[acuteobrn]

Now I am sure that everybody has a particular OB that they could live without. I have encountered several but this one just tops the cake!!!

Had a patient the other night who was a G8 P7 w/ hx of fast deliveries, she came in with mild pain and I let the offending OB know, asked if she wanted to check her, in front of the patient, she says No, I am going home now...let someone else do it, and don't call me unless you really need something! Out the door w/ her so house OB checks and she is 4/100/-2 bulging bag. So we admit and 10 minutes later, the variables begin. So I page her letting her know what was up, she is 5-6 now and wants something for pain. About a half hour later, she is 8/100/-1 and getting pushy, so I call the OB, she is on her way. 20 minutes later, states she is leaking, chux is soaked. So she walks in I had just checked her and she is complete, forebag bulging, with a big urge, pushing w/ the UCs. So she decides to check her and says she is not ruptured and only seven, ruptures the forebag and makes a comment about calling her too soon. SO ok, pt continues to push with the contractions, I am trying the help her, but OB keeps telling me to tell her not to push, she isn't ready...whatever, I know she is complete and am waiting for her to leave; all of 2 minutes later, the parineum is bulging and I call for her getting the room ready, and throwing on my gloves. She still doesnt believe she is complete...so I check and head is +3, I can see the head and the bulg, so can every one else but she wants the patient to stop pushing, because she still din't believe me. Lets just say she almost missed the delivery while in the room. And then had the gaul to b***ch at me for not calling her sooner!!!! ***!! She had her little hissy fit in the middle of this birth, all I kept thinking is why do you want the patient to sit here in pain, to prove that you are right???? Are you that insecure?? Man besides yelling at the staff and the patient and the family, why show up at all, patient would have been better off precepting w/out her attendance, she didn't even tear!! I still would have been to blame either way, which I really don't care about cause I think this particular OB is an idiot any ways!!!

She is only a few years into practice, and I just can't imagine why she went into medicine! Every time I have had encouters with her she is just plain mean and spiteful to the nurses, house OB and most of all the patients!!!!

This is the type of thing that just gets under my skin!!! How in the world do you deal w/ these types w/out getting into it with them in front of the patient????

Man I am looking forward to the day someone tells her to stop pushing because they don't want to admit that they were wrong when she has a 8 pound child between her legs

[nekhismom]

[
Man I am looking forward to the day someone tells her to stop pushing because they don't want to admit that they were wrong when she has a 8 pound child between her legs [/b][/quote]

That will be the day! I am so sorry to hear about this particular ob. I hope in the future she is not so quick to disregard your opinion as a nurse or the SAFETY of her patients.

[acuteobrn]

She has her self so high up on a pedistal that God could in and she would still disagree.

[SmilingBluEyes]

I work with a doc JUST LIKE THIS...( she has 20 years' OB experience but never changes...sigh)

This was one who had the nerve to tell me to check a cervix AFTER HER so I "COULD LEARN WHAT A 4-5 cm cervix feels like "---(she was 8-9 by my findings).

I said I was happy to check. And when she asked me, I said I felt an 8-9 cm cervix and that is what I was charting exactly. She said "well I feel 4 and I am putting that in my progress note." I said that was her privelege but I was not charting WHAT SHE FELT...I was CHARTING WHAT I KNOW IS TRUE BY MY FINDINGS.

She then huffed it would be HOURS before the patient delivered (she was a multip w/hx of rapid labor) and I had called her WAY TOO SOON. I said --"Oh no I think it will be within the hour". But the doctor left the hospital anyhow, to have breakfast. Needless to say, she was not too terribly far when we called her back .She was forced to catch a meconium-stained baby in her pretty church dress without benefit of gown or gloves------exactly 37 minutes after I said she would be delivered in the hour. so much for "hours" til delivery ha!

so what is the moral here? NEVER EVER LET A PHYSICIAN/MIDWIFE or OTHER NURSE cow you into doubting yourself. YOU CHART YOUR FINDINGS, YOUR INTERVENTIONS and WHAT THEY DOCTORS SAY and that is that. YOU politely disagree and TELL THEM YOU WILL CHART in YOUR NURSE' S NOTE WHAT YOUR FINDINGS ARE and put into quotes what he/she says, if need be.

Do NOT back down in shame needlessly when you know you are right---you certainly do NOT carry on an argument in front of patients/family but you do NOT admit being wrong, confused, whatever, either. You agree to disagree and chart thoroughly and intervene based upon YOUR FINDINGS.

The "proof is in the puddin", as they said on Fried Green Tomatoes. Your truth will bear out and you have to stand your ground early on or they WILL continue to push you around. They will never admit you were right, of course. So be it. Being assertive is not always easy to do, but you have to learn assertion and strength, now.

Take care and hang in there. You done good, kid.

[acuteobrn]

Blue eyes that is exactly what I did, I charted my findings, and hers in quotes and one day she will hang for this, because I am not the only RN who does this and sometime I am sure she will end up in court over this...so all I can say is that is on her. And thanks for the vote of confidence, man I wish I worked with you, I think it would be a blast. Anyhow, a day shift nurse gave me a good piece of advice, trust your exam, and above all trust your gut. So thanks again!

