Orientation continues…

It’s been a while since I’ve written about work, so thought I’d post an update on how things are going. It’s been hectic, as I anticipated. There is just so much to learn in labor & delivery that I know it will take years and years to become the nurse I would want if I were in the bed. Not that I’m a bad nurse now, just that my expert colleagues (rant about that later) can walk in a room and know what’s going on by what seems like ESP and I mostly feel helpless. I am feeling better technically. I am more comfortable with the documentation and the manual tasks, though there is still plenty of progress to be made. I am getting more comfortable with the fact that at the moment of birth all hell breaks loose and the nurse becomes a one-armed paper-hanger trying to make sure kiddo’s kicking and screaming appropriately, mom isn’t doing a human impression of Niagara Falls, physician is happy, and, oh yeah, dad isn’t passed out on the floor somewhere. I’m not good at this, not by a long shot, but I’ve stopped being quite so frustrated by it. To add to my learning curve, I started learning to circulate in the OR for c-sections. Gah. More one-armed paper-hanging. On the up-side, aside from the OR, I’m beginning to have that feeling of, “please just let me do this myself and bugger off” which means that I’m doing more independent learning and working out my own system.

I still need to get the damned IV sticks down. I was so pissed last week, I got one in beautifully, felt that gorgeous pop when I got in the vein (sorry for you non-health-care people, but it’s kinda cool), but managed to pierce the external part of the catheter when I was pulling the needle out, so we needed to do another one. Still trying to get my vag exams down, too. Cervixes (cervii?) are sneaky things that occasionally like to hide and my go-go-gadget arms are on backorder. Not to mention that there is a whole hell of a lot of subjectivity to the process. One doc will say, oh, she’s 90% effaced (thinned out) and the nurse will reexamine and say, well, I’d say it’s only 50%. In the end it really doesn’t matter much as long as, at some point, the cervix disappears and the kid comes out. But I guess we get comfort from numbers.

In terms of my orientation experience… well, I’d love to reorganize the whole process because at the moment it seems that there is no organization. I have a checklist to go through, but it seems that I only get a chance to look at it with a preceptor once every few weeks. There’s some scattered reading materials I’m apparently supposed to be doing, but again, no defined plan. I get a lot of wide-eyed, “You mean you haven’t done X yet?!” to things which I didn’t know I was supposed to have done. The more I go through this the more I consider that I’d like to get into education so that we can come up with appropriate programs that smooth the transition from new grad to nurse or from, say, med-surg nurse to L&D nurse. But that’s then, this is now. My other beef is that, despite my lack of interest in nursing theory, I am a big fan of Benner’s novice to expert theory which discusses the progression of the nurse from novice to advanced beginner and so on to expert nurse. Part of this theory is that the appropriate teacher for the novice nurse is NOT the expert nurse. It would be tempting to think so, no? Don’t you want the person who has seen everything to be teaching the newbies? But in fact, it’s the proficient nurse, the one who has been in the field for, say, five years or so, to be the preceptor. Whereas the expert nurse “just knows” from experience, the proficient nurse has adequate experience, but can still explain their thought processes to the novice. Instead I get a lot of looks from my expert preceptors which give me the impression that they think I am entirely stupid for not getting myself from point A to point B without pulling a Billy from Family Circus (you know, the Sunday comic where the kid goes all over the neighborhood in the process of going home from the next-door neighbor’s house). Yes, one of these days I’m going to do these things as if on auto-pilot, but that might take a few years. I have this creepy feeling that that damned PhD might be in my future after all, because the process of nursing education is a real passion of mine and I want to figure it out dammit!

The tough part of this process has been the fact that birth is my other passion and I am struggling with the way birth is handled in the medical setting. The nurses are great, don’t get me wrong. They do the best they can for their patients given the orders that they have to follow. I just don’t know if I am up for following along when I feel that my job is at odds with my own beliefs. I have no plans to up and quit my job (especially seeing as there aren’t really any jobs around here to be had), but I wonder what time is going to bring for me. I’ve got lots of possibilities swirling around in my head, but I know that realistically I need to just give myself more time. Some of my struggle is surely simply because I am new and, darn it, naive. I know the grass isn’t necessarily greener anywhere else, but I wish I had more days where I felt like gloating to my ex-coworkers in career A that I am doing this now. Instead I’ve had a few moments of wondering what the heck was so bad about sitting in my cube, surfing the internet and popping out the odd spreadsheet here and there. I do still love spreadsheets. Now rationally I know that I made the right move and I wouldn’t change it for the world. I just wish I felt more glee than I do.

On the upside, I still get my 4 hours a week in quality which I love. It’s like detective work going through the charts and I would love to do more of it, but all in good time. At the moment I’m just happy that my four hours weren’t cut during our recent budget crisis.

So, I’m sorry that this post hasn’t been entirely happy-happy-joy-joy, but I will admit that it was quite cathartic to get these ideas typed out as they’ve been swirling around in my brain for some time. Please don’t think that I’m regretting the choices I’ve made, because I don’t. I give thanks every day for my new career and the fact that I was able to start it in a specialty of nursing that means so much to me. I am thankful for being able to be part of such an intimate moment in a family’s life. And I am thankful that my coworkers really are wonderful people and have welcomed me fully without some of the nasty rumors I’ve heard about eating of young. I am well aware than much of my struggle is the normal first year transition as a new nurse and that I won’t always feel this discombobulated. But I think that it’s important to recognize that not all parts of the journey are pancakes and sunshine and that’s okay.

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One thought on “Orientation continues…

  1. RN Moxie says:

    Thanks for being so honest about this! If it makes you feel better, I didn’t convey from your post at all that you were unhappy or regretful of what you have experienced so far or what you are doing. I hope you keep writing about all of it.

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