be assigned or pick your own patient. If you don't take a patient then you are on stand-by duty for triage. L&D nurses are expected to circulate their own cases if they crash for cesarean- that was and still will be your patient even if there is an OR nurse you can still go and help. Scheduled cases go to the OR team but if you are experienced you can do it. You need to get fetal heart tones in the OR before they cut. You may also be asked to perform a 'lady partsl hand', place PR cytotec, or be on stand by for massive transfusion or NRP. Hope this gives you a better idea of the job. Feel free to PM.

Being friendly, helpful and asking questions as you mentioned sound like great qualities to have. I am excited for you! The most impressive thing a novice nurse can do in L&D world is come prepared with knowledge on the most up-to-date practice guidelines from AWHONN/ACOG. Ask where the unit SOPs or CPGs are, and compare them. Another really impressive thing is demonstrating self-control and confidence when there is something you are competent in. A 'don't' for this is don't wait to be invited to do anything- ask or offer to do things (your assessment, your labs, plan of care, etc). Having a binder or clipboard with major points to refer to or ask questions about in a debrief or post conference is good- nurses normally don't like to stay later than they need to but if someone demonstrates passion, they will spend the extra time to explain things. Take ACLS, PALS, NRP, ALSO and advanced fetal monitoring to advance your skills if you haven't already. Know your protocols for massive transfusions/shoulder distocia/ birth emergencies. Some other helpful don'ts: Don't feel bad/ashamed that you are new- many but not all laboring women do not like students but the important thing is to be honest and build a relationship if they allow it. Don't come unprepared. Labor and Delivery- 'labor' means work- so you need to eat, sleep, stay hydrated, exercise, be alert, ready and willing to work if you choose this specialty. Lots of calories are burned during a shift- especially if the patient doesn't have a support person or doula. Your cortisol and adrenaline will be skyrocketing all the time, so you need a self-care plan. Don't be lazy. Most nurses including new nurses aren't inherently lazy, but it can get tiring or overwhelming going into a stressful environment so early in the day or late at night-you may see other nurses over time not be as active or involved with their patients but do not be fooled- as a new nurse everyone will expect you to be constantly in the patient's rooms, and taking interest in the most complicated or unusual patients. Don't be afraid to speak up. You see anything concerning on the monitor, in the chart/labs/ something a patient says/ abnormal assessment finding, you are expected to intervene and communicate appropriately. But very important- do it respectfully- don't take an us versus them mentality when it comes to working with doctors or midwives, everyone is on the same team. Be extra careful with TOLAC, ECVs, and inductions. Good luck!

I am board certified, and I can help you with studying- We can connect by PM if you want.

Waiting on a decision as well. It can take up to a month for some, but I have read elsewhere that some people have gotten decisions within a week or two. A close friend of mine got into the midwifery program two years ago and she heard back within 2 weeks. Best of luck to all of us. The other schools I'm considering: Johns Hopkins & Columbia. All three have the best resources in addition to having the most influence on charitable engagement with communities & values. The downside for me was that the start date is Fall or Summer of 2022 versus Jan. I also didn't see Columbia offering hybird or virtual learning which means I'd have to move to the city and I can't. Anyone doing the DNP as well?

Anyone remember how long it took to hear back on a decision after interview? Anyone get offered any scholarships?

Anyone remember how long it took for the decision after the interview? Did you get phone/email/mail notification? Anyone get offered scholarship upfront?