OB in the ED

Specialties Emergency

Published

Alright this is just a quick question for the ER nurses here. Last night I had a really busy shift on OB, which is where I normally work. At the hospital I work at patients can only come in through the ED which I guess is pretty common (and much more safe), each time someone comes in for maternity, the lady from registration calls me and tells me that my patient is on their way up. Many times (unless the ED is really busy) a few minutes later I get a phone call from a nurses telling me what the patient is doing... my question is why do ED nurses get so nervous and upset by pregnant women. I understand thats not what they deal with everyday, but when the patients water breaks while she's waiting for the registration women to help her, she's not going to have her baby that minute usually. I get phone calls all the time saying "OMG her water just broke, what do I do, I don't know if we're going to get her up there in time, we're calling the resident." I try not to, but every once in a while I giggle, and just politely tell them that to bring the patient upstairs. (I work in a very small hospital, it takes about 2 minutes to get from the ED to maternity) I understand that for people who aren't around OB all the time it's a little scarey, but the number one thing to remember is to stay calm just like you would for every patient (even if her water broke and almost splashed your foot) usually the Mom is so embaressed that when people start getting nervous she starts to get really nervous. The thing I try to keep in mind is that whether or not we want it to happen (patients that are really early) or not, if the Mom is in late labor, the baby's coming whether you like it or not... with our with out you. :) Sorry, I just needed to tell someone how I felt even if you don't agree, I just get so much more stressed out when the ED is calling me four or five times to tell me that the patients water broke and she's going to have a baby... we know, just get the patient to the unit. Hope you all are having a great day!!

Specializes in ED, ICU, BICU.

As an ER RN who has worked triage on countless occassions I can tell you that it really doesn't have as much to do with being scared of the baby being born with us as it is a matter of resources. Similar to a critical pt which pulls many resources from a busy ER we in the ER do not have the equipment to monitor the fetus appropriately and safely. Because of lack of proper equipment this situation also pulls an ER nurse into that room and prevents her from juggling the multitude of tasks required of her for all of her patients. The ER Docs don't care that the woman behind curtain 2 is having a baby, why haven't you given the medications he/she ordered to bed 4?!?! I've worked ICU/BICU and now ER. I float to pretty much all floors and the one thing I've realized is that until you spend a shift mirroring an ER nurse you can not imagine the multitasking and constant reprioritization that must go on...and never stops. Unlike the floors are department is never full.

in an ob room, the tools are in the drawer next to you. i cant imagine every er room/triage room is set up with a vacuum, forceps, a precip kit, a baby warmer (that is on and warming,) a bag/mask for a neonate, all neonate resus tools, or any other tool that could become a necessity pretty quickly.

It just seems like the OP's question is trying to say that ER doesnt know what they are doing. An ICU nurse wouldnt go on an OB forum and ask why the OB's are freaking out about a post amniotic embolism who was coded and is totally unresponsive and going into DIC.

Specializes in Emergency Room.

Why am I okay with a 2 day old septic neonate but not a mom whose water has just broken? I KNOW how to do septic neonates. I have no idea what I'm supposed to do if mom's laboring too fast and all of a sudden there's a leg hanging out where the head is supposed to be. Maybe I would be okay if all I really had to do was "catch" the baby - assuming a totally normal birth here - but most ER nurses don't want to find out. Besides that, most ER nurses are not certified in NRP.....that in itself makes me nervous.

And I probably couldn't figure out a 1 min Apgar any easier than an OB nurse could figure out a RTS or how to work the rapid infuser.

It is all about different skill sets and what you're comfortable with. Most of us just aren't comfortable with the different issues that can arise when laboring someone.

Specializes in Emergency & Trauma/Adult ICU.

I would echo what many other posters have said - it's just a different skill set.

The only other thing that comes to my mind is ... as an ER nurse we're all familiar with that dreaded trip in the elevator in which a seemingly stable patient becomes unstable. That may play into the anxiety you feel from the ER nurses ... people can and do code in elevators, and we'd rather not have a birth in the elevator.

I suspect the OB nurse would most likely be nervous with a sudden chest pain or respiratory distress patient too. We all have our role.

Specializes in CT ,ICU,CCU,Tele,ED,Hospice.

i have never seen an er nurse freak with an ob pt .in my er if ob comes in strictly to give birth they are sent to maternity .if ob pt comesin for other complaint we triage and assess them.by we i mean pa/md .then the womans ob is called and pt is d/c from er and sent to ob for monitoring if that is what ob wants .of course we have done u/s if need be and fhr .

I did not have to go through the ED when I gave birth. We were told to use the ER entrance if we were coming in middle of the night but to go straight up to OB. Wouldn't it be simpler to direct women in labor straight to the OB floor rather than tying up ER nurses?

Ha Ha. We had a lady years ago who told them..take me up to ob now. The baby is coming. She was 50+ years old and not even pregnant.

Specializes in Nephrology, Cardiology, ER, ICU.

I should clarify that I was being sarcastic when I said that I didn't want to be birthin' no babies. Of course, I can assist with deliveries. However, in a precipitous delivery, there is no equipment, no oxygen, no nasal suction, no towels, nada. It does not scare me except for the fact that as an ER RN, I want to be prepared for the worst and if I know the woman is pregnant, I gather the emergency delivery pack prior to entering the room.

Our ED is our OB unit. We have no OB facilities at our place. I don't freak out, but I get upset that these women know we don't have OB and yet decide to come to me to deliver. Can you imagine a DR, 2-3 nurses, RT, warmer, 2 crash carts(room is normally trauma/cardiac room) and the patient in a room about 12X12? Nearest facility with OB is about 30 miles away.. I usually start muttering somethint that only I can understand

Specializes in LDRP.

Unlike the floors are department is never full.

well, ob technically isn't full either. we can't just send away the laboring women b/c of a lack of beds. we can and have labored them in the OB pacu before.

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