Noor545

Thanks to EVERYONE for replying to my call for help. Yes, another job would be best. I am almost 64, do you have any idea what it is like to interview for a job with a 25-y-o who asks if you think you could "handle the strain of hospital nursing?" Yes, I know, that's against EEOC - I've already submitted that one. I am definitely looking for another placement. Yes, no RN to orient me was ludicrous and crazy. As for a patient coming in to deliver, I've done that so many times over the years I can't count them. New standards state 2 NRP certified personnel must be present. We didn't have that in "the olden days" (as the young nurses refer to my experience). Although it sounds arrogant, I know that there is no emergency that would come to OB that I haven't learned to handle. Doing it all alone is no fun. At least the House Supervisor shows up when a patient comes in unexpectedly. My Head Nurse (Nursing Supervisor - whatever) is so non confrontational that she doesn't speak up for us at all. In fact, she was the one who handed me the Corrective Action form and didn't seem to notice that the DON kept referring to the fact that I had refused to do a STRESS test on a 22 weeker. Who on earth would put a 22 weeker on Pit????? He has no idea what he's talking about. As for people having their noses out of joint because of the experience I have had, you are right. Not a single OB RN has worked anywhere else. This hospital has about 30 births a year. I have worked at huge facilities with multiple births every shift. I'm not scared of anything there except the incompetency of the administration. I am formulating my reply. There is NO union there or I wouldn't be having this problem. One of the MD's told me today that if the administration tried to do anything about this they would be shot down immediately. Head nurse says "just sign it and forget it - it's no big deal". The HELL it isn't. Yes, I'm still hopping mad but instead of leaving in what some would think was disgrace, I will fight this to the wall. Thank you all - You have really given me a boost. Noor, RN

I am on orientation to a small community hospital OB unit. I have almost 30 years of experience in OB - both hospital L&D, Post Partum, Nursery, Antepartum, high risk and low risk and clinic settings. I don't claim to know everything in the world and learn something new each shift, but I KNOW WHAT I KNOW. Orientation at this hospital is tough. The regular OB nurses have been getting paid full wages to stay home on call if there are no mothers or babies in hospital. My orientation meant I was at the hospital BY MYSELF for 12 hour shifts with NO ONE to teach me the system unless patients were there. One day - while there alone - a doctor's office nurse called and stated that the doctor she worked for was unable to get fetal heart tones on a 22 week gestation patient. She said the doctor would like to have the patient come to the hospital so she could be put on the fetal monitor. Since there had been quite a flap between ER and OB recently at this hospital the OB head nurse and the director of OB MD decided we would not put anyone under 24 weeks on the fetal monitor. The head nurse had just sent out an e-mail to that effect to all OB staff. I told the office nurse that if the MD could not get fetal heart tones ACOG Standards of Care recommends an Ultrasound. She put the doctor on the line (which is how it should have been to begin with since he was standing right next to her). He told me he thought it would be 'REASSURING" to the mother to be on a fetal monitor. I'm thinking that 1) if the MD couldn't get fetal heart tones at 22 weeks gestation with a doppler, either the MD was a problem or there were no heart tones to be heard. 2) I told him that our Head Nurse had just sent out an e-mail to the OB staff telling us that we should not put anyone under 24 weeks gestation on the fetal monitor. 3) Since I was new and he had no idea who I was (I had never met him) I started to tell him that I had about 30 yrs experience when he simiply hung up on me. I knew I had told the doctor the right information - 1) ACOG Standards 2) the most definitive answer to the question of whether the fetus was alive or not and 3) the instructions of my head nurse as in NEW POLICY. Immediately after the MD hung up on me I tried to telephone my head nurse - no answer and message not returned. I called the RN who was on call at home and she agreed with my advice to the MD but stated she probably wouldn't have "had the nerve" to tell him that since he "doesn't like women". I then called the Director of Nursing to tell him what had occurred. I told him I knew the correct information to tell the MD and felt I was correct in doing so. He told me "there's a way to take care of people like you". I am now being charged in a CORRECTIVE ACTION for refusing the doctor's order. Not only that, but in the wording of the charges it states that the doctor ordered a STRESS TEST on the patient. That was never ordered. Who on earth would do a STRESS TEST on a 22 week gestation pregnancy??? The Director of Nursing has no idea what he is talking about. What seems to actually be the problem (as I see it) is that I disagreed with the DON's idea that an RN can NEVER refuse an order. Of course we can. Jehovah Witness RN's don't give blood even if it's ordered. They have to assign another RN. That's refusing an order. Just reading your state's Nurse Practice Acts also tells RNs that we can not do anything that would cause "Mental Stress" for the patient. Surely trying to trace a little 22 week fetus around with a monitor meant for TERM infants would delay her assurance of her baby's well being. How do I defend myself. My probation period has been extended for one month beyond my "orientation". Dog gone it. I know what is the right thing to do and I tried to tell the MD in the best way I could. I never REFUSED an order. He "requested" I put her on the monitor. And my head nurse should be baking me up that I did the right thing. Any ideas out there? I refused to sign the Corrective Action paper and stated that I wanted to write my own response. One of the things I am being charged with is not following the hospital policies - two of which are to show Empathy and Compassion. I certainly belive that I was doing just that by advocating for the fastest way to show that mother that her fetus was indeed ok (and the baby was okay according to the US done that day). Help, Please. Noor - OB RN

