Struggling with Expectations

[strugglingtobe]

To give a little background, I am a new nurse. I worked for 1 yr in the state I went to college, then recently (February) moved back home and got a job in the same field (NICU). I worked in a Level IV NICU with nearly 100 beds, and when I moved up here I took what I thought would be a much less stressful job in a 14 bed NICU that does no surgical procedures, doesn't really get transports, etc. I never went to deliveries at my previous job because this was something only nurses with 2+ years of experience did, and you volunteered for the position at that point if you wanted to do it.

Roll forward to now, the hospital I am working at has had a change in management/leadership. We are now being expected to staff other units (which I was not expecting when I was hired, nor am I really comfortable with.) They have sort of given us a few options, but these include Post-Partum/Well-Baby (which I have no experience with other than maybe the well-baby side), or to basically be the delivery nurse (attending all deliveries, caring for the babies until they are moved over to well-baby). Recently I was pulled to be this delivery nurse, and I was practically in tears. I was under the impression I would have more time to orient to the role (I had 2 days where I saw 1 C-Section and nothing else) during my NICU orientation. When they have had meetings to talk to us about this delivery nurse stuff they have said "It's just babies, you guys know how to do babies, it is just a matter of different paperwork and so you should only need one day to orient over there". But this does not ring true with me. I am not comfortable going to deliveries and being the only person present caring for the baby, especially if something were to go wrong. I've never dealt with a baby coming out with MAS or something similar. I feel as though they are putting my license at jeopardy by pulling me to do deliveries when I've worked there for a little over 4 months.

I have been considering e-mailing our higher ups (the new managers since the last manager left) but I don't know how to phrase it in such a way to get my point across without sounding like I'm simply complaining, or that I'm incompetent? If that makes sense. I don't particularly want to be this delivery nurse but if they are making us, I at least think I should get some more orientation time.

Any advice anyone would have about how to handle the situation would be greatly appreciated.

[HappytobeARNP, MSN, APRN]

I think that you should follow your chain of command and voice your concerns. Map out your career so far and point out that you have not had enough experience to feel comfortable at this time but that you are willing to learn. I would also talk to some of the more experienced nurses and ask if they are willing to show you the ropes. You need to make sure that you are taking notes that you can refer back to and also studying on your own (just like in school) in order to catch up and feel more comfortable. Depending on how serious you are about keeping this job you could ask to come in for additional shadowing on your days off (for a few hours) which may or may not be with pay.

I think that it is all in the presentation. If you show that you're committed to learning and want to offer the best care to your patients then they will respect that. If you come off as upset and stressed then I doubt that you'll like the outcome. I think that this is a good way to learn new skills which will ultimately make you more marketable. The path that you choose is completely up to you. Also understand that there may not be many jobs that will allow you to work only in the NICU.

I hope that this makes sense and that you really consider all options.

Good Luck!

[llg, PhD, RN]

What are the other nurses in the NICU saying about this change? Are they comfortable with being the delivery room nurse? If you are all feeling the same way, there is safety in numbers. Stick with the group. They have more seniority and credibility than you do and be part of the group response for self-protection.

If you are the only one feeling this way ... then maybe you need to reassess your response. Maybe this is not such an unreasonable expectation. Maybe you are being a little too timid/insecure in your skills. You might need a little extra orientation -- but these should be skills you can learn relatively easily.

I suspect that the truth lies somewhere in between the 2 extremes I mentioned above. If I were your manager/director, I would be focusing on what the majority of the NICU staff is saying about this new expectation to make decisions about the situation.

llg (2 years NICU staff nurse ... 14 years NICU staff educator ... 20 years hospital-wide educator)