I'm getting written up! (Very long)

[rn4babies63]

I'm getting written for an incident in which was completely misunderstood. Yesterday, I had a 20 year-old patient that was being induced for labor. On admission, she was asked what her plans were for pain control (part of our admission process). She stated " I don't want an epidural because I'm scared to get one". When I asked her what her concerns were, she stated she was afraid to be paralyzed and that the OB told her she may die if she gets one. I explained to her exactly how the procedure is done and although there are risks, these would be explained to her by anesthesia and the risk of paralysis or death were extremely low and that I've personally never seen either occur in 13 years of OB experience at 3 differant hospitals. I also told her that IV medication certainly was also an option and she could "play it by ear" and to just let me know what she decides when the time comes. Well, after several hours of increasing pain, the IV pain medication was becoming ineffective. She asked me at one point if she could have an epidural and I explained to her the the doctor only allows his patients to have epidurals once they are 5CM. Several exams later, she was finally 5 CM. When I told her the result of the exam, she stated "Can I have my epidural now?" So, I called anesthesia and she got her epidural without any difficulty and delivered a healthy baby girl 1 1/2 hours later with no complications. So here's the problem.. .......When the doctor showed up while the family was in the waiting room during the epidural, they complained to him that she was coerced into getting the epidural and that they didn't want her to have it The doctor was raving mad and complained to my charge nurse about this. 2 charge nurses talked to the patient and she told them that she was not coerced in any way and that she asked for the epidural and all I did was answer her questions and explain the procedure. She also told them that was embarassed by the behavior of her family regarding this. The S/O told them that he didn't want her to have it and since she was only 20 years old she couldn't make the decision for herself (he proudly announced he was 37 years old). On rounds the next day, our clinical coordinator asked the patient and family if they were happy with their experience and they never mentioned anything about this. However, the doctor is still insisting that I get written up! I've never had any issues with him but he is VERY anti-epidural and always tells his patients they WILL end up with a c-section, they WILL be paralyzed and MAY very possibly die from it rather than explains the risks. I merely was answering my patients questions and educating her and the family. And yes, there was a written as well as a verbal order from the doc allowing here to have it. I have a perfect 12 year attendance record at this facility and have never been reprimanded for anything and always get excellent evaluations. This is not fair! Sorry so long but I need some advice!

[Scrubby]

If this was me I would be writing up a complaint about the doctor. Not only is he misinforming the patient about the risks of epidural anaesthetic but he is harassing the nurse as well. I would complain about his behaviour and the fact that he has a PRN order of epidural, he is harassing you for doing your job. The whole situation just sounds disgusting and quite frankly I feel sorry for this poor girl with a controlling husband and idiot doctor.

[rn4babies63]

I want to thank EVERYONE who responded to my post and the words of support and encouragement. At work today, I confronted my Unit Director about the incident and how I felt about the write up. She told me that although the S/O and the family told her that they were now happy that she got the epidural and was comfortable for the duration of her labor, a complaint had to be filed. She assured my that NOTHING goes in my employee file and there was nothing that I had to review or sign. She said this was differant than a warning or being "written up" for some kind of misconduct. She said that hospital policy dictates her need to to this. The patient and family were happy with everything in the end. From what I understand C/O apparently has some mental issues going on. I love this website and all the advice from my peers! Again, thanks to all that have supported me!

[barefootlady, ADN, RN]

I would still get a statement from the patient regarding her request for the epidural, how happy she was with it and the care you gave her. I would question why the anestheist was not written up for administration of an epidural too. Keep these for your own file. I smell something rotten here.

I may be paranoid, but do not be too surprised if you start to feel the facility is too willing to sacrafice a good nurse for a bad doctor and things start to slide downhill from here on out. I hope I am wrong, but I have seen this sort of thing before and it always leaves a bad taste in the mouth of the nurse. Blessings to you for doing a good job for your patients.

[diane227, LPN, RN]

I have been "written up" in the past for stuff that was not my fault. I write a reply, sign the form and move on.

[Ginger's Mom, MSN, RN]

A Patient compliant can't be ignored your director is right. The next time you see the doctor, I would ask him in a professional manner with your director present., what evidenced based information does he have regarding epidurals. If he says nothing or give you no peer reviewed information, I would say, I didn't appreciate you asking for me to be written up, perhaps I should report you to the Board of Medicine or the chief of his service( which also has to do a review of his clinical practice). Your complaint would be he listened to a family member's request and not the Patient's request- HIPPA violation and not practicing evidence based medicine.

I am sick of good nurse being brow beat for practicing good nursing.