Dear "Nellie Nurse". As a night nurse working OB (L&D, Mother/baby and Nursery) it burned my tiny behind (well, it was tiny then) when the younger nurses on nights were working those nights so they could go to school during the day. They were all obtaining their Masters Degrees so they could get OUT of Hands On Patient Care. They would invariably choose to "guard" the nursery. There, they could sit in a comfortable rocker, hold a baby and fall asleep. If a baby started crying in the nursery their usual response, was "Naughty baby". As with you, my blood boiled. At first I would go in and simply wake them up - "Hey, you are holding precious cargo. What if you should drop that baby while you are sleeping?" But that wasn't enough. They were all BSNs and I was an ADN (although usually in charge). Finally I decided it was just too darn dangerous and disgusting as well. When I saw a nurse sleeping with a baby in her arms I would give a call to the House Supervisor. She would toddle on up with her Polaroid Camera and take their picture. Soon that nurse would be gone. I was certainly not best friend of any of them, but they too had gone into nursing only as a stepping stool to something "better". Personally, I have never found anything better. BTW - that House Supervisor and I are still very close friends. So, yes, it boils my blood to deal with nurses who don't give excellent, compassionate and quality care to every single patient - no matter what. Thanks for your note.:redpinkhe Noor

I think I just lost the message I wrote - so here goes again. Is there a thread on this site for we mature, experienced, hard working, well grounded, nurses who happen to be "older" than what the hospital criteria call for? Those of us, for example, who are struggling to find meaningful jobs that we know darn well we can perform (outperform the younger nurses if you will). For those of us who know not only how to treat the Patient, but also how to care for the PERSON. If there is one, please lead me to it. If there is not one - then let's start one. Noor

Although I surely welcome all comments - it seems that some of you TOO are focusing on my age. Yes, I am 63. Can I do the running, lifting, etc. that is necessary? YES! I certainly proved that while doing my practicum with the refresher course I took. Do I have experience and knowledge that it took 20+ years to obtain. Do I want an acute care setting with all that goes with it? Yes. I am a terrific nurse. (Yes I WILL toot my own horn). When some of you are 63, I hope you remember replying to my post and suggesting jobs that are "more suited" to my age. "Age is just mind over matter. If you don't mind, it don't matter". I feel 17. But I have life experience and nursing experience that is being wasted. It makes me angry. I will be researching legal aspects for the jobs I have been refused while ads are still in the newspaper for those jobs. Please, don't think that 63 makes me a useless old woman. I am NOT. I want desperately to be part of an acute care setting either in Gen. Surg, OB or Med/Surg. Noor

I am desperately trying to find a job as an RN. I have been out of hospital practice (in clinics) for about 20 years and took a refresher course with hospital practicum. Did great and got rave reviews - but can find NO JOB. I am sure part of it is my age (63), but it is illegal to discriminate. Of course, if I had a decent paying job I could afford a lawyer to fight that BUT.......... Why do I see almost all RN job offerings for Dialysis nurses???? Is it because their is poor job retention in Dialysis? Is it because the world needs so many more Dialysis nurses? What's Up? Any answers would help me out here. Thanks, Noor

