One of the funny things about being on orientation is how you view those around you who have experience in your field.
Before I accepted a job in L&D, I cared for adults almost exclusively. Save for a mandatory rotation in pediatrics in nursing school and a few close calls on a medical-surgical floor that saw patients from a few days old to a few days away from dead, I had never cared for anyone under the age of about 17. Back then, on the few occasions I was asked to float to the L&D or postpartum units, despite my undeniable interest in someday working on those units, my cry was much the same as other nurses who had never worked in those fields: “But I don’t know nothin’ ’bout birthin’ no babies!”
L&D nursing is an entirely different kind of nursing altogether, so it makes sense then that those of us who are entering the field from a different specialty regard the veteran L&D nurses with a sense of awe.
First, there are technical skills in L&D nursing that you don’t find anywhere else. In L&D, a fair amount of the nurse’s time is spent interpreting fetal heart patterns and contraction patterns that are printed off on a strip of paper–or, more modernly, collected in a computer program. This allows the nurse to ensure the well-being of the baby and make sure that the mother’s labor pattern is adequate. There’s also learning how to check a cervix for dilation, which is easily one of the trickiest skills I’ve ever had to master (and am still in the process of mastering, to be honest!).
A typical conversation between myself and my preceptor, LOTR style:
Preceptor: OK, what do you think the patient was dilated?
Me: …um, I’m not really sure. I couldn’t feel anything.
Preceptor: OK, try again.
Me: ………OK. *rechecks patient, thinking this couldn’t possibly be more awkward*
Preceptor: What do you think?
Me, giving up: Honestly, I have no idea.
And, of course, what would a day in L&D be without performing a quick in and out catheterization of a laboring woman with an epidural. Speaking of epidurals, do you know how to set up a room for a tired anesthesiologist who is preparing to place her tenth epidural of the night? Do you know how–or when–to set up a room for delivery, and when to call the physician? Do you know how to call the NICU for a delivery? Or how to perform CPR on a dying newborn?
A few months ago, I didn’t either, but I was surrounded by people who did, and I was in awe.
Aside from the complete newness of L&D, the burden of my inexperience and lack of raw knowledge on the subject made the transition a bit intimidating. Don’t get me wrong–I did a fair share of reading in advance, but no book can prepare you for the eventuality of caring for a woman in labor and finding both her safety and the well-being of her unborn child squarely in your hands.
Melody, a middle-aged woman with a brood of children at home, was my preceptor. Now, Melody was impressive in her own right as an L&D nurse, but much more than your average women and children’s RN, she brought years of ICU experience to the table. Decisive, quick-thinking, and with a sharp, assessing eye, she was highly intelligent, superiorly skilled, and surprisingly witty. For the first few weeks, I followed Melody around like a lost kitten, wide-eyed at the events around me that shocked me at every turn, but that Melody breezed through like a cruise in the Bahamas.
If you’ve ever watched Scrubs and seen the episode where one of JD’s daydreams involves Dr. Cox as a superhero, cape and all, then you know a little bit of how I view Melody.
Melody used to walk down the halls like that, her blue scrub coat flapping in the wake of the breeze as we headed to our next assignment. She was untouchable, unstoppable, and utterly fearless. She could calm the craziest patient, trace the wiggliest baby, and exerted a calm knowing in situations that were nothing but chaos.
I’ve had a few occasions since graduating from orientation status that I’ve felt that same confidence and commanded that same authority. I’ve been able to assuage the fears of an anxious mother-to-be, teach a nervous new father how to care for his infant, and coach a flagging couple through the rigors of labor into parenthood.
So if you’re an L&D nurse who has ever oriented a newbie, please consider this post my thanks to you. I wouldn’t be who I am today without the many, many nurses along the way who helped me learn the ropes of my profession, and I am excited to keep learning and to continue exploring this exciting, expansive new field. Thank you for answering my questions, for encouraging me when I’ve failed, and for teaching me without fail how to be the best nurse I can be.
You are my silent heroes in blue.