Terrified yet excited (a bit lengthy)

[ShannonSRN]

I had posted a thread in May of 2007 (I posted the thread at the bottom).

I quit working at the facility over a year ago, and just about quit nursing all together. I went to work at the "Competitor" hospital after about 2 months of being unsure what to do, and started doing GYN/Oncology. The director of the unit believed in me even when I didn't believe in myself. She encouraged me to join her unit and I really enjoyed it, and even got promoted to Clinical Charge nurse after only a month. Well, about a month ago she approached me about an opening in L&D as a staff nurse (she is also the director of L&D). She knew that L&D was my love, and felt I would be the perfect addition, and encouraged me to interview with the manager. After a lot of thought, I decided to interview and got the position. I start on September 3rd.

I am scared to death of it being like the unit I left, however I know deep down that it is a better unit. The doctors are great, anesthesia is always in house, and the nurses are a great team. The do many more deliveries than my old unit, about 250 a month (my old unit we were lucky if we did 60). I have never taken care of 2 women in labor at the same time. I could rarely even get a doctor to show for a delivery...How do you all do it? Does anyone have any advice?

Thanks,

Shannon

"I have been working in a small facility for about a year. We do do about 65-80 deliveries a month.

Problem is our doc's are no shows for about 20% of our deliveries...we have had 12 RN deliveries in the last 8 weeks. We have a midwife and 4 docs who deliver with us. When we call them re: pt status, give report of pt arrival, etc. the doc's who tell us that she will get there "after she takes a shower, and gets her kids to school" (the pt was crowning), our midwife on many occasions, states "I don't want to get out of bed" takes her time on calling the covering docs for pt's in need of section (2 abruptions in 2 weeks). Our last abruption was a 31 weeker with heart tones in the 60's x 70 min before we sectioned her. Waiting on docs!

We have had several incidents like these. Our new manager is trying to implement change with the MD's, but not making any advances.

Then we have nurse situations where we are cross trained to mother baby, but have nurses who refuse to work L&D, but we have to depend on them in emergency situations. (We have 2 L&D nurses scheduled everyday, with a backup nurse either on call or in M/B, but our backup has no idea how to function with us) so we end up "in a barrel with our feet in the air" with no one to call or back us up.

I hate to give up on the unit, but I do not want to be responsible for a bad outcome, I don't think I could live with myself if I knew I could be a cause for a parents heartbreak due to circumstances that WERE in another person's (Doc's) control.

I was wondering if anyone had any ideas or suggestions? What would you do?? Am I imagining the danger, or is this happening everywhere?

I know doc's don't like to come in at night. I have worked in busier units and have never seen doc's like these. Please help!"

[PICNICRN, BSN, RN]

First off, let me say that I am no L&D nurse.

But, it seems like this time you already know what you are getting into. You've posted that they have in house anesthesia, great docs, and a great team of nurses". Sound like you will be just fine! You are probably afraid because of you nightmare experience at your last job! Just remember, you are coming to the table with more under your belt now... organization, time management, clinical knowledge, and a better idea of what is "normal".

Congratulations on getting into the area that you love again!! I wish you the best of luck! Please keep us posted on your orientation!!

[L&Doldtimer]

Shannon,

Sounds to me like you are in a much better situation at your present hospital-even sounds like if L&D didn't work out, you'd probably not have a problem going back to what yur presently doing (good NM support can make a WORLD of difference). I'd say give it another chance-I've been in the OB field for 29yrs and I wouldn't trade it for anything! It can be really rewarding, but it also takes time to get a "feel" for it (I'm talking about L&D here). Don't be so hard on yourself and ask lots of questions-get lots of experience-give it a couple of yrs. at least and then see if you don't feel different. L&D isn't something that's learned overnight and NOBODY is born with the knowledge! We all started out knowing almost nothing but textbook and we all know L&D is almost NEVER textbook! On a good unit, with supportive docs and a knowledgeable NM, you should do great! Good luck to you!

Connie