SeattleRS24

I remember having a similar feeling when I first started on my unit. I was so unsure about the culture and it was very discouraging. However, I can happily say that I found my "peeps" and this made all the difference. Trust me, you will find your peeps and if you stick it out, you might grow to love some of the traits of those same individuals you once disliked. Best of luck regardless of what you decide!

Hi guys! I am interested in attending one of the Lisa Miller Advanced EFM Seminars this fall. I can't find any information on pre-requisites for attending the seminar, and I was curious if any of you knew about that. Is there a required number of experience in years, or is it necessary to have taken the intermediate EFM course first? I am guessing that the "courses" and "conferences" are unrelated but I'm really not sure. I left a voicemail with the Pro-Ed center but haven't heard back yet. At my facility, you need at least one year of experience before you can register for the intermediate EFM course. I am just one month shy of that, but would still love to attend the Lisa Miller conference. Thanks in advance!

You're going to love it! Congratulations on this exciting switch. I think you will find that your experience is extremely useful and relevant. One book that I really enjoyed when I was orienting was Intrapartum Management Modules. You can buy it on Amazon. Some of the information is dated, but the majority of it is very relevant/informative! It's a great introduction to all things OB! Good luck!

These are great! Thank you! Totally sharing this with the new residents on my floor.

Hi there! Congratulations, first of all. This will be a super exciting journey for you - crazy and scary at times for sure, but always lots of fun! Plus, if you know that OB is the field you want to start in after graduating, this will give you a huge advantage when applying for jobs. I completed a Versant L&D residency after graduating and have been working on a high-risk OB floor for about 8 months. My main recommendation is to remember that this specialty takes years to feel even remotely "comfortable" in, so be patient and gracious to yourself - there is a LOT to learn and a lot of unfamiliar territory! Remember that everyone you're working with was in your shoes at some point, feeling lost about what to do in the heat of the moment. Ask TONS of questions - I ask hundreds every day at work! Take every single opportunity possible to practice skills, including assessment, charting, IV placement, cervix exams, straight catheters, etc. This will give you tremendous advantage and increased confidence if you get a job in OB after graduating! Always act confident (not arrogant obviously, that's very different!) when introducing yourself to a patient and providing care. This is a time in your patients' lives when they need to know that you are calm and collected externally, even if you're panicking on the inside (which is also normal). Kindness, respect, and articulation go a long way with most patients; if you give them that, they honestly won't care if you had to poke them twice for the IV or if you miss the straight cath on the first try. :) I recommend you purchase the book Intrapartum Management Modules on Amazon. It covers all of the major things you might run into on the floor and gives you clinical tips in a simple-to-understand way. Some of the information is dated, but it's the best resource I've found as a new grad. I hope these tips are helpful! Good luck and continue to post with your questions/concerns!

Hello everyone! I've been working on my OB floor with an 8-hour night shift schedule for about 8 months. I finally was offered a 12-hour night shift position this morning, and I am super stoked to get some more days off! My manager said that I could work with her to build the ideal schedule for me. The main stipulation is that we have to work every other weekend, and we cannot work back-to-back weekends in a pay period. I'm wondering if any of you have suggestions about the perfect "schedule matrix." I definitely am NOT the kind of person who can handle 3 on, 2 off, 3 on, 6 off. The days off sound great but I am not up for the challenge of that many back-to-back shifts. The most days I want to work is 3 in a row, once every two weeks. One of my friends suggested Tues/Fri/Sat one week, Tues/Wed/Thurs the next week. That sounds pretty good to me. Any other suggestions would be appreciated!! Thanks!

Thanks for the help, everyone! Do you have any recommendations for the best fetal monitoring courses that I can purchase online? I see that AWHONN has some.

