Docs making stupid decisions - page 2

Quick background: I work in a small hospital birth center in a rural area. We serve patients from up to 75+ miles away. Two dedicated L&D rooms, 5 PP rooms, 2 antepartum/PP rooms and one... Read More

  1. by   CMCRN
    WOW what a mess. Actually my hospital system Sutter in California did a big study on inductions and ended up with recomendations that no Primip be induced before 41 completed weeks as to do it before increasd the risk of c-section by 50%. No multip inductions before 38 weeks.
    Do we follow our own rules??? Of course not. But the data is there, It is called the F-Pad study and should be on the web somewhere.
    Our charge nurse is allowed to bump inductions, esp elective ones for bed or staffing issues. Medically indicated ones we do our best to accomodate in a timely fashion. 18 labor rooms,6 ante rooms, 3 ORs, 500+ births per month
  2. by   htrn
    [FONT="Comic Sans MS"]Moral Distress I really like that, because that perfectly describes what I am feeling about work right now. The problem is, what do I do? I think I might need a vacation, have considered looking for a different job or even going back to school. My problem is, I really like the hospital that I work at - great people, great hospital.

    What have you all done when things at work put you in 'moral distress' to keep from burning yourself out. I really feel like that is what is going to happen if I cannot reconcile this stuff.

    I would also like to find that study that was mentioned - I googled it last night but didn't find it. I'll try looking again, but if you could point me in a more specific direction, I'd love ya forever:blushkiss
  3. by   HappyNurse2005
    http://www.sutterhealth.org/about/cl...pregnancy.html

    i think this is what you are looking for
    i searched fpad study inductions on google, and it was the first thing that popped up.
    now i'm off to read it.
    we have some induction happy docs, too
  4. by   tinyscrafts
    One of my doula clients' was induced by her doc at less than 36wks. because she was tired of being pregnant. She'd already had one preemie at 35 weeks so was convinced this one would "be ok too". depends on your definition of ok"

    This reminds me so much of the c sections on demand conference. there was at least one doc on there saying this will cost lives because of the missapropriations of our resources. All these elective's taking up space God help the woman who has a true emergency. I even know one doc that scheduled an "emergency" c section because all the hosptials scheduled time slots were full. ewwww.
  5. by   Alixandra
    I was induced at 39 weeks for PIH. My doctor wanted to induce me at 38 weeks but luckily the way things worked out I was induced at exactly 39 weeks. When I went in the night before to have my cervix ripened they were super busy, I think I spent an hour in the waiting area waiting for someone to come get me to my room. I was already contracting when they took me back so I got to spend the night at the hospital since I was already there(can't ripen the cervix of a woman already contracting) and they got the pit started at 6 that morning. I had my son at 5:15 that night. I remember my doctor having the nurse text her husband(she was fully gowned and gloved so she couldn't) as they were having a disagreement over who had to pick their 3 daughters up at daycare. I remember her saying "Tell him I have a woman who is fully dialated and pushing and have another one waiting for me when this one is done."(and she did right after I delivered the placenta she had to dash off to deliver another baby.) I also spent the night after I had my son in a labor room as all the PP rooms were full, didn't make any difference to me, the PP rooms were larger but that wasn't that big of a deal. I will say they were extra full as the only other hospital in the city had suddenly quit delivering babies so now they were taking all labor patients for a city of 192,000(as of 2000 and I had my son in 2002) people.
    She seemed to like to induce everyone at 38 weeks for some reason, I guess it was easier for her as she wouldn't have to get out of bed in the middle of the night to deliver too many babies that way. I was a primip and I have a feeling that if she had tried to induce me at 38 weeks(when my cervix was closed up tighter than Fort Knox) I would have ended up with a c/s. It was ok being induced and since I did have a valid reason for being induced(I was on bedrest for the last month of my pregnancy due to my bp) it was nice that my parents could come into town for the birth and everyone knew when the baby would arrive.
    Most of my doctor's patients were wealthy, well to do people, who schedule every last detail of their lives(and I certainly wasn't any of those) so I think that also played into it.
    I could tell the nurses were way over stretched with everything going on suddenly they were getting almost double the number of deliveries, they just didn't have the room for everyone. They tried to reschedule me for the next week(my actual due date) at the doctor's office but I told them I had everyone coming into town(neither my parents nor my MIL was local) for this so it really couldn't be rescheduled. They understood that and they also weren't too thrilled about my bp and decided to try to and reschedule a 38 week woman who was being induced because she wanted to instead. Even if I had consented to having it rescheduled I wouldn't have made it to my due date, as I said I was already in early labor when I got there to be induced so I would have wound up at the hospital that night or the next day anyways.

    Taryn
  6. by   htrn
    Your induction sounds like a very reasonable induction - and I would never complain about a true pre-eclamptic coming in to be induced, no matter how busy I was.

    Of course, then we have the 'pre-eclamptic' patient with BP of 120/60, trace edema, no HA, no visual disturbances, no protein in her urine and no labs done at all to determine how bad she was - oh, and had not been on bedrest - that torks me off. But doc insists she be induced even when we don't have a bed to put her in.
  7. by   CEG
    :smackingf
    Quote from obrnheather
    Your induction sounds like a very reasonable induction - and I would never complain about a true pre-eclamptic coming in to be induced, no matter how busy I was.

    Of course, then we have the 'pre-eclamptic' patient with BP of 120/60, trace edema, no HA, no visual disturbances, no protein in her urine and no labs done at all to determine how bad she was - oh, and had not been on bedrest - that torks me off. But doc insists she be induced even when we don't have a bed to put her in.
    Yeah, we had a 37 week mom with "elevated" BP come in to rule out pre-eclampsia. It was ruled out... but doc induced her anyway. So, welcome to the world, baby, you'll love the NICU. Clearly a made up reason, why bother? Billing?

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