What does an appropriate OB/GYN orientation consist of...

gdelrosa · Jun 19, 2007

OMG... I don't know anything about OB/Gyn orientation since I'm not an L&D nurse but this sounds like it is totally inadequate. Can you talk to a nurse educator or your manager???

Just_Me_2 · Jun 19, 2007

So, if I understand correctly, you are going to be expected to work labor and delivery with only a couple of days of orientation? Or just postpartum? Either way, that isn't long enough.

I am going to be starting in OB next week, also in a smallish rural hospital averaging around 30-40 deliveries a month. My nurse manager said to expect 3-6 months orientation, depending on what I need. I will orient to the postpartum patients and nursery first, then when I can function independently in those areas and after I take a fetal monitoring class I will be cross trained to work labor and delivery.

There are so many things that can go wrong in labor that I can't imagine *not* having an extensive orientation. Most L/D nurses I have talked to say it takes at least a year or two to feel even remotely competent.

msmention58 · Jun 19, 2007

That time frame is definitely not long enough. I work in fetal testing unit for 4 years and that does not make me competent to work in labor and delivery. If you don't feel comfortable doing what you do speak up.

msmention58 · Jun 19, 2007

Every day

Kelly_the_Great · Jun 20, 2007

Hey guys,

Thank you for your input. It makes me feel a lot better about my perceptions of the situation.

Gdelrosa, it's just postpartum/newborn but STILL!

Yeah, I've definetly voiced my concerns. The initial response was that I'd get to take a neonatal rescuitation (always spell it wrong) course. My response: uh, well, if i can i'd like to be able to catch changes BEFORE they need that if possible.

Like for instance, i can tell you right now, that i probably couldn't tell the difference between a neonate grunting d/t resp distress or just having a bowel movement. I mean, their changes can be soooo subtle and then BAM you gotta baby in trouble, you know? Let alone, hypothermia, hypoglycemia, "shocky" stuff...(scary) :eek:

So far, I've voiced my concerns and have not been individually assigned any couplets. Although, I have taken care of them with another nurse as primary and me doing most of the care with A LOT of second opinion/consulting @ my seeking. All the while, I've voiced that I did not believe that it was adequate prep.

Wow, Just_me_2, wish i could have your trainin'... :rolleyes:

Do you guys know of any resources that I could find and site in regards to the recommended length of training required? I'm gonna try to call my OB instructor from school but I know she's probably out for summer.

mitchsmom · Jun 23, 2007

I can't tell you any training matrix resources off the top of my head, but the hospital knows better without you having to provide it.

I believe our postpartum training for new grads is 8 weeks with a preceptor.

Personally, I'd find another job if they wouldn't give me an adequate orientation. If you can't or won't do that, you could consider doing some crash extra learning on your own, get something like AWHONN'sCompendium of Postpartum Care, etc. I would start with postpartum emergencies/problems (hemorrhage, postpartum preeclampsia, embolism, infection, use of mag sulfate, baby respiratory/heart issues, etc.) so you have that down solid, since everything after that isn't, well, an emergency. FWIW

crissrn27, RN · Jun 23, 2007

That is totally inadequate. They are throwing you to the wolves, sounds like to me. I would run, run, run, as fast as I could, lol. Seriously, this is moms and babies lives we are talking about. I got 12 weeks in just nursery! Things can happen so fast, and guess who they are gonna blame if something goes really wrong with one of your pts? I would demand real orientation for at least 8 weeks, or I would be out of there. Good luck and let us know what you decide.

Kelly_the_Great · Jun 23, 2007

Hey Mitchsmom,

Thank you for your advice...:wink2: and the resource!

Just today, I once again voiced my concerns to the charge. Received mom and baby s/p emergency c-section d/t d-cels in 70's (don't know if they were late or what), mom a smoker, thin cord, baby swallowed a "little," according to the report i received, mec.

They all just look at me like I'm such an alarmist...

You know, i really like this hospital, it's the 1st time i've done hospital and am really likin' the med-surg, see a real variety of pts, the environment is very team oriented (unlike any i saw in the bigger hosp during clinicals) or elsewhere in my nursing career as an lvn in home, public and clinic care. Plus, it's in the town i live (of which, i'm a transplant - most of my extended family have all died). I'm really enjoying getting to know ppl in my community.

But I feel so insecure, inadequate and scared - not just for me either. I mean, I ask myself, "would i want me caring for me or baby?," and the answer isn't, "yes." :bluecry1:

I'm willing to learn, just not through this model. The labor nurse did spend addtl. time w/ me during report, explaining a few things that i knew from texts. It's just not the same as shadowing or even providing the care - just with more supervision.

Sorry, guys, I know I'm rambling. I guess I'm looking for support and guidance that...

Oh well, thank you all for your reponses.