"Pit to distress..." (Rant) - page 3

I'm gonna try to make a very long story short... I had the chief resident today give me an a** chewing because I had turned off the Pitocin of a pt who had persistent episodes of... Read More

  1. by   tryingtomakeit
    I had a similar run-in with one of our physicians just this past week. I won't drag you into all the details, but what my supervisor said to me later stuck with me. She said, "We can't let people like him keep us from being good nurses."

    If I were in L&D I would want YOU as a nurse! :spin:
  2. by   camay1221_RN
    Just an update on the pt from OP. It sounds like the delivery was awful! Shoulder dystocia with mom put in every possible position to deliver vaginally, which she finally did, however, baby was in bad shape. Had to resuscitate baby and from what I heard through the grapevine, he is in the NICU.

    I know what happened with the delivery may be totally unrelated to the pit issue, but, I still think it was a bad sign of things to come. And not to sound like a heartless witch, but, I'm glad I left when I did.
  3. by   TinyNurse
    I don't know much bout labor and deliery, but i'd call the attending.
  4. by   SmilingBluEyes
    so unfortunate for those parents and that baby. I hope the baby does ok.
  5. by   fergus51
    Shoulder dystocias are the pits. Other than a rupture, it was always my biggest fear in L&D.
  6. by   riern
    You handled the situation well. I agree, always use your chain of command. The days of doing what the doctor said because he said so are long gone and we are expected to be accountable for what we do. This is especially difficult in L&D. Kuddos to you for biting your tounge. I've been in L&D for a long time and haven't learned that one yet. You'll learn that when you call the doc and he doesn't come or when he has a fit and doesn't agree with the hyperstim or even decels...make it a point of letting him know you'll document what you reported and what his response was.......this always makes them think twice and usually calms them down too.

    Keep up the good work and always trust your instincts.
  7. by   jaimealmostRN
    Camay- I do not work in L&D, but I do not think that your thoughts (what you wanted to say about your license) were out of line. It is perfectly acceptable to let anyone know that YOU, as a RN, are responsible for this pt's safety as well. Speak up! Good idea about hi-lighting the P&P though!
  8. by   RN4mommy's
    We have residents all the time get upset with the nurses for 'managing' the patient (last I checked this was our job). We have tried the thing where we say, 'if you want to up it you will have to do it yourself.' There have actually been times when they have upped the pit themselves on a non-reassuring strip/hyperstimmed uterus! Problem is, they don't know how to work the pumps, and they don't stay in the room after they up it. So then who's responsibility does that patient become when they up the pit and leave the room???
  9. by   Spidey's mom
    Quote from fergus51
    Shoulder dystocias are the pits. Other than a rupture, it was always my biggest fear in L&D.
    You are so right . . . . so very scary.

    steph
  10. by   SmilingBluEyes
    Lord, so glad I dont' work in a teaching hospital. I avoided it due to things like this. Yes, residents NEED to learn, but many are very stubborn in their newness and ignorance, and nurses are NOT allowed to manage their patients. Like pointed out, I thought that WAS nursing's job. I feel for you who work in situations like this.
  11. by   BETSRN
    Quote from SmilingBluEyes
    Lord, so glad I dont' work in a teaching hospital. I avoided it due to things like this. Yes, residents NEED to learn, but many are very stubborn in their newness and ignorance, and nurses are NOT allowed to manage their patients. Like pointed out, I thought that WAS nursing's job. I feel for you who work in situations like this.
    That's exactly WHY I have stayed away from a teaching facility, although there are definite advantages to being in a larger facility.
  12. by   BETSRN
    Quote from RN4mommy's
    We have residents all the time get upset with the nurses for 'managing' the patient (last I checked this was our job). We have tried the thing where we say, 'if you want to up it you will have to do it yourself.' There have actually been times when they have upped the pit themselves on a non-reassuring strip/hyperstimmed uterus! Problem is, they don't know how to work the pumps, and they don't stay in the room after they up it. So then who's responsibility does that patient become when they up the pit and leave the room???

    FIRST, I would make sure YOU chart what they have done: to cover yourself. Then, you need to go up the chain of command, reporting them to their attending. Then, if it is your patient, I would go back in and adjust the pit down to a safe level (or off as the case may be)..
  13. by   SusanJean
    It is stories like the one posted by OP that made me refuse a transfer to a teaching hospital when I was pregnant and experiencing complications. Fortunately, my OB, our ped and a few other doctors had time to put together an emergency plan and all felt competent to deal w/ worse case senarios. I just did not want someone learning on my soon to be newborn!! The downside was that he would have had to be transferred across town to the Children's hospital should he need a vent. (long story short.)

    DH and I held our ground w/ this. We both have experience w/ medicine and medical community and agree that yes, people need to learn, but just were not comfortable having them learn in this situation.

    And, it is stories as w/ OP that I insist whenever a friend or family member is hospitalized - someone stay with them - just to make sure things are going as they should be... not all nurses are as vigilent as OP.

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