[LizzyL&DRN]

I was just wondering what other doctors do for fetal demise? We had a 16 week demise last week. When the mom began to deliver we called the doctor to come. I wasn't the nurse taking care of the pt but was the nurse to call the doctor. He was mad that I called him and asked me if the nurse had the pt push. I told him no and when he started ranting about this only being a dead fetus, I interrupted him and asked him if he was coming or not. Reluctantly he came and started lecturing a bunch of nurses at the station, I didn't listen to his lecture, I just walked away. I think what he wanted was for her to deliver and he would just come and see her in the morning. I think he needed to come and see his pt and reassure her, let alone examine her. Its not in my scope of practice to deliver his pt whether demise or not. Sure it happens, but all our other docs always come in and see the pt even if it is late at night. What do you do at other hospitals?

[wannabeL&D73]

Originally Posted by LizzyL&DRN

I was just wondering what other doctors do for fetal demise? We had a 16 week demise last week. When the mom began to deliver we called the doctor to come. I wasn't the nurse taking care of the pt but was the nurse to call the doctor. He was mad that I called him and asked me if the nurse had the pt push. I told him no and when he started ranting about this only being a dead fetus, I interrupted him and asked him if he was coming or not. Reluctantly he came and started lecturing a bunch of nurses at the station, I didn't listen to his lecture, I just walked away. I think what he wanted was for her to deliver and he would just come and see her in the morning. I think he needed to come and see his pt and reassure her, let alone examine her. Its not in my scope of practice to deliver his pt whether demise or not. Sure it happens, but all our other docs always come in and see the pt even if it is late at night. What do you do at other hospitals?

You have got to be kidding me. What an uncaring jerk! Why would a dr. like that even be an OB? I would be outraged if my dr. waited until the next morning to see me. IMHO that is inexcusable and I would be definately getting a new OB.

Shannon

[JaneyW]

When I worked a community hospital over the last couple of years, the docs didn't routinely come in for FD deliveries. They would leave it to us to deliever and would come and see the patient right afterwards to make sure everything was out, etc.

That was one of the reasons I have switched to a teaching facility. I can remember one situation in particular with a 20ish weeker. The baby slid out feet first and the head got stuck because she wasn't very dilated yet. We called the doc at that point, but it was a good 20 minutes before he came in and got the head out. That poor woman had to be there with her dead fetus half out of her for that long!!! I did my best to be there for her, but it would have been better if he had been there to begin with.

Having said this, it would have been different for a more near-term demise. They would come for those.

[imenid37]

Hello DOCTOR??? A pt. who is preterm and delivers a dead fetus whether induced or spontaneously has a high risk of having placental retention and HEMMORHAGE. No way should the nursing staff be left to deal w/ this one. This jerk needs to come in for this delivery even if it is only a dead fetus and even if he is doing something important like watching a ball game, golfing, or chatting up some little hunny. What a jerk. He needs a lecture from a malpractice lawyer.

[SmilingBluEyes]

Ours absolutely DO and well THEY SHOULD! I wonder about yours here. time for incident reporting and also some serious conferences with your manager and risk management team! This is unacceptable on any level.

[palesarah]

absolutely, our docs & midwives are present for these deliveries, and they are absolutely amazing with the patients. Besides needing the reassurance of having someone familiar at the bedside (they've known the doc/midwife through their whole pregnancy and often before pregnancy, they've just met us nurses in the hospital) there's also the risk of hemmorhage, etc as imenid37 posted. Our practitioners would never abandon their patients like that. Most of the time they spend a lot of time at the bedside during the labor/induction as well.

[Spidey's mom]

Originally Posted by SmilingBluEyes

Ours absolutely DO and well THEY SHOULD! I wonder about yours here. time for incident reporting and also some serious conferences with your manager and risk management team! This is unacceptable on any level.

I agree, ours absolutely do also. And please write this incident up!

steph

[JaneyW]

Did everyone see that the OP was talking about a 16 weeker? Most of the time, they probably wouldn't even end up on the unit. This is quite different from a demise although I have seen enough of them to know that it is still a baby and I am not trying to be heartless. There is a difference between a SAB and a demise. SABs are traumatic--especially after 13-14 weeks--but it is a different scenario than a demise. I'm not sticking up for this doc--sounds like a real a-hole--I'm just saying that policy may be different in this situation. He should have come for the risks/complications.

I know what it is like to work in that kind of environment which is why I have left and gone elsewhere.

[Spidey's mom]

Yes, I saw that and have experienced it as a nurse with a patient.

I still think a hospitalized patient needs to be seen by a physician. Otherwise I should get the big bucks.

Also, delivery of a 16 week baby can still be tricky.

steph

[fourbirds4me]

It is very common for us to deliver a 16+ week demise. However, this is mostly due to circumstance. Since these moms tend to go from nothing to delivery in a very quick time. However, our docs always come in to deliver the placenta (which is usually stuck like glue) and to make sure everything else is ok.