what2donow

Thank you so much, everyone, for the advice! Today I had 5 attempts and got...... ONE! Terrible. I know I just need to keep trying, and I need someone good to tell me what I am doing wrong. In general, I have no trouble hitting a vein (get immediate flashback), but I CANNOT thread the catheter. Often I blow the vein (get a big ol' bubble), but many other times I just can't tell why it won't thread. I have been through other periods of time where I seemed to get most of mine in, but lately I just can't do it. I know there has to be some consistent, tactical error I am committing! Anyway, thanks again.

Anyone have tips on how to get good at placing IVs? My previous job did not require it, and now I am suddenly expected to be able to do this with no experience or instruction or anything! I know the most likely answer to my question is, "practice", but I HATE doing that to patients. I have missed the last SEVERAL I have attempted on people and it's breaking my spirit. I feel like it makes patients mistrust me and think I am incompetent right off the bat.

I am just starting in out in a much sought-after, much anticipated job as an L and D nurse, where I hoped to gain the foundations of a potential future career as a CNM. And..... I am way disappointed. From what I am seeing, this unit resembles an ICU or ER much more than I ever would have thought. Crisis situations are so frequent, I am wondering if anyone has a "normal" birth ever? I have seen a few, but (maybe it is because these ones are leaving a greater impression, at least at this point) it truly seems that more often than not, something goes wrong. If the birth doesn't end in an emergent C section or a traumatic vacuum, there is at least a significant period of time where it absolutely seems that it will. I already feel like my nerves are fried. We work with a lot of midwives- I would say more than half of the deliveries are attended by midwives (or the labors are until the sh** hits the fan and OB has to rush in to the room), and our C section rate is actually low compared to the rest of the country. So I don't think that I work in a necessarily over-medicalized or overreactive environment. It just seems like things never go smoothly. I asked one of the nurses who had been there for 20 years if it had always been like this, and she emphatically shook her head no. So what is the deal? And another thing it has me thinking: how are home births or even birth center births EVER safe when it seems so common for a healthy, uneventful pregnancy to turn into a code blue-like delivery? Maybe some practicing CNMs or more experienced L and D nurses out there can give me some perspective. Thanks.

THANK YOU.

So... I am on orientation in an L&D unit, where I felt so sure (for a long time) that I wanted to be. I have a pretty solid nursing background (8 years, some ICU) and consider myself to be fairly smart, conscientious, and careful. The problem is that I made a mistake the other day on the job and it is absolutely killing me. I don't want to give specifics, because I can't bear the comments that may come back telling me how stupid/dangerous/wrong it was to do that. I KNOW. I cannot figure out for the life of me why I made the mistake, why I didn't talk to my preceptor before giving the med as I always do otherwise, why I didn't carefully read the policy, why, why, why. I am sick about it for so many reasons: I could have caused harm to the patient and her baby (thankfully, nothing happened). I am ashamed and embarrassed in front of my new coworkers, who will see me as careless or stupid or dangerous now. I wonder if I should even be working here in this high intensity, litigation-likely, high-stakes area. And, I wonder if I should even be a nurse. I guess I am looking for advice on how to get over this. Or for someone to tell me to find a new job. 'Cause I've already been looking. Thanks.

Hi. I will be starting in L and D next month and, while it is what I've always wanted to do, I am SCARED. I am coming from an ICU and med/surg background and just don't know what to expect. Does anyone have any advice as to how to prepare myself? Any books or guides I should read? Any insider tips? Thanks so much.

After a VERY long time of applying to new jobs in the area I desperately want to work (OB), I have finally gotten 2 calls back. I am ecstatic, because I never before got so much as a call. BUT, of course I missed the calls. I called each of these recruiters back, and now they are not getting back to me again! Has anyone experienced this? I missed the calls by 30 minutes and 2 hours. Why do you think they aren't calling me? It has been 2 days now.

Trying to network here. Anyone? Thanks!

Thanks so much for taking the time to respond. I am right now torn between two motivations: to find some kind of work in perinatal or women's health nursing because this is my interest and I want to move in that direction before/while getting my CNM degree... OR to take something, ANYTHING, that will take me out of my current job. Since my OB searches are going so poorly, I have started to apply to a wide variety of areas with that second goal in mind. I have an interview tomorrow for a position working as a coordinator for a specialty clinic (not AT ALL related to women's health or OB) and I am completely torn between taking it for the better hours and setting, or holding out for the elusive OB job. (This is all hinged, of course, on the unlikely event I get offered the job...) I would imagine that taking an advanced position in a specialty would make it even more difficult to be considered for an OB job, or for a CNM position down the road. The employer will be like, "are you just totally confused about what you want to do?" And I will be like, "yes and no." And they will be like, "good bye."

I have med-surg and ICU. Despite two years of applying (getting NRP, joining AWHONN, etc), no one will hire me to anything related to perinatal or women's health, including post-partum positions, clinic positions, you-name-it. I feel that this is where my interest has always been, but for a variety of reasons I have been stuck for over 6 years in different areas of nursing. I just don't know what to do. I don't have the option to relocate and I don't know what more I can do to move into this specialty. So, any insight you have is very appreciated.

Does anyone have any sense of how employers view graduate CNMs who don't have an L and D background? I don't want to set myself up for an unemployable future by going through with CNM school without having that prior L&D experience.

Want to send me your address, Barkow, for the cookies? Looks like you are the only taker. Ha.

I am in a very similar situation. I am SO TIRED of searching for OB jobs, SO TIRED of applying, SO TIRED of not even getting an interview. Then, the one interview I did have did not land me the job. I am getting so hopeless. I just did the NRP course and have ACLS. I tried to purchase the intro to fetal monitoring course through AWHONN (member of that, too) and can't take it because I have a MAC and it is only compatible with PC. Just wanted to say that I feel your pain. Unfortunately, I can't offer any suggestions because nothing is working for me. I feel so unwanted! And I also HATE my current job. Strong word, but true. Best of luck to you. Sorry to be a downer.

Thanks for your reply, Barkow. Do you feel like elaborating on these "politics and frustrations"? I'd love to hear what you think about the program.

Please help! I have been accepted to Frontier's CNEP program and I was initially ecstatic. However, now I am starting to second-guess myself, and I need to give them confirmation of my enrollment in 2 days! My dilemma is this: There is a nurse midwifery program near me that is apparently ranked a bit higher than Frontier, which I didn't care too much about, but now after looking into things a bit, I found that this school provides 1320 hours of clinical practice, while Frontier has 675! Nothing is as important to me as feeling fully ready and capable when I graduate, and that seems like a big difference. The reason I did not initially apply to this school was that it requires OB experience which I do not have and am having an impossible time getting, whereas Frontier just requires nursing experience. And I want to get started! But now I am thinking that I should just keep trying to get an OB job and eventually apply to my local University when I have the required experience. I would appreciate any sincere advice so much. Please! The clock is ticking! Thank you in advance.