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Discussion

Re-thinking this specialty

I'm new to L&D but not nursing. I was an LPN for 9 years before I got my RN license last year. I started on my unit. (LDRP) in August and I feel like my labor orientation has been riddled with issues. I know this is a hard specialty and it takes years to be comfortable but I feel an immense amount of pressure to know it all and to be proficient. Every time I start to feel good about my performance, an issue happens and it shakes me to the core. I have cried more times on this unit than I have my entire career. Yesterday was my 1st day off orientation and I had my own labor patient. Everything was great until it wasn't. I checked her and she was 8cm, delivery table made but not in the room. Started having some issues, other nurses came to help, we are rolling her from side to side and the OB came in and asked if I had checked her. No, I'm trying to keep this kid's heart rate up. Well, she was complete and +3 with no table in the room, which pissed her off. The wireless monitor I was using was taken off and I grabbed the toco by mistake instead of the EFM and of course that cord was tangled. THEN it was a shoulder and a possible abruption. Crash course in OB emergencies. Well, this OB told my charge nurse to email my manager about what happened and made a huge deal out of it. I get it, the table should have been in the room and I own it. Should I have had the cords for the EFM ready? Yes, and I admit it. My charge nurse and I talked about it and she said I did phenomenal with the labor, it was the delivery that was the issue. Mom and baby are both fine and no harm was done as a result of what I didn't do. Other nurses have had issues with this provider and her reputation is one of being rude. They told me that any other provider would not have made such a big deal about it. But now I am questioning this specialty and my ability to do it. 

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    People sometimes respond poorly in intense situations, especially ones like in L&D where there's so much on the line. Sounds like you own the things you could have done better, and hopefully you don't make the same mistakes again. Nursing, and L&D specifically, is a team effort. Next time lean on your resources. Call someone for the table, keep it outside the door when you hit 7-8cms, try to keep your cords right above their respective plugs on the monitor so you can plug and go. All things you learn as you spend time in the L&D world! You got this!

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    In my opinion, the OB was overly critical of you. This was your first shift off orientation and a new specialty for you! You can expect to need a lot of support from your teammates for the next year. I know next to nothing about "birthin babies " but it sounds like a team sport to me. 

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    Are you passionate about L&D? Does the enjoyment you get out of helping someone have a good birth experience outweigh the negative stuff that might happen from time to time? I too have been subjected to overly harsh criticism by a doctor, which is what this sounded like in your case, and it sucks! But, you will learn as you go. If the team you work with is healthy, they will help you learn and grow. If not, you might want to look for a better place to work after a while. Meanwhile, keep focusing on the positive. Examine your thoughts, and to quote someone else "Don't believe everything you think!"

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    It sounds like you did everything fine, and you know what to do next time. Plus, it was your first shift off orientation! You are not expected to know everything yet. It will come with experience. Plus, if other nurses have had issues with this provider, then you know it is not a reflection on you at all. Do not let this experience turn you off to this specialty.

    You did mention you have had a tough orientation. I am not a L&D nurse but a postpartum nurse, and 2+ years in, I am still learning a lot. Everyone learns at their own pace. Hang in there a bit longer before you make any huge decisions. But you know yourself best. Reach out to your nurse educator and charge nurse as well re: your concerns. I wish you the best. ❤️

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    Thanks everyone. I was told by my immediate supervisor that she and my manager thought it best if I stay on orientation a few more weeks. I spoke to my night preceptor (I was training on days for several months) and she said several things. First, that for the weekend I was on days (to help out) I was supposed to be doing postpartum,  not labor, and    finish out this schedule still on orientation. I have no clue why I was put on labor by myself, leading me to believe I was off orientation ?‍♀️. She also told me that from what I told her and what she heard, that nothing I did was entirely unexpected from someone at my level. I do own what I did wrong and when I make a mistake, I take pains for it to not happen again. She asked if the baby was delivered in the bed with the MD not dressed and I said no. She asked if the mom and baby were OK and I said yes. Then she said good, don't worry about what the MD said. All of the nurses there have agreed that none of the other providers would have made this big of a deal over it and it's just her and her dislike of new people. I'm also dealing with a family issues involving my mom who lives out of state and that is weighing on me. 
    I go back to work tomorrow night and my supervisor and I are going to talk about it. 

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