After 27 years in OB - mostly L&D or Hospital Birthing Centers where an RN does all areas as she is primary nurse for the "family", I can tell you this with a fair amount of confidence. L&D is extremely competitive. I'm wondering if all ICU areas are like that. After all, we, as L&D nurses are dealing (literally) with life and death every single time we care for a mother and her infant. While at one of my jobs, the House Nursing Supervisor for Night shift gave me an article called 'How to Swim with Sharks". I've never forgotten that. She is my friend to this day. I am sorry to say that even in clinics, the nasty behavior of some other nurses is embarrassing. I've never really worked with men very much, but after working for the last 45 years in different areas - almost always with mostly women, I am ashamed of the behavior I see. All I can do is try very hard NOT to be like the others. Not to judge immediately, to give everyone a chance and to let the ones who just aren't "getting it" that they are being seen that way and ask if I can help in any way. Noor

For all you New Grads - How about this. I have been an RN for 27 years. I worked clinics while my adopted sons were growing up, but worked hospitals before that. So I have been active this entire time. BUT - can I find a job in a hospital???? Not on your life. I have applied at 12 hospitals and only two bothered to interview me. One of them was where I had my Practicum for the RN Refresher course I took (which it turned out was a waste of time and money). The Preceptor I had highly recommended me for the open .8 position therre, but somehow when I had my interview "There aren't any openings right now" was the speech I got. Their are two jobs posted outside the cafeteria. My specialty has been OB. L&D in hospital. The Head Nurse of the OB department at this small hospital has been an RN for ONE YEAR. She has witnessed TWO BIRTHS. I have witnessed, participated in at least 1,000 births in my career and delivered at least 30+ (not by choice - just emergencies and no MD's avail). That head nurse doesn't want anything to do with me. Perhaps she is threatened, as well she should be. Bottom line.........I am 63 years old. I still feel 17 and I can move just as well. I absolutely LOVE nursing. It is the only thing I ever wanted to do in my life. But I can't find a job anywhere. Any suggestions? No, thank you, I do NOT want to shuffle papers in a nursing home. Besides, Medicare doesn't pay for childbirth. Can you spell F R U S T R A T E D ????? Noor

One More Thing - I have found L&D to be the most competitive area I have ever worked. I love it, but the nurses are extremely competitive. Sometimes that means you don't get a good orientation. Control is their issue. If you are meant to be a L&D nurse, you will "get it". Hang in there. Noor

OK - here's where I will probably upset everyone. The first time I was told to do a lady partsl exam I told the head nurse (also my preceptor at a high risk very busy L&D unit) that I had never done one before. She said, just look at the dilitation chart on the wall above the patient's head and try to visualize what you feel. I got it right and haven't made an incorrect eval since. I feel like L&D nursing is in my soul. I'm not trying to boast. There are better nurses out there, I am sure. But I seem to have a sixth sense for trouble and have made it my business to know what to do in such cases. It takes time and lots of reading and practice. I ate up every minute of my orientation. It was to be 6 weeks, but at 4 weeks I was mostly on my own. I asked one of the nurses how long it would take before I felt "comfortable". She said a year. By six months I think I had seen about everything I could ever imagine and made it through all of it. Yes, there were times I was frustrated or unsure of myself. But I ASKED QUESTIONS whenever. I never felt like any question was too stupid. Once an MD found my crying after a particularly difficult crisis (mom and babe were fine). He asked me what was wrong and I told him I felt awful that I hadn't anticipated his needs. He reminded me that none of us are mind readers. We do the best we can and if we need help we ASK. If you don't feel like you are "getting it" perhaps L&D isn't where you will shine. If you don't feel you are getting a good orientation - ask for a different preceptor - talk to the head nurse. Do whatever you can to be the best nurse you can be. I hope you make it. I love OB. Noor

My entire career I have been an OB nurse. But after a few years off I took a Refresher course and ended up working a Med/Surg Floor in a small town hospital. Most of the patients were quite elderly and I found them to be an absolute delight. My favorite was a spry old fellow (97) whose eyes just sparkled with mischief all the time. The first time I helped him up to the bathroom I stepped outside to give him a little privacy and then went back in to hand him tissue. I balled up a bunch of tissue and handed it to him. He looked at the tissue and then up at me. Then he very patiently tore off two squares of the tissue. He folded them together, then in half and then in half again. Now he had about a 2x2" piece of Toilet Paper. He then used that to wipe his behind. When he was finished he looked up at me and said, "Save the rest of that for some other time, it's only a tiny hole anyway". Loved that guy. He went home happy and healthy.:heartbeat

This is the first day for me on allnurses.com and this is the first post I've read. Good Heavens (I cleaned that up a bit) that is all so true. Thank you so much for starting me out with the best quotes I've read. Once worked with a CNA who taught a non-english speaking patient that the bedpan was called "orange Juice". Noor