Hello, more experienced OB nurses! I've worked on my floor, a high-risk L&D unit, for about 8 months (half of that time was residency training). My OCD personality makes me very anxious about monitoring/titrating oxytocin. For some reason, it makes me really nervous (I know, I know...everyone says that's a good thing). :) I'm just hoping to alleviate some of my anxiety by asking a few questions. Thanks in advance for the help! When titrating oxytocin using MVUs from an IUPC, if contractions are inadequate (total MVUs less than 150-200?), can you overlook tachysystole because the contractions are less intense? Like, for example, this patient scenario I had last night: Category I baby most of the night, occasional periods with 6-8 contractions in 10 minutes, but total MVUs of 120-140 in 10 minutes. I got a little confused about whether or not I should still increase the pitocin, or if it should be decreased because that uterus was still technically tachy by definition. I'm curious - what are some of your tips for making this thought process easier? How long do you sit on a strip like this before making a change to the infusion rate? I know when to shut pit off, but the nuances of titration are starting to confuse me. I've gotten some different responses from the nurses at my workplace so I'm opening the floor to a wider demographic! ANY tips about safely managing oxytocin would be appreciated! Thank you again!

I feel for you!! I completed a new graduate residency program in L&D and have been working on my floor for about 6 months. I have struggled so much with SVEs since the very start, and it's required a LOT of encouragement/education from my peers to keep me from feeling totally incompetent. Don't beat yourself up; the other responders are telling the truth - it's tricky! I just recently had my breakthrough where most of the time, I can at least find the cervix...but that still doesn't mean I necessarily have a confident exam. People with epidurals are deeeefinitely the best to practice on. My best piece of advice is to take your time (when they have an epidural). In the beginning I would honestly spend 5-10 seconds doing an exam; but now I take up to a full minute making sure I have some information before I'm done. You'll get it - and honestly, there is NO shame asking for sometime to check behind you (although I understand how much better it feels to be independent in that skill). Good luck :)

Four people in my graduating class started out in L&D as new graduates, myself included. Apply for residency programs, write a killer cover letter template, and utilize any/all personal connections you think may be of help. Get on LinkedIn, too. Good luck!

As someone who has only been an L&D nurse for about 6 months (I graduated last May), I can tell you that it is indeed very subjective. However, I just ask for a second opinion whenever I'm on the fence about what is normal vs. what is ominous. Just the other night I asked a more experienced nurse to take a look at the clots that my patient passed. She said that she completely understood why I asked, however, she wasn't concerned because the patient breastfed so long, had an extremely precipitous delivery, and only had scant bleeding for the first hour or so. Does this make sense? Each situation is so unique that it's difficult to explain. My best advice is to trust your gut.

Thank you very much for the kind words!!

Thanks, everyone! So far, so good. :)

Hi there! I am a new RN graduate, just one week away from completing my 18-week OB Residency! Starting next week I will be taking my own patient assignments. Despite all of the training, I obviously still have a lot of fear/anxiety about the fact that I NEVER know exactly what kind of night I'm walking into. There are certain scenarios that I simply was not able to see while on orientation, so I thought I would post this forum just to see what kind of last minute advice/suggestions you more experienced OB nurses might have for me! I have been getting lots of positive feedback from my preceptors, who seem to think I am more than ready to be "on my own." It's comforting to hear that, but I still feel like a mess when it comes to the crazy, rapidly progressing deliveries! I welcome and appreciate any tips/advice/suggestions! Thanks for reading.

Hello! I recently received my first graduate nursing position as an L&D nurse. My interview asked a lot of prioritization questions (which patient will you see first), so it would be helpful to review your OB assessment and potential emergency scenarios in OB. Be prepared to talk about how you respond to grief and loss, especially if it's a high-risk maternity unit like mine. I also had questions about whether or not I'm confident in standing my ground when a provider is pushing me to increase pitocin or AROM. Other than that, convey a genuine passion for patient/family-centered care, as well as the ability to think quickly on your feet. Obviously these are skills that come with time, but they want to know that YOU know how important those things are for this job. I hope this is helpful. Good luck - you'll do great!!