What should I do about my new Job in Orientation. HELP! L&D nurse

[NICUnLDRN]

Hi, I've always wanted to become a L&D nurse. I started off as a level 4 NICU nurse and did that for 10 months before landing a job at a different hospital in L&D. I started of on postpartum and from the very beginning the manager and nurse educator kept telling me that they have concerns and don't think L&D would be a good fit for me. The training was for 8 weeks and I requested an extra week and they gave me 10 weeks of training in postpartum. They expected more from me because I had prior experience in nursing and thought that I should have grasped on to things quicker. I felt differently because as a NICU nurse I had 1-3 patients max. If they were not sick babies I had 2 or 3. If they were sick I sometimes only had 1 patient and maybe 2 max. Everything had more of a set schedule whereas with postpartum you had up to 8-10 patients or 4-5 couplets to take care of. Not to mention that sometimes you would get GYN and medical patients since the floor opened up due to Covid.

That was a transition and they would have sit downs with me and say that if I can't get the hang of things now then L&D would not be a good job for me in which I told them I did not agree. Fast forward I finished my postpartum training and did that for about 2 months on my own and they finally started my L&D training. I was told it took so long because they wanted 2 other new grads to finish their postpartum trainings then we would all go over together. I'm currently on my 4th week of orientation in L&D and once again they sat me down and said they are concerned and I should be further along by now and that they feel as if I might lack basic nursing skills per my preceptor.

There was this occasion in which I found out my close relative was dying minutes before and I was trying to hang an antibiotic for a patient and my mind went blank and I asked my preceptor for help. They felt like I should know how to hang fluids. However, on postpartum and in the NICU I've hung several fluids and antibiotics.... So I know how to do it. (Also I'm a quiet persona and don't like people in my business so I did not tell anyone about my close relative) Another example was when my preceptor grabbed meds and handed me the bottle and told me to do the math off the top of my head in front of everyone at the nurses station. I got nervous and couldn't think so it was like this battle of her telling me to think and do the math and I couldn't under pressure like that. Eventually I calmed myself down and did it but it was completely embarrassing. In all that was another strike against me and to be fair I 1,000 percent understand that I need to know these things and the calculation on these meds as well. (Also my preceptor is nice...she is just very particular and expects a lot which is fair).

Mind you throughout my 4 weeks, the first week my main preceptor was out so I was stuck with someone who was nice but didn't explain anything to me and would randomly get up and leave without saying anything so I didn't learn nothing.

Second week it was literally dead on the floor and didn't see much of anything in my assignments. I literally sat for 12 hours straight and did trainings because it was no labors and no one in triage. This was also the week where I had those mishaps with my preceptor.

My 3rd week that close relative died and I missed like 4 days due to bereavement. Here we are week 4 and I feel like I have learned nothing, but I'm expected to be further along. They get that I had a week off due to a death but feel like its still 3 other weeks that I should have skills to show off for. I feel like they are not looking at the prior 3 weeks in which I learned nothing basically.

Not sure what to do. Orientation is only 12 weeks long and I feel so lost and discouraged. They are actively telling me they have BIG concern's and they hope I can prove them wrong but I feel so defeated. I asked my preceptor what I can improve on and she said being more hands on and explaining things to patients and not needing to be told to do something which again is fair. However, how can I explain a procedure I know nothing about. How can I do an intervention if I'm not 100 percent sure on what the strip is reading. I've taken fetal monitoring class but am I expected to know every little thing. I've had two people tell me different things about a single tracing which doesn't help.

I need words of encouragement because I feel like just giving up at this point. To constantly here how they have concerns and that I'm lacking basic skills and should maybe look into another field is devasting.

[Hoosier_RN, MSN]

Start asking your preceptor about resources: YouTube videos, in-house videos, etc; read books and manuals; ask coworkers questions, such as " I saw you do this in x situation, why?" People love to explain so they will tell you as long as you're receptive to learning. Ask coworkers where they learned to read strips/other activity so well. Be proactive in your learning if you want to stay in this specialty. This advice really applies to any specialty 

[klone, MSN, RN]

If you feel like you learned nothing in 3 weeks, that's a problem. There is ALWAYS something to learn.

[Nurse Beth, MSN]

They seem to have made up their minds but have not given you specific goals. But there's still time to turn it around.

What you could do is ask your preceptor for more specific goals. When she says, "You need to be more hands-on," and if you're not sure you can succeed at that because it's subjective, you could ask, "What exactly would it look like if I were more hands-on?"

Or " How will I know if I've met the expectations of being more hands-on?" or "What can I do to succeed at this by next week?"

Secondly, you need to identify your areas for improvement. We all have them, and you have not acknowledged yours. If you want to realize your dream of becoming an L&D nurse, then starting your next shift, show your preceptor that you are proactive and engaged. Do several things out of your comfort zone, such as patient teaching or attempting to interpret a strip.

Best wishes to you 

[klone, MSN, RN]

Nurse Beth said:

Secondly, you need to identify your areas for improvement. We all have them, and you have not acknowledged yours. If you want to realize your dream of becoming an L&D nurse, then starting your next shift, show your preceptor that you are proactive and engaged. Do several things out of your comfort zone, such as patient teaching or attempting to interpret a strip.

Best wishes to you 

^^^^^this was so much more helpful than what I said!

[Nurse Beth, MSN]

klone said:

^^^^^this was so much more helpful than what I said!

yours inspired me on this thought track ?

[feelix, RN]

Looks like word has gotten around and you don't have a future at this hospital.

At this point, instead of mourning the loss, I would actively plan my next move. I would start learning and soaking in every moment. I would aim at becoming an expert on whatever they are teaching. With ten weeks of L&D internship you could find another hospital willing to train you. Those internships are hard to find and people are willing to steal those nurses.

Just be honest in your interview and let them know there were not enough opportunities to practice what you learned or whatever the truth is.