[imenid37]

About a year ago, I was in charge and one of my co-worker's pt had some vag bleeding. Pt. was 28 weeks g2p1 and was a nurse in ltc. She had a marginal previa. U/S tech scanned her a day or so before and said it was resolved. So pt. went out for her annniversary and had sex. Then she came to us bleeding. Pt. bleeding more and more throughout the night. Nurse who had pt. was scared of her grumpy physician. So, I made 1 phone call to her early in the shift and then 2 more as the bleeding worsened about 15 min. apart. I told her I thought she should see this bleeding. She said no. She expected some, no big deal. Pt. had "a little cramping", but no pain. As I was about to pick up phone to call dr. back, I saw her initials on the computer screen. She had come in from home because we "kept calling." She was transferring pt. to tertiary facility basically because the nurses were "anxious and couldn't handle this pt." The pt's nurse did not want to go on transport w/ her (even though I insisted physician come along too), so I went. We made it there ok, though bleeding persisted. Baby was active w/ stable fht's. We returned to our own hospital about 45 min. after leaving the tertiary facility. BEFORE we even got back that hospital called. They had sectioned that pt. who was having an abrution before we even got back. STICK to your guns. Better to suffer the wrath of an irrate doctor than have to tell it to God or someone's lawyer.

[moondancer]

Excellent posts SmilinBluEyes and imenid37! Hang in there acuteobrn, it is tough dealing w/those types!

[BETSRN]

That typr of doc always wants you in back of them until they get into court: and then they want you out in front. You did the right things. Always chart what you think and if you don;t like a physician's (or CNM's) intervention (which can also be a nursing intervention) make sure you chart WHO did the intervention so that there will be NO question of who was right or worng if something ever goes to court. Too bad we ahve to deal with this, isn't it?

Betsy RNC
CT

[ktwlpn]

Originally posted by acuteobrn
Now I am sure that everybody has a particular OB that they could live without. I have encountered several but this one just tops the cake!!!

Had a patient the other night who was a G8 P7 w/ hx of fast deliveries, she came in with mild pain and I let the offending OB know, asked if she wanted to check her, in front of the patient, she says No, I am going home now...let someone else do it, and don't call me unless you really need something! Out the door w/ her so house OB checks and she is 4/100/-2 bulging bag. So we admit and 10 minutes later, the variables begin. So I page her letting her know what was up, she is 5-6 now and wants something for pain. About a half hour later, she is 8/100/-1 and getting pushy, so I call the OB, she is on her way. 20 minutes later, states she is leaking, chux is soaked. So she walks in I had just checked her and she is complete, forebag bulging, with a big urge, pushing w/ the UCs. So she decides to check her and says she is not ruptured and only seven, ruptures the forebag and makes a comment about calling her too soon. SO ok, pt continues to push with the contractions, I am trying the help her, but OB keeps telling me to tell her not to push, she isn't ready...whatever, I know she is complete and am waiting for her to leave; all of 2 minutes later, the parineum is bulging and I call for her getting the room ready, and throwing on my gloves. She still doesnt believe she is complete...so I check and head is +3, I can see the head and the bulg, so can every one else but she wants the patient to stop pushing, because she still din't believe me. Lets just say she almost missed the delivery while in the room. And then had the gaul to b***ch at me for not calling her sooner!!!! ***!! She had her little hissy fit in the middle of this birth, all I kept thinking is why do you want the patient to sit here in pain, to prove that you are right???? Are you that insecure?? Man besides yelling at the staff and the patient and the family, why show up at all, patient would have been better off precepting w/out her attendance, she didn't even tear!! I still would have been to blame either way, which I really don't care about cause I think this particular OB is an idiot any ways!!!

She is only a few years into practice, and I just can't imagine why she went into medicine! Every time I have had encouters with her she is just plain mean and spiteful to the nurses, house OB and most of all the patients!!!!

This is the type of thing that just gets under my skin!!! How in the world do you deal w/ these types w/out getting into it with them in front of the patient????

Man I am looking forward to the day someone tells her to stop pushing because they don't want to admit that they were wrong when she has a 8 pound child between her legs

It's a darn shame that the patient and her family had to listen to this crap during her delivery.That unprofessional behavior would really scare me-I would totally loose faith in my doctor...I think I would have apologized to the patient and her s.o.-and encouraged them to write a letter.....And maybe document it and report itmyself.....

[acuteobrn]

Ohh, I must update you all: This particular patient was Hispanic as was her family including her niece who speaks English Well the niece is completely upset becuase the OB made a "fatal" mistake, assuming that since they are all Hispanic, that non of them could speak a lick of English WRONG!!! The pt understood enough from the tone and the interactions, and the niece went to school here, so she can speak quite well. They are totally upset and are writing her up...As am I and the RN who was w/ me for delivery.

Thanks again for all the advice and support guys!!! I feel bad because sometimes I come here to vent out my day, nice to beable not to have to sugar coat my experiences, helps me let it go as well. So in the immortal words of Bartles and James "Thanks for your support"