Friday, September 27, 2013

Baby RN Feeling Overcome


So now that I’ve earned my license and I’ve floated on cloud 9 for a while…REALITY hits quite fast and hard.

I came home last night feeling defeated, deflated, and depressed.  I unloaded my stress and fears unto my hubby before bed and cried myself to sleep.  I hope my hubby wasn’t shocked or upset by the many things that spurted out of my mouth like, “I don’t want to be a nurse”, or “I thought getting the license was only the hard part”, or “I just don’t want to work this hard”.

Part of this stems from the sacrifice of my family time through school, all of summer studying, and now getting used to my RN job in OB.  I just want time with my family.  I want to enjoy them.  I want to put work and “learning new things” on the backburner or auto pilot so I can focus on what really matters to me. 

I’ve been working in OB for almost 2 years.  Right after graduation I transitioned to graduate nurse until I passed my boards.  I’ve had about 2.5 months of orientation on postpartum and labor and delivery.  Unfortunately my orientation was scheduled to accommodate my need to study to pass my boards which meant a lot of overnights.  Many times I only saw vaginal progression of labor, but few deliveries and zero c-sections.  In fact a little over a week ago, I set sail off of orientation, on my own without even seeing or knowing what to do in a c-section.  One of my two preceptors was appalled that I hadn’t seen one yet, because as she put it, “potentially any delivery could become a c-section and you have to be prepared”.  I think she must have thought my other preceptor showed me one and vice versa.  Either way Wednesday of this week my boss switched my schedule around to get me some time through an entire c-section from prep, to section, to recovery. 

Bless the nurse I was following that day, she made me a little to-do list, which helped but there are always things that get forgotten, and the day wasn’t running smoothly.  She had forgotten a med to give and lab forgot to draw a platelet count that the doctor ordered to have done before the c/s, so the surgery was delayed over an hour.  Ultimately things went well after that, and I did most of the recovery.

Fast forward to yesterday (just a day later) and I was helping a co-worker through a twin delivery.  The doctor for good measure had the mom delivery in the OR “just in case”, because she was having them vaginally.  After she pushed the first twin out, the second twin started to get in trouble.  The whole situation went from stable to emergency stat c/s asap!  I didn’t know what to do and I just froze.  The secondary MD looked me right in the eyes and yelled “SCRUB HER BELLY NOW”!!!  So I did.  If I hadn’t been in the c/s the day before I wouldn’t even know what to grab or what to do.  The Lord was with me through that but I was still shaken up. 

Afterwards the docs and nurses all sat around the nurses stations digesting what had happened but I just listened.  I went on break shortly thereafter and called my hubby and cried about it.  I went back up to my unit, and nearly broke down to another co-worker who said “geez you’ve been through a bunch of tough situations right after being off orientation”, “how are you doing”?  I told her if I stopped to talk about it I would cry and I had to round on my next set of patients so I didn’t have time.

After I got done with rounding, the charge nurse told me that my manager wanted to talk to me for 5 minutes and to go to her office.  When I got there she wanted to know how I was doing, if I thought I felt comfortable on my own, and did I need more orientation time.  I admitted that I don’t feel comfortable in L&D with either a vaginal delivery or c/s.  I’m fine and feel confident after baby comes out and recovery, but leading up to that is hard for me.  I’m okay for the most part as far as checking the dilation of the cervix except if she’s a mul-tip because the cervix stretches.  I can’t figure out effacement, nor do I understand station well.  And because there’s soo many small details and things to accomplish before delivery, and not wanting to hurt the cervix I don’t know when to tell mom to start pushing.  I’m fine during the actual pushing and moving out of the way for the doctor when the mom starts crowning.

After relaying all this to my manager and then some, I also followed up with the fact that I ask lots of questions and never hesitate to stop if I don’t know something or don’t feel right about something. 

Basically she just agreed that I’m not ready to be on my own yet.  She suggested I take 2 more weeks of orientation, sit down with her assistant manager and go over critical thinking exercises, ask a different co-worker for a list of “to-do lists” she created when she was brand new and see how it goes from there.  They’re going to follow up with me weekly to see how I’m doing.

…But really, all I want to do is run and hide.  I feel embarrassed that I haven’t gotten to a place where I feel comfortable yet.  I really just want to quit, maybe find a desk job.  At least until my kids are on their own and not home as much… Then I could work bedside and be gone for a 12 hour scheduled shift that turns into 14/15 hours. 

I say all this because I went to http://allnurses.com/general-nursing-discussion/new-nurse-feeling-177487.html and found a good post called “New nurse feeling overwhelmed” posted in 2006.  One of the responses was from anne74, and she said after I hit the sixth month mark, I'm having moments of feeling -sort of- like I know what I'm doing. I still ask questions constantly, but there's no way of knowing everything without experiencing it first. And the only way to experience it is to show up every day and learn. That doesn't always feel good and it's frustrating, but you'll get there.

You will start to see changes, you'll be able to answer questions more often and you'll start to catch things all by yourself. You'll even feel comfortable suggesting things to doctors, etc. The only way to gain this wisdom is through experience, and you'll get there in time. Seriously - it gets better. But it doesn't happen in a nice, linear fashion. It goes in spurts - good days, bad days, etc.

No one really tells you how hard - and awful - your first year of nursing is. I think the people who have it the hardest are the ones who are challenged the most, and in the long run become the best nurses.

A piece of good advice I got from my Mom (a retired RN) is after every shift, think of 3 new things you now know how to do. Before, I was only focusing on mistakes I made, and totally ignoring my accomplishments. Take time to see how far you've gone already, and it only goes up from there.

After reading that, I was inspired to write a blog post.  I just have to look at where I’m at and say for instance, I learned on Wednesday how to scrub the abdomen during a c/s.  That came in handy because I put my skills to the test the following day.

I am learning, I am growing, but I just wish I didn’t have to sacrifice anymore family time along the way.

4 comments:

  1. Our orientation on L&D goes for 16 weeks. We're on 5 8-hr days for 4 weeks, then we go to 3 12-hr day shifts, then switch over to nights usually 2-4 weeks before orientation is over. After the first 4 weeks, we spend 2 weeks with the c-section nurses learning the OR and section routine. It takes awhile to feel competent in a section, but thankfully they're pretty routine from case to case and doctor to doctor.

    I completely understand what you're feeling. I'm just 9 months into my job, 5 months out of orientation and I still feel there are times I don't know what I'm doing. However, I'm starting to have my moments where I realize that I do actually know a thing or two, things are finally starting to click. Try to hang in there....it really does get better!

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  2. First year of nursing is very tough! I'm right there with you.

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  3. Hi, I haven't been around much, but great to see you are going into L&D :) that's my favourite area of all areas I have worked!!! Hope things are going better for you now that you have a few more months under your belt, and don't worry, it sounds like you are doing fine! We all start somewhere! Let me know how u are doing! :)

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  4. Hi CC! Welcome back to blogland! I'm so happy to see you on here. L&D is going well and I've been at it since June 2013. I'm not sure if that is where I'll end up but I'm learning so much every single day. I'm like a sponge!

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